Aspirin May Reduce Cardiovascular Disease in Diabetics

When I get accused of being “woo woo” about natural remedies, I remind people that a popular medication, aspirin, originally came from nature, in willow bark. Willow bark has a long history, with Assyrians and Egyptians using it to relieve pain. Besides treating pain and fever, doctors often advise their diabetic patients to take low-dose aspirin, also known as baby aspirin, to reduce the risk of cardiovascular disease (CVD).

Willow Bark, the Original Aspirin

In 1828, Johann Buchner, a professor of pharmacy at Munich University, extracted the active ingredient from willow bark and named it salicin, which means “willow” in Latin. Salicin would later form the basis of aspirin. Once ingested, your body turns salicin into another chemical substance called salicylic acid.

In 1897, Felix Hoffmann, a German scientist working for Bayer, altered salicylic acid to make acetylsalicylic acid, which was given the name aspirin.

Aspirin to Reduce Heart Attack Risk

An aspirin a day was first recommended to patients to reduce heart attack risk in 1948 when California physician Dr. Lawrence Craven observed positive results in his patients.

Subsequently, the discovery of how aspirin accomplishes this won a Nobel Prize in medicine in 1982. Researchers uncovered aspirin’s ability to block the production of hormones called prostaglandins. Prostaglandins form clots that cause heart attacks and strokes. A clot that cuts off blood flow to the heart leads to a heart attack; one that cuts off blood flow to the brain causes a stroke. Aspirin acts as an anticoagulant, meaning it helps to prevent blood clots from forming.

Heart Disease in Diabetics

According to the International Diabetes Federation, cardiovascular disease is the most common cause of death in people with diabetes (https://www.idf.org/aboutdiabetes/complications.html).

Moreover, the CDC warns that if you have diabetes, you’re twice as likely to have heart disease or a stroke than someone who doesn’t have diabetes. And, the longer you have diabetes, the more likely you are to have heart disease.

(https://www.cdc.gov/diabetes/library/features/diabetes-and-heart.html)

Why are Diabetics at an Increased Risk for Cardiovascular Disease?

Diabetics may have the following conditions that put them at risk for developing cardiovascular disease:

• High blood sugar
• High blood pressure
• High cholesterol
• Obesity
• Lack of physical activity
• Other factors such as smoking, drinking too much alcohol and eating a diet high in saturated fat

American Diabetes Association 2020 CVD Risk Management Antiplatelet Guidance

The ADA recommends aspirin as primary prevention for diabetics over 50 with at least one other major risk factor (family history of CVD, hypertension, smoking, or chronic kidney disease) who are not at higher risk of bleeding (older age, anemia, and renal disease).

• Use aspirin therapy (75–162 mg/day) as a secondary prevention strategy in those with diabetes and a history of atherosclerotic cardiovascular disease.
• For patients with atherosclerotic cardiovascular disease and documented aspirin allergy, clopidogrel (75 mg/day) should be used.
• Dual antiplatelet therapy (with low-dose aspirin and a P2Y12 inhibitor) is reasonable for a year after an acute coronary syndrome and may have benefits beyond this period.
• Aspirin therapy (75–162 mg/day) may be considered as a primary prevention strategy in those with diabetes who are at increased cardiovascular risk, after a comprehensive discussion with the patient on the benefits versus the comparable increased risk of bleeding.

Source: https://diabetesjournals.org/care/article/43/Supplement_1/S111/30374/10-Cardiovascular-Disease-and-Risk-Management

Who Should Not Take Aspirin?

Aspirin can be a double-edged sword: the same mechanism that stops blood clots from forming can also raise a person’s risk of bleeding by preventing blood from clotting at a wound site.

In other words, aspirin thins the blood and prevents blood clots from forming. However, you need blood clots to stop heavy bleeding from wounds.

The American College of Cardiology (ACC) and The American Diabetes Association (ADA) updated their guidelines recently to recommend that adults over 70 should not take low-dose aspirin to prevent heart attacks or strokes. The reason is that the risk of internal bleeding outweighed the benefits.

Bleeding risks for adults in their 60s and up who haven’t had a heart attack or stroke outweigh any potential benefits from aspirin, the U.S. Preventive Services Task Force said in its updated guidance.

There are others who shouldn’t take aspirin:

• If you consume three or more alcoholic drinks each day. Heavy drinking can increase your risk of stomach bleeding while taking aspirin
• If you are on anticoagulant (or blood thinner) therapy
• If you are allergic to aspirin
• If you have hemophilia or another bleeding disorder

Side Effects/Interactions

Aspirin may interact with herbal supplements that possess antiplatelet activity which prevents platelets from clumping and also prevents clots from forming. They include ginkgo, garlic, ginger, bilberry, dong quai, feverfew, ginseng, turmeric, meadowsweet, and willow. Aspirin may also interact with supplements containing coumarin (chamomile, motherwort, horse chestnut, fenugreek, and red clover) and with tamarind, increasing the risk of bleeding.

(https://pubmed.ncbi.nlm.nih.gov/12472978/#:~:text=Non%2Dsteroidal%20anti%2Dinflammatory%20drugs,with%20those%20containing%20coumarin%20(chamomile%2C)

Also, do not take aspirin with ibuprofen or naproxen. Aspirin, ibuprofen, and naproxen belong to the same group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs).

Finally, ask your doctor if you should stop aspirin before surgery, since it may increase bleeding.

Conclusion

Having diabetes may put you at a higher risk for cardiovascular disease. As well as taking low-dose aspirin with your doctor’s permission, there are lifestyle changes you can make to reduce cardiovascular disease. They include managing your ABCs (A1C, blood pressure, and cholesterol), eating a heart-healthy diet, managing weight, and quitting smoking.

Diabetic News

The University of Florida researchers said Type II diabetics can add over a decade to their lives through lifestyle changes such as slimming down to a healthy weight and controlling blood pressure and sugar levels. Researchers monitored 421 patients aged 50 to 80 for nine months. See their results in the graph below.

Quote

“About 80 percent of deaths from premature heart disease and stroke could be prevented by changes in physical activity, diet, smoking, and management of common medical conditions. The good news is that it’s not too late to make small changes that matter to heart health. At any age as adults, we all need to find out if you need to take daily aspirin, get control of high blood pressure and cholesterol with changes in diet, and by taking medicine. Stop smoking and be more physically active.” Dr. Anne Schuchat, CDC Deputy Director.

Disclaimer

Please remember this is not medical advice or intended to replace the advice of your doctor. This is my experience with the natural supplements that have helped me manage my diabetes.  They are not intended to cure any disease. Please do not self-diagnose. Always check with your health care provider before trying new treatments.

Also, natural does not mean safe. Many natural remedies have side effects and can interact with medication and supplements. It should be noted that the FDA does not regulate dietary supplements but treats them like foods and not medication. Unlike drug manufacturers, supplement makers do not have to show their products are safe or effective.

I ask you to please keep an open mind; be a diabetic detective and do your own research; work with your healthcare team; see what works best for you, and monitor your blood sugars.