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Vitamins and Aspirin for Heart and Stroke Prevention
Dr. Larry Robbins
Posted: October 2005  

Vitamins and Aspirin for Heart and Stroke Prevention

In people at risk for heart disease, 1/2 or 1 aspirin per day with food can help prevent heart attacks (as well as strokes and colon cancer). However, aspirin may cause stomach irritation or ulcers. If you do take aspirin and experience stomachaches or pains, stop it right away. Generic aspirin is fine. Anti-inflammatories such as ibuprofen (Advil) or naproxen (Aleve) will counteract the good effects of aspirin.

There are a number of vitamins and supplements that may be worthwhile for the prevention of heart disease and stroke. None of these are completely proven, but each has shown some benefit, in studies. Lutein, 20 mg. per day as a capsule, is a natural antioxidant-carotenoid that has had some benefit in reducing plaque formation in the arteries. Other supplements that may be worthwhile include flaxseed oil capsules, 1000 mg., 1 or 2 per day, which are rich in omega-3 fatty acids. Fish oil capsules (or eating fish once a week) are also rich in omega-3 fatty acids.

For most patients at risk for heart disease I would suggest
the following: Lutein, 20 mg. per day; One-half or one aspirin per day;
Eat fish once or twice per week
(or take Flaxseed or fish oil capsules, 1 per day).


Cholesterol

High cholesterol is one risk factor for heart disease and stroke. Cholesterol tends to be genetic, with genetics determining 80% of your cholesterol, and diet and exercise approximately 20%. However, since we cannot change our genetics, we work on a low fat diet and exercising 20-30 minutes daily. The total cholesterol is broken down into the good cholesterol, HDL, and bad cholesterol, LDL. These are very much determined genetically. Someone’s HDL usually will remain about the same throughout life. The higher the HDL, the better. Along with cholesterol, other risk factors are very important to assess, such as blood pressure, and family history for early heart disease. We particularly are concerned with people who have parents and/or siblings who have had heart attacks in their 40’s or 50’s. For those with known coronary artery disease, we want to get the LDL down to 70 or lower.

If your cholesterol is borderline (210 or higher) or high, it is crucial to begin an exercise program and maintain a relatively low fat diet. The diet is somewhat complicated, and I would encourage you to read a book to learn how much saturated fat is in the foods that you eat. There are many good books on a low fat diet at Borders or Barnes and Noble.

There is a new blood test, ultrasensitive CRP, that can help to predict the risk of heart disease; ask your doctor about doing a CRP.