Garlic, Antioxidants and Low Dose Aspirin to Prevent Heart Attack
Garlic (Allium sativum) is promoted as a miracle nutrient and the world's most ancient, versatile and enjoyable medicine. Garlic has been used for the prevention and treatment of an impressive range of diseases from plague to heart disease and cancer. Garlic is rich in vitamins and antioxidants and garlic extracts are fashionable nutrient supplements. The principal active ingredient is allicin, a sulphur containing component that, with its breakdown products gives garlic its smell.
Garlic's putative cardioprotective effects include:
- Lower high blood cholesterol
- Control high blood pressure.
- Has antiplatelet activity thus prevents solidification of blood
- Has fibrinolytic action thus dissolves clogged blood
- Antioxidant property.
Much of the research, especially on the control of heart disease risk factors, has been presented at international meetings, and few studies have been published in peer-reviewed journals. The best evidence is on the use of garlic for the treatment of high cholesterol. In one study garlic powder could reduce cholesterol level by 0.6 mmol/L in the treated group.
The American Dietetic Association suggested that in order to obtain the potential health benefits of garlic, one must take 600 - 900mg (about 1 fresh clove) per day.
A meta-analysis documented a 9% net reduction in the total cholesterol concentration attributable to garlic. Another similar study noted a greater effect, a 12% lowering of total cholesterol in the garlic treated group, which was apparent after 1 month of therapy and persisted for at least 6 months. A few small randomized trials also suggested the benefits of garlic in the prevention of platelet aggregation and thrombosis (the formation of plaques in the blood).
Some evidence of blood pressure lowering property of garlic have been noted in few studies but the mechanism is yet unknown. It is presumed that garlic has got a very small role in the prevention of coronary heart disease. At this stage, the evidence does not support use of garlic powder for cardio protection. Further well-designed controlled studies are required to increase our confidence on garlic.
Use garlic with caution if you are planning to have surgery or dental work, or if you have a bleeding disorder. A cautious approach is to avoid garlic in your diet or as a supplement for at least 1 week before surgery. Garlic has antioxidant properties. Antioxidants help destroy free radicals -- particles that can damage cell membranes, interact with genetic material, and possibly contribute to the aging process.
Epidemiological studies have suggested that high intake of antioxidants may modify coronary artery disease risk. Much research has recently focused on how antioxidant vitamins may reduce cardiovascular disease risk. Antioxidant vitamins — E, C and beta carotene (a form of vitamin A) — have potential health-promoting properties. The relative impact of vitamin E, vitamin C, beta carotene and flavonoids still remains unclear.
Antioxidants are natural substances that exist as vitamins, minerals and other compounds in foods. They are believed to help prevent disease by fighting free radicals, substances that harm the body when left unchecked. Free radicals are formed by normal bodily processes such as breathing, and by environmental contaminants like cigarette smoke. Without adequate amounts of antioxidants, these free radicals travel throughout the body, damaging cells.
Nurses Health Study and the Health Professional's Follow-up Study showed 34% and 36% reduction in coronary events, respectively among women and men who take vitamin E supplement regularly. Oxidized LDL (bad cholesterol) particles are believed to play a key role in the atherogenesis (blockage formation).
So, theoretically any oxidant is likely to prevent coronary artery narrowing by preventing oxidation of LDL. In the European Community Multicenter Study on Antioxidants, Myocardial Infarction and Breast Cancer trial high beta carotene intake was protective only among smokers; vitamin C intake showed no relationship with coronary artery disease.
Results from most of the observational and experimental studies consistently support an effect of vitamin E supplementation on reducing the risk of heart attack. It is suggested that supplemental intake of vitamin E at or above 100 IU/day will reduce incidence of coronary artery disease. Long-term intake of vitamin E may reduce the progression of blockage in coronary arteries.
To enjoy healthy eating and ensure you eat plenty of antioxidants, the Heart Foundation recommends following an eating pattern which is rich in vegetables, fruit, dietary fiber, wholegrain cereals and cereal products, low in saturated fat and salt.
Coffee consumption and heart disease:
Epidemiological studies have not yet clarified whether coffee consumption is a risk factor for coronary artery disease. Framingham study assessed the survey data on coffee consumption in relation to age, blood pressure and total cholesterol with regard to impact on coronary heart disease. The analysis did not show any association between coffee consumption and the presence of atherosclerosis (coronary narrowing).
Moreover, there was no demonstrable relationship between coffee intake and subsequent coronary events in patients with coronary heart disease. The effects of coffee intake on cholesterol were gender dependent: an inverse correlation with total cholesterol and with LDL in men and a positive correlation with each of these cholesterol values in women.
Can low dose aspirin prevent heart attack?
Attention has recently focused on the possible role of prophylactic low-dose aspirin in reducing the risk of heart disease. The hypothesis that platelet inhibition with low-dose aspirin reduces the risk of heart attack in apparently healthy people has been tested in two trials of primary prevention in men.
The FDA says that as little as one-half (160 mg) of a regular-strength aspirin tablet reduces the risk of death by up to 23 percent if administered when a heart attack is suspected and continued for 30 days thereafter. Aspirin taken during a suspected heart attack can also lessen the damaging effects of the heart attack.
Aspirin makes it harder for these clots to form. By healthy men over age 40 who have one or more risk factors for heart disease, as long as their blood pressure is controlled and the benefits of aspirin are greater than the risks. By healthy women over age 65, or women under 65 who have one or more risk factors for heart disease as long as their blood pressure is controlled and the benefits of aspirin are greater than the risks.
The U. S Physicians Health Study of 22, 071 men 40 to 84 years of age observed a statistically significant 44% reduction in the risk of first heart attack whereas the British Doctor's Trial of 5139 men 50 to 79 years of age observed no significant reduction. However an overview of both trials of primary prevention demonstrated a 33% reduction in the risk of fatal heart attack. Low-dose aspirin may be used:
- After a heart attack, bypass surgery or angioplasty, stroke or transient ischemic attack (TIA) to prevent another one.
- By people who have coronary artery disease, stable and unstable angina
Although no randomized trial has been completed specifically in women, the Nurses Health Study recently reported that women who took one to six aspirin weekly were 32% less likely to have an acute myocardial infarction.
At present the data on the role of aspirin in the primary prevention of stroke and heart attack are inconclusive. But some authorities recommend routine use of aspirin in asymptomatic men and women older than 50 years to prevent first myocardial infarction. If you have disturbed heart rhythm known as atrial fibrillation and cannot take or choose not to take warfarin, you may take an adult-strength aspirin (325 mg) every day to help lower the risk of a stroke.
It is important to view the clear benefits of aspirin in the primary prevention of heart attack in the context of what is already known about the modification of other coronary risk factors. It would be unfortunate if a middle aged smoker took aspirin instead of quitting smoking, because the benefits from quitting far exceed any protective effect of aspirin on heart attack.
Any decision to use aspirin prophylaxis should be made on an individual basis, and in general, should be considered only for those whose absolute risk of a first heart attack is sufficiently high to warrant accepting the potential adverse effects of long-term aspirin use.
The clots occur because of atherosclerosis, a disease which clogs the inside of arteries. Aspirin works by reducing the stickiness of the blood cells (called platelets) so they don't clump together, form a clot, or stick to the walls of the arteries, making them narrow. While aspirin itself is not enough to prevent heart disease and strokes, it is an important part of your medical treatment.