Owen R. Fonorow
On the advice of their physicians, millions of Americans, encouraged by
massive advertising and the apparent government stamp of approval, are taking
an aspirin a day to keep a heart attack away. Is this the best advice orthodox
medicine has to offer? An explosion of recent research, stemming from the 1998
Nobel prize in medicine, now strongly supports the idea that there are better;
safer and more effective alternatives to aspirin for preventing heart attacks
and extending life.
The recent research into Nitric Oxide (NO), a short-lived free radical
that the human body can create out of arginine, an essential amino acid, lead
not only to the prescription impotence drug Viagraź, but also to the finding
that arginine, like aspirin and many other substances, can act as a very potent
blood anticoagulant. Thus arginine, like aspirin and other substances, may
prevent Myocardial Infarction (MI) AKA
heart attack.
Arginine vs. Aspirin
L-Arginine, an amino acid, is essential to our diet and required for
life, has no known toxicity. Arginine has been shown to stimulate the body's
production of Human Growth Hormone (HGH) by the pituitary gland, probably by
blocking the secretion of HGH inhibitor somatostatin. It increases the body's ability
to produce Nitric Oxide when needed, and restores sexual function in impotent
men. Studies have shown that oral arginine boosts immunity, fights cancer,
promotes healing, protects and detoxifies the liver, improves thymus function,
enhances male fertility and is the precursor of the non-essential amino acid
ornithine.[1]
Aspirin on the other hand is not always safe and there are no studies
that show taking plain aspirin extends life. Linus Pauling pointed out in 1986
that "Aspirin, like other salicylates,
has the property that in concentrated solution can attack and dissolve tissues.
An aspirin in the stomach may attach to the stomach wall and cause a bleeding
ulcer." [2] A recent report from the Boston University school of
Medicine confirms that aspirin can irritate the stomach lining, sometimes
causing severe upper gastrointestinal bleeding and, in rare instances, death.
[3,4].
Given the potentially serious health concerns surrounding aspirin, why is
this substance being heralded as a miracle drug in the fight against heart
disease and worthy of the U. S. Government's stamp of approval? One reason is
that aspirin is readily available over-the-counter; another reason is that one
of aspirin's many properties is the inhibition of platelet clumping. Less
clumping might mean fewer blood clots resulting in fewer heart attacks. Medical
correspondent Wayne Martin writing in the Townsend Letter explains the Platelet Adhesiveness Index (PAI)
test:
"At the National Heart Hospital in London
circa 1970, they were using a test for platelet adhesion and the results were
stated as PAI, platelet Adhesiveness index. In this test a blood sample was
taken and a platelet count was made. Then a second blood sample was taken and
this time the blood was passed over glass beads. If half the platelets stuck to
the beads, PAI was 50. Patients who had survived a heart attack would have PAI
of 50 and hence were considered to be at risk of death from a second heart
attack. Young women who never suffer from Myocardial Infarction (MI) have PAI
of 20 yet they will have proper blood clots in wounds.
At the National Heart Hospital, in the years
1960 to 1965, they did a PAI test on every patient to come to this hospital and
they never found a single patient with PAI less than 40. They felt anyone with
a PAI of less than 40 was not going to have a heart attack. Put another way,
they felt that the great problem about MI was one of blood clots in coronary
arteries.
The idea of testing for PAI never came to the
USA. [5]
Because aspirin will reduce blood clotting, clinical trials were launched
to find out whether aspirin may benefit heart patients. These trials have mixed
results, none showing longer life; but two recent studies concluded that
aspirin is a "life saver" because it cut down the number of non-fatal
heart attacks, especially second heart attacks in the aspirin group.
Wayne Martin's interpretation of these trials:
"In 1980 cardiologists resurrected
platelets and blood clots as a cause of Myocardial Infarction (MI) deaths - and
told everyone over 40 to take aspirin to prevent having a heart attack. One
factor in the prevention of MI is the Adhesiveness of platelets as the greater
the adhesion of platelets the greater the chance of having a coronary blood clot.
Then came a series of trials on aspirin for
the prevention of MI. There were in the 1970s two trials in England that were
failures. No benefit or very slight benefit was found for aspirin in the
prevention of MI. This was followed by a much larger US government-financed
trial in the USA and reported in 1980. This trial was an abject failure with
much bleeding of the stomach due to aspirin and no benefit at all in the
prevention of MI.
Doctors felt that the case could be made for
aspirin if only doctors were the subjects. A trial in England among doctors was
again a failure, however a larger trial among doctors in the USA was hailed as
a great success. In this American trial, non-fatal heart attacks were reduced
by 40%. The bad news however, was that fatal heart attacks were not reduced and
moreover overall survival was not increased. Nonetheless as the result of this
trial, it was suggested or even demanded that all men over 40 should be taking
aspirin.
There was something a bit different about this
trial among doctors in the USA. Bufferin was used and Bufferin contains both
aspirin and some magnesium. Magnesium is greatly beneficial to the heart. It
reduces platelet adhesion, is a vasodilator and is a potent antiarrhythmic
agent. [5]
The authors of The Arginine
Solution, Robert Fried, Ph.D. and Woodson Merrell, MD, summarize the
aspirin research this way:
"The results of the physician study,
which were published in 1997 in The New England Journal of Medicine, concluded
that a daily aspirin does indeed have a significant impact on heart health,
lowering the risk of heart disease and heart attacks. Other researchers have
also shown that aspirin can slash the risk of a second heart attack in patients
who have already suffered a first heart attack. And because unchecked platelet
clumping has also been implicated as one cause for chronic high blood pressure,
aspirin and other anticoagulants may help in the treatment of hypertension as
well.
"Unfortunately, many of these
anticoagulant drugs, aspirin included, can have pernicious side effects for
many patients, side effects that can range from serious stomach bleeding to
kidney damage. Indeed, further analysis of the same landmark physician study
itself found that those doctors in a control group who received a placebo
instead of aspirin had the same overall incidence of death as those who
received the aspirin.[2]
Surprisingly, Fried and Merrell question the validity of the claim that aspirin
takers enjoy such a comparative reduction of heart disease and heart attacks:
"Well it turns out that physicians on
aspirin increased their odds of another, often fatal condition:
hemorrhagic stroke, that is, unchecked bleeding into the brain. This kind of
stroke is a prime example of where you need some protective blood clotting, but
the anticoagulants have turned of the capacity to do so".[2]
Although aspirin apparently reduces the incidence of blood clots that
lead to heart attack, much safer substances are known that work equally well or
better:
"There are all kinds of things other than
aspirin that reduce PAI, one of which is the drug dipyridamole. Here mention
will be made of the European Stroke Prevention Study. About 90% of strokes are
thrombotic strokes, blood clots in blood vessels in the brain. This trial had
as subjects patients who had had an indication of a stroke. First aspirin alone
was used with little or no benefit. Then dipyridamole was added to treatment,
300 mg a day and the results were outstanding. Stroke deaths were reduced by
50%, heart attack deaths by 35% and cancer deaths by 25%.
There are many things that reduce PAI better
than aspirin. Vitamin E at 400 iu a day will, as will Vitamin B6 at over 40 mg
day. There was an editorial in The Lancet a few years ago on how anti-thrombic
is vitamin B6 at over 40 Mg. So is fish oil. This is the omega-3 fatty acid
that we have been hearing so much about of late. Then recently, from the University
of Wisconsin, comes a report that purple grape juice at 10 oz. a day will
reduce PAI better than aspirin. It has been suggested that gamma linolenic acid
in evening primrose oil will reduce PAI better than anything else. Also the
oils of onion and garlic will reduce PAI. Ground ginger also is greatly
effective in reducing PAI and like aspirin, it will reduce pain. It is highly
anti-inflammatory. It is a sad state of affairs that doctors in the USA have
gotten most men over 40 taking aspirin while not setting up a test to see if it
is in fact reducing PAI. [5]
One of the great discoveries stemming from the recent NO research is that
the amino acid arginine may share an ability to prevent blood clots with
aspirin, without any known risks. Scientists now think that NO derived from
arginine regulates whether or not blood platelets clump together. If platelets
were always clumping, The entire circulatory system would grind to a sludgy
halt. Whenever a blood vessel suffers an injury, platelets clump together
blocking blood from seeping out of the artery until the damage can be repaired.
Clumps or clots that block coronary arteries can cause a heart attack.
Something has to trigger clumping when it's called for, while inhibiting it
when there is no need. It turns out that a number of blood-borne chemicals are
released when an injury occurs that can alter electrical charges, and these
chemicals determine whether or not platelets will repel or attract. According
to Fried and Merrill, nature's elegant solution for regulating whether
platelet's clump relies on the free radical Nitric Oxide (NO) made available in
the body from arginine. [2]
"The good news is that researchers have
found another "blood thinning" approach that is equally effective in
controlling platelet aggregation, but without the side-effects of conventional
anticoagulants from aspirin to leech saliva. This discovery came after Drs. M.
W. Radomski, R. M. J. Palmer and Salvador Monacada learned that platelets
themselves contain their own form of the enzyme nitric oxide synthase, which
lets them create NO from arginine. [2]
Researchers now say that supplemental arginine can also help the
hypertensive patient's remaining undamaged endothelial cells produce additional
NO to keep arteries open and to prevent platelets from clumping and sticking to
vessel walls. In 1994, researchers at the Hanover Medical School in Germany
reported that intravenous arginine resulted in a 33 percent decrease in
platelet aggregation - very impressive results. Moreover, the researchers
concluded that arginine inhibits platelet aggregation specifically "by
enhancing nitric oxide formation." [2]
According to the Linus Pauling/Matthias Rath Unified Theory of
cardiovascular disease, the primary
cause of heart disease is a vitamin C deficiency. This deficiency leads
to an inability to manufacture sufficient collagen, which causes blood vessel
weakness and instability. Collagen is a basic animal protein that provides
structural integrity analogous to the function of cellulose in plants. Blood
vessel instability from a lack of collagen leads to lesions or wounds in the
arterial wall, especially where blood pressure is high and mechanical stresses
are great. Plaque forms as a healing response to these wounds.
It has long been known that taking aspirin increases one's requirement for vitamin C. Vitamin C molecules
are used up detoxifying the body, so taking aspirin may lead to lower blood and
tissue levels of vitamin C. According to Irwin Stone in 1976:
Certain drugs, such as aspirin, cortisone, and
other anti-inflammatory agents, and cinchophen, are known to provoke ulcers and
gastric hemorrhage. This is especially the case when a deficiency of ascorbic
acid [vitamin C] is present. In animal experiments, the administration of
ascorbic acid along with the toxic drug reduced the incidence of peptic ulcer
and gastric hemorrhage to such an extent that it prompted one author (Aron) to
suggest, "Therefore it would seem judicious in human therapeutics to
include ascorbic acid in every prescription for an anti-inflammatory
drug"[6].
Aspirin's ability to dissolve human tissues would seem to make this
substance contraindicated in atherosclerotic patients. If Pauling and Rath are
correct and the lack of vitamin C causes heart disease, and if aspirin can
cause blood vessel lesions, and finally, if the body uses its vitamin C stores
to "fight" the toxic effects of aspirin, then taking aspirin may be
the last thing a heart patient should do.
Most authorities now accept the proposition that heart attack is not
generally a problem of arterial occlusion; rather MI is a problem of blockage.
The problem with occlusion is that blockages are more likely in arteries
narrowed by atherosclerosis. When platelet adhesiveness increases, the risk of
heart attack rises. Nitric Oxide causes arteries to dilate and blood pressure
to drop. Interestingly, the research shows that atherosclerosis interferes with
the ability of endothelial cells to make NO, so clotting is more likely when
atherosclerotic plaque is present. If a blood clot is the reason for the
blockage, thinning the blood with an anti-coagulating agent may be of significant
value. The discovery that NO derived from arginine regulates blood coagulation
at the platelet level is important. Arginine has been shown to have the same
anti-clotting ability as aspirin, but not continuously, only when needed, i.e.,
when chemicals associated with injury are released into the blood stream.
Aspirin's health risk is that this substance may unconditionally prevent blood
coagulation, even when clotting is called for, e.g., to prevent a stroke.
Furthermore, aspirin's known characteristic of dissolving tissue may not be
limited to the stomach. If aspirin causes arterial lesions, then it would be a
contributing factor in atherosclerosis.
While rethinking your daily aspirin, please consider these remarks made
by the late chemist and medical researcher Linus Pauling writing in HOW TO LIVE LONGER AND FEEL BETTER:
"It is drugs, especially the analgesics
and antipyretics such as aspirin, that are responsible for most of the five
thousand deaths by poisoning that occur each year in the United States. Of that
mournful total about twenty-five hundred are children. About four hundred of
these children die each year of poisoning by aspirin (acetylsalicylic acid) and
some other salicylate. Aspirin and similar drugs are sold openly, without
prescription. They are considered to be exceptionally safe substances. The
fatal dose is 0.4 to 0.5 gm per kilogram body weight: that is 5 to 10 gm for a
child, 20 to 30 g for an adult."
"Aspirin has been in use as a
nonprescription drug, sold casually over the counter, for more than a century
before the physiological basis of its pain killing and fever-reducing action
was discovered in 1971. Then it was found that aspirin acts upon a central
hormonal control system in the body. If it were now coming on to the market
from a pharmaceutical laboratory, it would be surely placed under the
constraint of prescription.
"Some people show a severe sensitivity to
aspirin, such that a decrease in circulation of the blood and difficulty in
breathing follow the ingestion of 0.3 g to 1 g (one to three tablets.)
"The symptoms of mild aspirin poisoning
are burning pain in the mouth, throat and abdomen. Difficult in breathing,
lethargy, vomiting, ringing in the ears, and dizziness. More severe poisoning
leads to delirium, fever, sweating, incoordination, coma, convulsions, cyanosis
(blueness of the skin), failure of kidney function, respiratory failure, and
death.
"Aspirin, like other salicylates, has the
property than in concentrated solution it can attack and dissolve tissues. An
aspirin in the stomach may attach the stomach wall and cause the development of
a bleeding ulcer.
"The U. S. Centers for Disease Control
have reported that if children and teenagers suffering from influenza or
chicken pox are given aspirin they have a fifteen to twenty-five times greater
chance of developing Reye's syndrome, an acute encelphalopathy and fatty
degeneration of the viscera, causing death in about 40 percent of the
patients." [2]
Should you decide, in consultation with your physician, to replace your
daily aspirin with 3-6 grams of oral arginine, you may notice some other
interesting effects as well. One effect in particular may negate the need for
men to spend upwards of $10 on a Viagra pill.
Owen R. Fonorow
PO Box 73172
Houston, Texas
77273
http://www.vitamincfoundation.org
REFERENCES