Aspirin steps up as anti-inflammatory for arteries

May 13, 2002

DALLAS, May 14 - Americans with heart disease may have yet another reason to use aspirin, according to a report in today's rapid access Circulation: Journal of the American Heart Association. Researchers found that aspirin can protect the blood vessels from dysfunction caused by even mild inflammation.

Aspirin is often given to people with heart disease to help thin the blood, but other effects could make it useful to prevent heart disease. Blood vessels with atherosclerosis become inflexible and inflamed. Researchers wanted to know if aspirin might protect against inflammation.

"Aspirin is widely used to prevent heart attacks and strokes, but it is assumed that its effects are solely attributable to its blood-thinning actions. But our research turns the clock back on aspirin, and suggests that some of aspirin's effects really are due to its anti-inflammatory properties, which people have known about for 100 years or more," says Patrick J. T. Vallance, M.D., FRCP study author and professor of clinical pharmacology at University College London, in England.

Even mild inflammation, which occurs from common ailments such as a cold, causes changes in blood vessels similar to those seen in people at high risk for heart disease.

Researchers used a typhoid vaccine to cause inflammation in 17 healthy volunteers to determine if aspirin would prevent changes to blood vessel function. Twelve of these people randomly received either 1.2 grams of aspirin or an inactive pill (placebo) two hours before vaccination. The remaining five patients received aspirin after the vaccination.

The researchers measured an inflammatory factor called Interluekin-1 (IL-1) to determine the level of inflammation. In the placebo group, IL-1 peaked at three hours and remained elevated until 8 hours after vaccination. This corresponded to a 30-fold increase in baseline values. In the group treated with a single oral dose of aspirin before the vaccine, the concentration of IL-1 did not differ from baseline.

In a second test, researchers measured endothelial function, which is the ability of the blood vessels to expand. Researchers did that by infusing drugs that affect the endothelium into the artery of one arm and measuring blood flow in that arm. The six participants who received placebo had decreased forearm blood flow eight hours after vaccination compared to baseline, indicating a temporary stiffening of their blood vessels. However, the six who received aspirin showed an increase in forearm blood flow 8 hours after vaccination, indicating a protective effect from aspirin.

"There is an exciting opportunity to rethink how we use aspirin and whether there are situations in which we should be giving aspirin to reduce cardiovascular risk," he says.
Co-authors include Rajesh K. Kharbanda, B.Sc., MRCP; Benjamin Walton, MRCP; Meredith Allen, MBBS, FRACP; Nigel Klein, Ph.D.; Aroon D. Hingorani, Ph.D.; and Raymond J. MacAllister, M.D.

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