Monday, May 2, 2011


Aspirin is frequently called the “wonder drug” because of its many beneficial properties. Two of the most significant are the prevention of cardiovascular events and cancer. It makes the blood platelets which are 1/10 of the size of a red blood cell less sticky . The drug works by inhibiting the production of prostaglandins forming on the outside membrane of these. Additionally, aspirin induces the formation of Nitric Oxide-radicals an independent mechanism of reducing inflammation in the blood vessels. More recent data also suggests that aspirin modulates signaling through NF-κB, a transcription factor complex, plays a central role in many biological processes, including cancer. This may be why folks who take a low dose aspirin daily for at least five years have a 30% less incidence in breast, prostate, stomach, esophagus, lung, and ovarian cancer. Additionally, if they already have the tumor, have far less distant spread.

Although Hippocrates, in 400 B.C left historical records of treatments, with the mother of aspirin from the bark and leaves of the willow tree, it was not until 1828, that Johann Buchner, professor of pharmacy at the University of Munich, isolated a tiny amount of bitter tasting yellow, needle-like crystals, which he called salicinin and Leroux had extracted salicin, in crystalline form for the first time, and Raffaele Piria succeeded in obtaining the salicylic acid in its pure state. A hundred and fifty years later (1971), British pharmacologist John Robert Vane in London, showed aspirin suppressed the production of prostaglandins and thromboxanes. For this discovery, he was awarded both a Nobel Prize in Physiology and Medicine in 1982 and a knighthood.

More than 50 million people in the U.S. take aspirin every day to help prevent heart attacks, strokes and cancer. However, research has demonstrated that up to 25 percent of these individuals may not benefit from the anti-clotting effect of aspirin, and are more than three times more likely to die from a heart attack or stroke. So Aspirin does not have the same effect on everyone. This suboptimal response to aspirin by an individual is commonly known as aspirin resistance or insensitivity Since these individuals are at increased risk of heart attack or stroke, doctors are beginning to recognize the importance of testing for aspirin effect. On the other hand, the higher doses of aspirin, not only in some will produce a paradoxical clotting effect, but in others a hemorrhage!

Until recently, there was no quick, accurate and effective way to test for aspirin effect. An ADP adhesive study or a specific prostaglandin assay was used in research settings and not paid for by insurances. But now, with the AspirinWorks Test, we can be sure the aspirin is working with a simple no fasting urine test. The AspirinWorks Test is FDA cleared for use in apparently healthy individuals, and test samples can be collected in the doctor’s office at any time. The AspirinWorks Test determines the effect of aspirin on platelets by measuring the level of the biomarker called thromboxane B2 (11dhTxB2). The higher the levels of thromboxane B2, the stickier the blood platelets, and the less impact the aspirin is having. This crucial information allows physicians to individualize a patient’s therapy, which may be as simple as adjusting the dose.

When prescribing blood pressure or cholesterol medication, doctors routinely check the patient’s blood pressure or cholesterol to make sure the patient is getting the right dose of medication. Similarly it is important to know if the dose of aspirin you’re taking is effective. Now, when prescribing aspirin we can then decide to increase or decrease your aspirin dose or if additional medication is needed. As mentioned in my previous writings that just as important is the aspirin to prevent blood from clotting within the blood stream, acetaminophen is needed to inhibit the clot on the arterial wall!

Therefore acetaminophen (Tylenol) has been shown to work in conjunction with the aspirin. At the University of Georgia, Dr. Phillip Greenspan found that the acetaminophen is a potent inhibitor of the enzyme, myeloperoxidase. This enzyme oxidizes the LDL, modifies it in such a way that it is more delectable to the certain white cells (macrophages) that reside within the wall of our arteries. These ingest the LDL cholesterol and cause the plaque and obstruction, which is the father of atherosclerosis. In that the acetaminophen blocks the activity of this enzyme, there is less transformation of the bad cholesterol (LDL) that is available for the macrophages to ingest. This research was presented at the conference on arteriosclerosis, thrombosis and vascular biology in Denver, May 21, 2000 and in 2006 documented by John Merrill PhD at Rutgers. This can also be taken to prevent pain. Some people state it helps them to sleep, when taken at bedtime. Also a recent study at the University of Florida demonstrated that acetamenaphen elevates the mood. The bad press that Acetaminophen has recently had makes this well studied drug almost a curse word. It is true in very high doses like over 6,000 mg a day it can negatively affect the liver and perhaps the kidney, but 1000mg/day is positively healthy for all who want protect their blood vessels.

THE BOTTOM LINE-“Betwixt and between, Aspirin and Tylenol will keep the artery clean” One each 81 mg Aspirin and 500 mg Acetaminophen (TylenolR), both twice a day, will keep the heart attack and stroke away!!

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