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Er aspirin det bedste middel til at forebygge hjerte-karsygdomme med ?

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I mange år har lægevidenskaben anbefalet en daglig hjertemagnyl til forebyggelse af blodpropper i hjertet, men ny forskning viser, at det for raske mennesker kan have uønskede bivirkninger. Spørgsmålet er, om der findes alternativer, som er mindst ligeså effektive og samtidig er sikre at anvende?

 

Af Bjørn Falck Madsen, videnskabsjournalist
Artiklen blev bragt i magasinet sund-forskning – august/september 2019

 

Da forskere analyserede data fra i alt 13 kliniske undersøgelser af virkningen af aspirin (hjertemagnyl) på over 134.000 personer, observerede de en 37 procent højere forekomst af potentielt farlige bivirkninger hos dem, der havde taget aspirin, i forhold til dem, der tog en snydepille.

 

Ikke en gevinst for raske mennesker

Lægevidenskaben fastholder trods dette, at det stadig kan svare sig for personer, som har været ramt af blodprop i hjertet eller slagtilfælde, at tage en daglig hjertemagnyl som beskyttelse. Men for raske personer overskygger risikoen for blødning den mulige forebyggende gevinst ved at tage en hjertemagnyl hver dag. Det store spørgsmålet er så, om der findes alternativer til aspirin, som ville kunne anvendes i stedet. Det kunne det tyde på, og Danmark og Sverige har faktisk lagt sig i spidsen med banebrydende forskning inden for dette område.

 

Livreddende kombination af selen og Q10

Et af de største gennembrud inden for kardiologien i de seneste 5-10 år er to undersøgelser, hvor forskere ved hjælp af naturligt forekommende stoffer har påvist en markant nedsat risiko for hjerteproblemer. Den ene undersøgelse blev foretaget af en gruppe læger og kardiologer fra Universitet i Linköping samt Karolinska Institutet i Stockholm. Den viste, at når man gav stoffet coenzym Q10 i kombination med mineralet selen til ældre, raske mænd og kvinder, faldt deres risiko for at dø af en hjerte-kar-sygdom betragteligt.

 

54 % lavere hjerte-kar-dødelighed

443 personer medvirkede i undersøgelsen, som blev offentliggjort i International Journal of Cardiology i 2013. Deltagerne blev tilfældigt inddelt i to grupper. Den ene gruppe fik 200 mg af præparatet Bio-Qinon Q10 samt 200 mikrogram af den organiske selengær SelenoPrecise. Den anden gruppe fik snydepiller med uvirksomt stof. Efter fire års behandling viste tallene, at hjerte-kar-dødeligheden i gruppen, som fik Q10 og selen, var 54 procent lavere end i gruppen, der fik snydepiller.

 

Langtidseffekt af stofferne

Det vil med andre ord sige, at ved at tage to naturligt forekommende stoffer, som i forvejen er en integreret del af kroppens biokemi, havde man mere end halveret risikoen for at dø af en sygdom i hjertet eller kredsløbet. Det er en langt større grad af beskyttelse, end man nogensinde har kunnet opnå med aspirin. Hvad der er særlig interessant er, at de svenske forskere fortsatte med at følge forsøgsdeltagerne i mange år efter, undersøgelsen stoppede, og de kunne fortsat se en beskyttende effekt af de to præparater.

 

Virksomt ved kronisk hjertesvigt

Coenzym Q10, det ene af de to stoffer, var ligeledes inde i billedet i en anden undersøgelse, som blev offentliggjort i Journal of the American College of Cardiology, Heart Failure i 2014. Her havde den nu afdøde danske hjertespecialist fra Rigshospitalet, Svend Aage Mortensen, i samarbejde med internationale kolleger, givet 300 mg co-enzym Q10 (også i form af Bio-Qinon Q10) eller tilsvarende snydekapsler til 420 patienter med kronisk hjertesvigt. Q-Symbio, som undersøgelsen hedder, viste, at de Q10-behandlede patienter havde 43 % lavere risiko for at dø af hjertesvigt, og de fik samtidig forbedret deres hjertemuskelfunktion markant.

 

Stor interesse blandt hjertelæger

Det skal siges, at Q10-behandlingen (og snydekapslerne) blev givet som supplement til den medicinske behandling, patienterne i forvejen fik for deres hjertesygdom. Men forskerne kunne ud fra resultaterne konstatere, at den 43 % forbedrede overlevelse udelukkende kunne tilskrives Q10-behandlingen. Undersøgelsen vakte stor interesse blandt hjertelæger fra hele verden, og den blev betragtet som et kæmpe skridt fremad inden for forebyggende hjertemedicin.

 

Selen beskytter mod slagtilfælde

Sporstoffet selen ser imidlertid også ud til at spille en isoleret rolle for hjerte-kar-sundheden. En canadisk undersøgelse, som er offentliggjort i maj-udgaven af JAHA (Journal of the American Heart Association), viser, at forsøgsdeltagere med højt selenindhold i blodet har lavere risiko for slagtilfælde end patienter med lavt selenindhold.

 

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