A Healthy Heart may NOT Need Aspirin

Q: I take one regular aspirin a day and a small dose of a beta blocker to regulate the electrical impulses in my heart.  I’ve been told that these medicines are compromising my intestinal and liver function.  I’d like to discontinue the pharmaceuticals completely.  Is that possible to do safely?
Jenny M-Y, Bellingham WA

A:

Hi Jenny,

I’m pleased you are interested in natural approaches to health care.  You bring up several important issues.  First, while you can most likely safely discontinue aspirin immediately, you need to wean off the beta-blocker more slowly. Beta-blockers are the “first generation” of drugs used mostly to control high blood pressure, because they block the “beta-adrenergic”, or adrenaline, receptors in the heart tissue.  Adrenaline is an extremely potent vasoconstrictor, so blocking adrenaline means the tissue stays more relaxed (not constricting).  In your case, the beta-blocker is being used to regulate the electrical impulses, which is a different story.  The heart is an amazing organ with both electrical and plumbing functions.  The plumbing is of course the pumping of the oxygenated blood around the body.  Each of us has about 5 litres of blood and each drop of blood passes through the heart about 12 times an hour, or every 5 minutes.  Blood pressure can rise for several reasons but usually because the blood vessels get constricted.

Two major reasons for vessel constriction, or narrowing — which of course will increase pressure — are plaque build-up and stress.  The major stress chemical is adrenaline.  A major effect of adrenaline is vaso-constriction.  People who are chronically in “fight or flight” mode almost invariably have elevated blood pressure, or at least blood pressure that spikes up readily.  Folks with constantly high blood pressure either have atherosclerosis, or major organ damage (kidney, liver or heart disease), discussion of which is beyond the scope of this response.  The beta-blocker in your case, Jenny, is being used to “relax” the electrical system in the heart, not the plumbing.

The cardiac electrical system starts with the heart’s natural pace-maker (the sinus node, in the right atrium), which sends impulses along nerve fibers in the cardiac muscles to orchestrate a regular rate and rhythm of muscle contraction, known as the heart-beat.  There can be numerous reasons that people have somewhat irregular cardiac rhythms.  Many are benign such as mild mitral valve prolapse or occasional pre-mature ventricular contractions. Some are more of a nuisance, and potentially dangerous, such as PVCs or atrial fibrillation.   However, some arrythmias, often known as “blocks”, can be downright scary and lead to sudden oxygen deficit, with fainting, blacking out or even a “heart attack.”  I have successfully treated many mild cardiac arrythmias with the plant medicines Cactus (Selenericus grandiflora) and Lily of the Valley (Convallaria majallis).  Other botanical heart nutrients include Hawthorne berry (Craetagus oxycantha) about 1 gram daily, Motherwort (Leonorus cardiaca) 500 to 750 mg daily, and Co-Enzyme Q-10 at least 100 mg daily.

Much of the research on Co-Q10 has been done in Japan.  This marvelous nutrient is also called Ubiquinone, because it is ubiquitously needed for optimal cell function.  Inside every cell of your body (there are trillions) are the nucleus and various organelles (tiny organs).  Many of the organelles are mitochondria, which among other functions, produce the fundamental unit of energy (ATP) used for all physical activity.  The mitochondria also increase levels of oxygen WITHIN the cells — which is different than the red blood cells in the lungs picking up oxygen from breathing.  The production of oxygen within the cells happens through an enzymatic “chain reaction” sequence in the walls of the mitochondria and this series of bio-chemical events is “rate limited” by the amount of available Co-Q10.  In other words, the more Co-Q10 you have available for your mitchondria, the more oxygen you can create within the cells.  More intra-cellular oxygen takes some of the burden off the cardio-vascular system (heart and lungs) of providing all the oxygen the body needs to run in top form.

When it comes to heart health, you can put nutrients and exercise in place at home, but please don’t try experiments with medications without a doctor’s supervision.  Please check with a nutritionally oriented, professionally trained healthcare provider for an individualized and specific recommendation for your cardiac condition.

Aspirin, or acetyl-salicylic acid (ASA), is an old and trusted medicine which works as a mild analgesic by “thinning the blood” because it makes the platelets less “sticky.”  Aspirin is an effective minor pain reliever and muscle relaxant for many people.  However, it can also severely irritate the mucous membrane of the entire gastro-intestinal tract.  This includes the throat, esophagus, stomach, small and large intestine and rectum.  Aspirin can cause bleeding anywhere along the entire GI tract.  Bleeding from aspirin or other “NSAIDS” (non-steriodal anti-inflammatories) is one of the top reasons people present to emergency rooms in the US.  They have severe abdominal pain, or have become untenably weak from chronic, low-level bleeding.  Often  people are not aware of GI bleeding.  Be advised that if you regularly use Aspirin (or Aleve, or Ibuprofen or Tylenol etc) you must check your stool for hidden (occult) blood every year.  Your doctor or public health clinic can give you a simple Colo-Care kit which you can easily use at home to check for GI bleed.

If you have been told to “take an aspirin a day” for heart health, this may be outdated advice.  For women, it has been definitively disproven to prevent the first heart attack.  However, for women with a strong family history of stroke, and no family history of gastro-intestinal cancers, a baby aspirin a day MAY prevent a stroke.  Oddly, the aspirin a day adage may help men, especially men under the age of 65 who have already had one heart attack, not suffer a second heart attack.  But aspirin does not seem to prevent strokes in men of any age.

Many strokes are triggered by chronic atrial fibrillation, which causes the blood flow around the cardiac muscles to be somewhat spasmodic.  This sometimes causes temporary pooling of the blood, which can allows a small clot of platelets or fibrin to clump together.  If this small clump gets into the general circulation and lodges in a tiny blood vessel in the brain, impeding oxygen delivery, a stroke results, which can kill a swath of brain cells around the impedence.  This sequence of events can sometimes be prevented by using aspirin or other blood-thinners.  However, blood thinning has a down-side — which is, as you can guess, too-easy bleeding.

While most strokes are “embolic” (because of a clot), some are “hemorrhagic” (because of a bleed).  Depending on your age and flexibility, blood thinning may be a bad risk for you.  For example, if you have compromised balance or eyesight, and consider yourself at risk for slipping and falling, using a blood thinner is probably a bad idea.  Internal bleeding would not be a pleasant way to die.

If you have a strong family history of strokes, and are willing to check for aspirin-induced bleeding every year, a baby aspirin (81 mg, not the full-strength 325 mg) may be reasonable for you.  However, there are other ways to prevent stroke.  For example, eating raw foods daily or taking digestive enzymes with your high protein meals will help keep the level of enzymatic activity in your body high.  Enzymes are your natural “clot-busters” — actually they prevent clot formation altogether.  Pineapple (especially the core which usually gets thrown away) is exceptionally high in enzymes, as are papaya seeds.  You can take these in capsule form, with meals to help digest food, or away from meals to reduce inflammation and potential clot formation.  About 500 – 1000 mg daily of protein-digesting enzyme from any healthfood store or supermarket taken at bedtime is almost always a safer choice than aspirin for stroke prevention.

You could also use aspirin infrequently only, at times when you will be in a prolonged seated position, such as on a long flight or car ride.  A common place for clots to form is behind the knees when bent.  It’s a good idea to stand and walk around a bit every few hours when traveling.

One simple gauge as to whether or not your blood is overly thinned is to keep track of your bruising.  If you frequently observe bruises on your body that you have no recollection of incurring, it’s likely your blood is too thin and you are at risk for excessive bleeding.  However, if you take a baby aspirin a day and have no stomach irritation, no evidence of bruises on your arms and legs and pass the annual Colo-care test, you are probably fine with a baby aspirin.

The take-home message here is to get individualized treatment.  What is good for you is not necessarily good for your neighbor.  Make sure to work with a health care professional who prioritizes researching your optimal, individualized, therapeutic recommendations, which may not match pharmaceutical advertising.