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Editor--Many studies have been published showing that regular Statins
and Aspirin administration over a long period of time reduce the incidence
of coronary thrombosis, as both drugs reduce the narrowing of the walls of
the coronary arteries by preventing deposition of low density cholesterol
and of platelet thrombi.
It is rarely mentioned in these reports that such prophylaxix is only
effective, if the endothelial wall of the coronary or cerebral blood
vessels is first injured. This injury occurs as a result of repeated,
fluctuating hypertensive filling of these arteries in usually normotensive
or hypertensive patients. Thus in the absence of initial injury Statins or
Aspirin will have little effect, but may be useful in patients with
fluctuating hypertension which is diagnosed at a later stage in life.If
patients with fluctuating hypertension,e.g.those with a Type "A"
personality, are prescribed drugs which prevent or lower hypertension,
Statins and Aspirins my not be required and atheromatous,arterial changes
could be slowed down or prevented. It is not sufficiently recognised that
Aspirin, though statistically beneficial in preventing heart attacks, has
a serious haemorrhagic tendency, particularly after trauma.
Prevention of coronary heart Disease
Editor--Many studies have been published showing that regular Statins
and Aspirin administration over a long period of time reduce the incidence
of coronary thrombosis, as both drugs reduce the narrowing of the walls of
the coronary arteries by preventing deposition of low density cholesterol
and of platelet thrombi.
It is rarely mentioned in these reports that such prophylaxix is only
effective, if the endothelial wall of the coronary or cerebral blood
vessels is first injured. This injury occurs as a result of repeated,
fluctuating hypertensive filling of these arteries in usually normotensive
or hypertensive patients. Thus in the absence of initial injury Statins or
Aspirin will have little effect, but may be useful in patients with
fluctuating hypertension which is diagnosed at a later stage in life.If
patients with fluctuating hypertension,e.g.those with a Type "A"
personality, are prescribed drugs which prevent or lower hypertension,
Statins and Aspirins my not be required and atheromatous,arterial changes
could be slowed down or prevented. It is not sufficiently recognised that
Aspirin, though statistically beneficial in preventing heart attacks, has
a serious haemorrhagic tendency, particularly after trauma.
Eric Frankel
Retired Consultant Physician
Whipps Cross Hospital London, E11
email address: efrankel@doctors.org.uk
Competing interests:
None
Competing interests: No competing interests