Aspirin, Ibuprofen, Naproxen, Statins, and Peanuts

Ibuprofen and other NSAIDS, aspirin excepted, are associated with a significant increase in heart attacks. Aspirin, on the other hand, reduces heart attacks, but carries a bleeding risk that cancels the effect. Statins also reduce heart attacks somewhat, but have side effects and further have no overall benefit for most groups. The winner, therefore, is peanuts, which reduce heart attacks 30%, have no side effects, and are delicious.

A recent paper, found here, indicates a significantly elevated risk of heart attack associated with NSAIDs (NonSteroidal AntiInflamatory Drugs). The list includes ibuprofen (Advil), naproxen (Aleve), celecoxib (Celebrex), diclofenac (Cambia), and rofecoxib .

The risk was about 50% higher for all except celecoxib, which elevated risk 25%.

Aspirin is usually included with NSAIDs, but was not included in this study. Aspirin appears to reduce heart attack risk. More on that in a bit.

That these pills—several of them over-the-counter—elevated heart attack risk was news to me (Davis), but not to Dr. Mike, of course. Says he: “I have been following this for several years and it is more complicated than first blush would suggest: some say the data does not apply to women and others says not men and most seem to say both. The early take was that somehow Aleve [naproxen] was exempt from this effect but it is now included in the list of risky NSAIDs. Though aspirin is formally an NSAID – it is never included in the risk predictions – I am not sure what to make of this.” While aspirin has the effect of inhibiting platelet aggregation, the other NSAIDs do not and this is the aspect of benefit. Still no study has adequately parsed the cumulative good and bad effects; for example, as it is an NSAID surely it has triggered some heart attacks by this method and prevented others by the effect on clotting; who was helped and who hurt must, at root, be a genetic difference in response to those two functions. Hmmm…is it worth the risk for you? (N.B. there are genetic tests to parse this out, but few ever get such tests.)

What’s the story on aspirin?

Aspirin is known to reduce heart attacks 30-35%. This is widely known and widely followed. What is less widely known is that aspirin, even baby (low dose) aspirin, causes internal bleeding. Usually, such bleeding is minor and of no consequence, but sometimes it is major, even fatal. (And this includes baby aspirin.) The overall result is that there is no net benefit, and regular use of aspirin may even be harmful.

What about statins?

Statins also reduce heart attacks 30% to 35%. The question is overall benefit. Do people who take statins live longer? For people who have already had heart attacks, statins may have benefit. This is controversial. Taking statins in this case is called “secondary prevention” as there has already been a heart attack.

People who have never had a heart attack are often prescribed statins. This is called “primary prevention.” While there may be specific cases that benefit, numerous studies have shown no overall benefit (i.e. living longer) for almost all cohorts.

There have been many drug company-sponsored studies that have concluded otherwise. Most of these studies have been heavily criticized, often in quite scandalous terms.

More on statins found here, here, here, and here.

Seems you can’t win!

Yes, there does appear to be risk all around. It is clearly best not to regularly take any of these. But what if you have a headache? The answer is too long for this post, involving genetic factors as well as cardiac risk. The short answer is find out what triggers your headaches and fix that. Otherwise, keep the consumption of NSAIDs to a minimum.

There are several ways to win the heart health battle

A couple of handfuls of peanuts per week will reduce heart attacks around 35%. Most other nuts are likely to have the same effect. Nobody seems to know why this is, but the association is well established.

The Mediterranean diet will reduce heart attacks by about that amount as well.

So we have two delicious options here.

Win Big – Quantitative Medicine

Following the tenets of Quantitative Medicine will reduce heart attack from 70% to close to 100%, depending on when the protocols are started and how stringently they are followed. Quantitative Medicine also can reverse heart disease, which cannot be said of any of the preceding pills or diets.

The primary factor in the heart risk reduction in Quantitative Medicine is interval exercise. This keeps the heart working over its full range of pulse rates and pressures, and allows the arteries to flush out. More on that here.

The Quantitative Medicine diet is heart healthy as well. It accomplishes this by keeping triglycerides low, which leads to larger, safer LDL-cholesterol particle sizes. High carb diets do the exact opposite. More on that here.

Finally, the spiritual discipline or meditation aspects of Quantitative Medicine help keep cortisol low. High cortisol is yet another major heart risk factor.

The major bonus to the Quantitative Medicine approach is that risk of cancer, adult onset diabetes, dementia, including Alzheimer’s, osteoporosis, and osteoarthritis is greatly reduced as well.

 

  4 comments for “Aspirin, Ibuprofen, Naproxen, Statins, and Peanuts

  1. Drifter
    June 25, 2017 at 10:31 am

    Hmmm. I thought peanuts were a seed and not a nut. And isn’t peanut oil one of the most Athrogenic substances?

    For those who are interested, Dr. Kendrick has talked a lot about the problems with anti-inflammatories in his series “What causes Heart disease”.

    Aspirin also chelates Iron I believe, which can have a beneficial impact.

    Finally, you touched on one of my pet peeves, which is that it’s important to distinguish between the bogus westernized version of the Mediterranean diet and something approximating the health one, which minimizes breakfast, has only moderate amounts of grains (historically spelt, not wheat) and whole fat, often fermented dairy.

    • Jim
      June 26, 2017 at 8:04 am

      Actually, peanuts are a legume, but are often included in references as nuts due to their similarity in use as with true tree nuts.

      I think (correct me if I am wrong Drs Mike and Charles) Dr. Mike’s stance is not that different from Dr. Kendrick’s – at lease as far as being cautious when tampering with natural body mechanisms such as response to inflammation. They probably would disagree to some extent as to what is acceptable trade-off with agents like aspirin.

  2. Jim
    July 2, 2017 at 3:34 am

    So I know that the concept of “if a little is good, more is better” isn’t really true. But, is it a problem to have more than a few handfuls of nuts a week. I love peanuts and buy dry roasted and unsalted. I usually eat them every day.

    • July 19, 2017 at 2:59 pm

      Enjoy! Sort of fun: I have a patient who is an almond grower and we are starting an ‘almost all almonds all the time diet’ trial looking at a full array of metabolic markers.

      In general as long as you rotate protein and fat sources more nuts is not a bad thing at all, Dr. Mike

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