Just came from the Cardiologist

Thanks man. I just called for a routine physical. I figure that is a good place to start asking questions. I just had another child and do not want to leave my wife a widow with two small kids.

I am 32, do you think it would do me some good to start an Aspirin regimen?

I will ask the Dr, but I figured it would be good to crowd-source as well.

I'm no doctor, but I would think it's not necessary at your age if your lipids, BP, and family history are all OK.

I plan to do the same before summer is out.

I hear what you are saying, but my family also has a heart disease history. My brother had every test possible and was given a clean bill of health. He was always a very good athlete - running, basketball, baseball, etc. However, while on a run, he suffered a widow maker heart attack and died at the age of 50.

Everyone was just shocked that someone in such good shape and seemingly good health could die from a heart attack. However, as his doctor told us, sometimes you can't outrun your genetics.

I am 46, dad died on a long run when I was a kid, so I have been on top of this since 40. I see Dr. Paul Thompson in Hartford, CT, whom I think is the best on this topic so I drive a couple hours once a year to check in.

He also says "baby" aspirin is a great way to lessen the effects. My numbers are always great, but he zoned in on one little metric on "LP(a)"...don't ask me what the hell it is. He even says little is known about the effects of high LP(a) but they think it might increase the clotting and there is a correlation between sudden heart failure with endurance athletes. He gave me a prescription to reduce it, but I have declined to take it so far.

There're different types of cholesterol, as most people know (HDL is good, LDL is bad), but there's also different sub-types within those groups. It looks like LP(a) is a type or relative of LDL.

from Wikipedia:

"High Lp(a) in blood is a risk factor for coronary heart disease (CHD), cerebrovascular disease (CVD), atherosclerosis, thrombosis, and stroke.[15] Lp-a concentrations may be affected by disease states, but are only slightly affected by diet, exercise, and other environmental factors. Commonly prescribed lipid-reducing drugs have little or no effect on Lp(a) concentration. Niacin (nicotinic acid) and aspirin are two relatively safe, easily available and inexpensive drugs known to significantly reduce the levels of Lp(a) in some individuals with high Lp(a); they should be used under the supervision of a qualified physician.

High Lp(a) predicts risk of early atherosclerosis similar to high LDL, but in advanced atherosclerosis, Lp(a) is an independent risk factor not dependent on LDL. Lp(a) then indicates a coagulant risk of plaque thrombosis. Apo(a) contains domains that are very similar to plasminogen (PLG). Lp(a) accumulates in the vessel wall and inhibits binding of PLG to the cell surface, reducing plasmin generation which increases clotting. This inhibition of PLG by Lp(a) also promotes proliferation of smooth muscle cells. These unique features of Lp(a) suggest Lp(a) causes generation of clots and atherosclerosis.

Vegetarians have higher levels of Lp-a than fish eaters in one homogeneous tribal population of Tanzania raising the possibility that pharmacologic amounts of fish oil supplements may be helpful to lower the levels of Lp-a.

Some studies have shown that regular consumption of moderate amounts of alcohol leads to significant decline in plasma levels of Lp-a while other studies have not."

Might be worth asking your doc if you should drink a glass of wine a day, and take fish oil pills, too.

Does diet really make no difference?

Diet certainly makes a difference - I mentioned keeping your lipids in check - high LDL and low HDL are a very bad combination for someone with family history of heart disease.

However, I heard that Ric Sayre was fanatical about keeping his cholesterol in check, as did the Dad of a previous poster. Like my doc said, unless we've lived on nothing but fruit juice since birth, we all have some level of plaque coating our arteries. When the plaque ruptures and our dumb blood rushes to form a clot at the point of the "wound" we have a cardiac incident. The Widow Maker type of heart attack (left artery, etc) is what sends us to the big race in the sky in a matter of minutes...reminds me, I forgot to tell my wife to buy the baby aspirin.

Appreciate what you're saying but a blanket recommendation for aspirin a day for everyone over the age of 30 "because they all have plaque" is not prudent, either. Aspirin has extreme biologic potency.

xlev2 wrote:

Appreciate what you're saying but a blanket recommendation for aspirin a day for everyone over the age of 30 "because they all have plaque" is not prudent, either. Aspirin has extreme biologic potency.

I agree. Although I don't think that was the intention, it did come across like that. In fact, for myself, my doctor told me not to do this. I fortunatly don't have a family history of heart disease.

I made no such recommendation based on a specific age, nor did my doctor. I'm 50 and just started the aspirin a day.

Runners spend alot of time with elevated blood pressure - when running hard...blood is gushing through your arteries. It makes sense for older guys like myself who still run track intervals that jack the heart to ~190 bpm, to at least keep the clotting platlettes slippery with low dose (81mg) aspirin just in case the pounding blood disrupts some artery wall plaque as I continue to act like a 20 year old.

I've heard very much the opposite.Asprin a day for everybody is highly recommended (take the small tablet). It wont hurt you unless you have some specific problem with asprin.

ecin wrote:

xlev2 wrote:

Appreciate what you're saying but a blanket recommendation for aspirin a day for everyone over the age of 30 "because they all have plaque" is not prudent, either. Aspirin has extreme biologic potency.

I agree. Although I don't think that was the intention, it did come across like that. In fact, for myself, my doctor told me not to do this. I fortunatly don't have a family history of heart disease.

Highly recommended? By whom?

Stating the obvious wrote:

I've heard very much the opposite.

Asprin a day for everybody is highly recommended (take the small tablet). It wont hurt you unless you have some specific problem with asprin.

ecin wrote:

I agree. Although I don't think that was the intention, it did come across like that. In fact, for myself, my doctor told me not to do this. I fortunatly don't have a family history of heart disease.

[quote]Stating the obvious wrote:

I've heard very much the opposite.

Asprin a day for everybody is highly recommended (take the small tablet). It wont hurt you unless you have some specific problem with asprin.

+++++++++++++

There are definite risks with aspirin. It's wrong to point out "n of 1" type examples but a friend's father, age 65 and in excellent health with no major medical problems to speak of, taking Aspirin "just because" was in a car wreck, backseat with seatbelts on, rollover accident he walked away from with no apparent injury and a week later developed confusion and staggering--->massive acute and chronic subdural hematomas for which he required emergency neurosurgery. His doctors say being on aspirin contributed to his risk. True story--

I was taking aspirin "just because" when I established with my PCP a few years and he overwhelmed me with Framingham data, number needed to treat etc etc all about the downside of taking it. I actually got a 64 slice CT Scan for calcium content b/c I do have a family history of heart disease and a young son. It was negative which was reassuring, although the cardiologist who did the test said he would still take aspirin.

You need to go here and follow the recommendations...no wheat, sufficient D3, sufficient O3s, etc.:

http://www.trackyourplaque.com/blog/

Widow Maker wrote:

Diet certainly makes a difference - I mentioned keeping your lipids in check - high LDL and low HDL are a very bad combination for someone with family history of heart disease.

LDL particles can be small and dense (bad), or large and fluffy (benign). The former are typically found in high-carb diets, the latter in low-carb diets. Hence, a high LDL number can be bad or not bad, depending. Furthermore, most LDL numbers are calculated, and low-carb diets can screw up the calculations. You need to get an actual LDL reading with an actual particle size breakdown. And remember the greater importance of triglycerides.

Sounds like more crap made up by the low-carb fanatics to justify their high cholesterol readings (of course, originally they said low carb would drop your cholesterol). I can't wait to see the justifications when you guys start getting heart attacks.

Edele wrote:

Sounds like more crap made up by the low-carb fanatics to justify their high cholesterol readings (of course, originally they said low carb would drop your cholesterol). I can't wait to see the justifications when you guys start getting heart attacks.

All of the assertions made are accurate; a host of studies have been released quite recently linking high consumption of simple carbs with heart disease, disproving links between saturated fats and heart disease, and supporting the cardiovascular benefits of low-carbohydrate diets...among other things.

ecin wrote:

xlev2 wrote:

Appreciate what you're saying but a blanket recommendation for aspirin a day for everyone over the age of 30 "because they all have plaque" is not prudent, either. Aspirin has extreme biologic potency.

I agree. Although I don't think that was the intention, it did come across like that. In fact, for myself, my doctor told me not to do this. I fortunatly don't have a family history of heart disease.

I also agree. An aspirin a day is probably bad for your liver & kidneys. I am very lucky that I have ridiculously good genetics when it comes to longevity. All 4 grandparents lived over 80.