With the realization that half of the people experiencing a sudden mortal heart attack were taking aspirin on the day of their demise, and the fact that higher-than-recommended doses of aspirin are needed to prevent blood clot formation in coronary arteries, coupled with an announcement that the red wine molecule resveratrol (rez-vair-ah-trawl) may protect from sudden mortal heart attack in a superior fashion to aspirin, suggests re-evaluation of cardiology's current instruction regarding prevention of heart attacks, says Nate Lebowitz MD, cardiologist with the Advanced Cardiology Institute in Ft. Lee, New Jersey.
In a presentation at a National Institutes of Health symposium in Washington DC today, University of Connecticut researchers showed resveratrol limits damage caused by a heart attack, prevents sudden cardiac death in animals, and is "the best yet devised method of cardioprotection."
This phenomenon is called "cardiac pre-conditioning" because it works to activate antioxidant defenses in the heart prior to a heart attack via the release of a chemical called adenosine.
"Being one of the few cardiology groups in the nation to have experience with both of these preventive agents, we are in a unique position to provide consultation to patients seeking answers to questions about the best ways to prevent fatal events," says Jacqueline Hollywood MD, another cardiologist with the Advanced Cardiology Institute.
Dr. Lebowitz says aspirin therapy for prevention of heart attacks has, in his experience, a limited effect. The greatest benefit of low-dose aspirin therapy is for women with a positive mutation of the apolipoprotein(a) gene (LPA gene), with diminished results for others, he says. This mutation is present in about 3% of Caucasians and higher in other subgroups.
A recent paper published in the American Journal of Medicine indicates the aspirin dosage recommended by the American College of Cardiology, the American Heart Association and the US Preventive Services Task Force (75-81 milligrams) appear to be far too low to produce a significant reduction in stroke or heart attack. The Food & Drug Administration first approved aspirin for secondary prevention of a heart attack in 1988.
Data shows that there will be ten times more patients who experience gastric bleeding from aspirin therapy than non-aspirin users, and no reduction in stroke or fatal heart attacks, when aspirin is taken in low doses.
James E. Dalen, MD, MPH, former dean of the University of Arizona College of Medicine, who wrote the review of aspirin therapy, says only one of seven human studies using 100 mg of aspirin show a decreased incidence of heart attack.
Dr. Dalen says one conclusion is that the recommendation of aspirin for prevention of heart attack is incorrect because aspirin is ineffective. Dr. Dalen says millions of people throughout the world are taking aspirin for prevention. He asks: "Should they be told to discontinue aspirin?"
The other conclusion is that the dose is ineffective and points to the US Physicians Health study where 325 mg of aspirin taken every other day (162 mg per day) reduced the relative risk of a heart attack by 44%.
Dr. Lebowitz says resveratrol appears to exhibit broader action than aspirin. Resveratrol is documented to reduce clotting that may block blood circulation in coronary arteries, reduce homocysteine, an undesirable blood protein associated with cardiovascular disease, reduce markers of inflammation like C-reactive protein, regenerate vitamin E, as well as release adenosine, the molecule responsible for the "pre-conditioning" effect seen in animal experiments.
Howard Rothman, senior cardiologist at Advanced Cardiology Institute, warns resveratrol supplement users that the pre-conditioning effect of resveratrol is achieved at a dose ranging from 175-350 milligrams and higher doses may actually be counterproductive. Dr. Rothman says only one branded resveratrol pill has been proven to produce the pre-conditioning effect, which their group has recommended for over a year now.
Advanced Cardiology Institute