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Potential Good News For Seniors Who Take Blood Thinners

Many seniors citizens take the blood thinner, Warfarin, also called Coumadin and the population of those who require it is expected to peak in 2030, when the number of people over age 65 will soar to 71.5 million — one in every five Americans. Blood thinners do not actually thin the blood, but work on chemical reactions in the body to lengthen the time it takes to coagulate and form a blood clot. The drug is prescribed to reduce the risk of heart attack and stroke from the formation of blood clots in the arteries and veins. Other conditions that warrant taking the anti coagulant are abnormal heart rhythm, heart valve surgery and congenital heart defects.

In October 2010, the U.S. Food and Drug Administration approved the first potential anticoagulant rival to the sixty year old Warfarin. German drug maker Boehringer Ingelheim’s drug, Pradaxa, is expected to limit some of the negatives of the problematic Warfarin, which interacts badly with food and other drugs. Clinical trials that ultimately led to the FDA approval say the lower dose of Pradaxa, (dabigatran), causes less bleeding and was easier to manage than Warfarin, a famously difficult drug to administer and monitor.  In contrast to Warfarin, dabigatran is given in a fixed dose twice daily independent of body weight, sex, food, whatever, and you don’t need to monitor the coagulation system,” study author Dr. Hans-Christoph Diener, Chairman of Neurology at University Hospital in Essen, Germany, said during a news conference held during the meeting.

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“For patients and health care providers, dabigatran is a far more convenient drug than Warfarin, because it has no known interactions with foods and minimal interactions with other drugs and therefore does not require routine blood coagulation testing,” wrote the international team of researchers led by Dr. Sam Schulman of McMaster University and the Henderson Research Center in Hamilton, Ontario, Canada. Warfarin has been effective in limiting the formation of deadly blood clots, but is a medication that must be taken exactly as directed to be safe and effective. Regular blood tests are required to monitor the seconds it takes for clots to form. The effectiveness of Warfarin is also affected by alcohol and certain food consumption.

Diet is very important in maintaining proper coagulation times. The synthesis of the clotting factors in the liver depends on the availability of Vitamin K. Thus, the amount of Vitamin K in the diet changes the effects of the Warfarin. Foods high in Vitamin K are green leafy vegetables such as spinach, broccoli, kale and brussel sprouts. Certain over the counter drugs and herbal supplements can easily alter the effectiveness of Warfarin: too much coagulation can allow blood clots to develop, whereas not enough can cause internal bleeding. The Pro Time, or “prothrombin time,” is the name of the test used to monitor the effects of Warfarin. It measures the tendency of blood to clot as compared with a normal control sample. It is measured in the number of seconds it takes for the blood to clot, and may be expressed as a ratio of the blood sample to the control.

The proper ratio depends on the reason for taking Warfarin in the first place. For most conditions, the International Normalized Ratio or INR, is optimally kept in the range of 2.0 to 3.0. For some conditions, the desirable range is higher, around 3.0 to 4.0. The goal is set by the attending physician, depending on a number of factors of the condition. Without the Pro Time test, there no way to tell for sure what range a person’s dose should be. An eighty pound woman may need 20 milligrams a day, while her two hundred fifty pound counterpart may only need 2.5 milligrams a day. Simple blood tests are normally done on a monthly basis and more frequently if results do not fall into the projected INR range and dosage is adjusted.

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About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

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