Coronary Artery Disease and Aspirin

A person’s risk of developing coronary artery disease is influenced by several non-modifiable factors such as family history, age and gender. However, other factors that increase the risk for coronary artery disease can be modified by taking measures to change lifestyle.

Some of the life style factors that raise the risk of coronary artery disease include smoking, alcoholism, obesity, a diet high in saturated fats and low in fibre, a sedentary lifestyle and a lack of exercise.

In coronary artery disease, fatty deposits called plaques start to form in the walls of the coronary arteries that supply the heart muscles with nutrients and oxygen. This is called atheromatosis, an inflammatory arterial change that leads to dysfunction of the endothelium and the deposition of lipids or fats in the artery walls.

The formation of atheromatous plaques often begins with the endothelium becoming damaged due to factors such as high cholesterol and triglyceride levels, high blood pressure, toxins form cigarettes, and other factors. Once an area is damaged, platelets, fats and cellular debris start to accumulate, the presence of which can stimulate the arterial cells to produce other substances that, in turn, attractsmore cells. These accumulating substances start to form a plaque at the site of damaged endothelium. This plaque thickens the endothelial wall and narrows the space for blood to flow through, which reduces the oxygen supply to the heart muscles.
 

Aspirin is a non steroidal anti-inflammatory drug (NSAID) that is commonly used to relieve pain and fever and to ease inflammatory reactions. Regular use of low dose aspirin (75mg) has been shown to have a protective effect on the heart, reducing the risk of death form cardiovascular disease and of cardiovascular events such as heart attack or stroke. At this dose, aspirin has an anti-platelet action, preventing platelets from aggregating and forming plaques.

As per the recommendations of the U.S. Preventive Services Task Force, regular use of aspirin at low dose can help prevent the complications of coronary artery disease. Clinical practitioners are recommended to prescribe low dose aspirin to be taken daily, especially in adults who are at increased risk for coronary artery disease.

Examples of high risk individuals include:

• Men older than 40 years
• Postmenopausal women
• Younger people with other risk factors such as diabetics, smokers and those with high blood pressure or a previous history of a heart attack