Low-Dose Aspirin Therapy to Address Disparities in Severe Maternal Morbidity

2021 ◽  
Vol 50 (5) ◽  
pp. S25
Author(s):  
Adriane Burgess ◽  
Julia Wheeling
2009 ◽  
Vol 106 (2) ◽  
pp. 500-505 ◽  
Author(s):  
Lacy A. Holowatz ◽  
W. Larry Kenney

Full expression of reflex cutaneous vasodilation is dependent on cyclooxygenase- (COX) and nitric oxide synthase- (NOS) dependent mechanisms. Low-dose aspirin therapy is widely prescribed to inhibit COX-1 in platelets for atherothrombotic prevention. We hypothesized that chronic COX inhibition with daily low-dose aspirin therapy (81 mg) would attenuate reflex vasodilation in healthy human skin. Two microdialysis fibers were placed in forearm skin of seven middle-aged (57 ± 3 yr), normotensive, healthy humans with no preexisting cardiovascular disease, taking daily low-dose aspirin therapy (aspirin: 81 mg), and seven unmedicated, healthy, age-matched control (no aspirin, 55 ± 3 yr) subjects, with one site serving as a control (Ringer) and the other NOS inhibited (NOS inhibited: 10 mM NG-nitro-l-arginine methyl ester). Red cell flux was measured over each site by laser-Doppler flowmetry, as reflex vasodilation was induced by increasing core temperature (oral temperature) 1.0°C using a water-perfused suit. Cutaneous vascular conductance (CVC) was calculated (CVC = flux/mean arterial pressure) and normalized to maximal CVC (CVCmax; 28 mM sodium nitroprusside). CVCmax was not affected by either aspirin or NOS inhibition. The plateau in cutaneous vasodilation during heating (change in oral temperature = 1.0°C) was significantly attenuated in the aspirin group (aspirin: 25 ± 3% CVCmax vs. no aspirin: 50 ± 7% CVCmax, P < 0.001 between groups). NOS inhibition significantly attenuated %CVCmax in both groups (aspirin: 17 ± 2% CVCmax, no aspirin: 23 ± 3% CVCmax; P < 0.001 vs. control), but this attenuation was less in the no-aspirin treatment group ( P < 0.001). This is the first observation that chronic low-dose aspirin therapy attenuates reflex cutaneous vasodilation through both COX- and NOS-dependent mechanisms.


Author(s):  
S. Falahatkar ◽  
S. Esmaeili ◽  
N. Rastjou Herfeh ◽  
E. Kazemnezhad ◽  
R. Falahatkar ◽  
...  

2005 ◽  
Vol 63 (9) ◽  
pp. 1262-1265 ◽  
Author(s):  
Gautam A. Madan ◽  
Sonal G. Madan ◽  
Gauri Madan ◽  
A.D. Madan

2007 ◽  
Vol 5 ◽  
pp. P-S-647-P-S-647
Author(s):  
U.S. Tantry ◽  
K.P. Bliden ◽  
S.K. Chaganti ◽  
J. DiChiara ◽  
P.A. Gurbel

2020 ◽  
Vol 9 (4) ◽  
pp. 928
Author(s):  
Luis A. García Rodríguez ◽  
Angel Lanas ◽  
Montse Soriano-Gabarró ◽  
Pareen Vora ◽  
Lucía Cea Soriano

Estimates of the effect of proton pump inhibitors (PPIs) on risks of upper and lower gastrointestinal bleeding (UGIB and LGIB) among low-dose aspirin users in routine clinical practice are variable (UGIB) or lacking (LGIB). We aimed to establish these risks in the same observational study population. Using UK primary care data, we followed 199,049 new users of low-dose aspirin (75–300 mg/day) and matched non-users at start of follow-up to identify incident UGIB/LGIB cases. In nested case–control analyses, adjusted odds ratios (ORs) were calculated for concomitant PPI use vs. past (discontinued) PPI use among current low-dose aspirin users. For UGIB (n = 987), ORs (95% CIs) were 0.69 (0.54–0.88) for >1 month PPI use and 2.65 (1.62–4.3) for ≤1 month PPI use. Among the latter group, ORs (95% CIs) were 3.05 (1.75–5.33) for PPI initiation after start of aspirin therapy, and 1.66 (0.63–4.36) for PPI initiation on/before start of aspirin therapy. For LGIB (n = 1428), ORs (95% CIs) were 0.98 (0.81–1.17) for >1 month PPI use and 1.12 (0.73–1.71) for ≤1 month PPI use. Among low-dose aspirin users, maintaining PPI use (>1 month) was associated with a significantly reduced UGIB risk. Neither short nor long-term PPI use affected LGIB risk.


2013 ◽  
Vol 25 (11) ◽  
pp. 1265-1272 ◽  
Author(s):  
Florent Ehrhard ◽  
Pierre Nazeyrollas ◽  
Hedia Brixi ◽  
Alexandra Heurgue-Berlot ◽  
Gérard Thiéfin

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