Cinnamon plus aspirin: A recipe for lowering short-term recurrent stroke risk

In the treatment of patients with mild ischaemic stroke or transient ischaemic attack (TIA), the combination of cinnamon and aspirin outperforms aspirin alone at reducing the risk of 90-day recurrent stroke, as shown in a study.

Commonly used in traditional Chinese medicine, cinnamon has already been studied before and proven to be useful in bringing down levels of blood lipids, blood glucose, and inflammation—risk factors for both ischaemic stroke and TIA. [Diabetes Care 2007;30:2236-2237; J Int Soc Sports Nutr 2006;3:45-53; Int J Food Sci 2019;2019:4138534; J Tradit Complement Med 2016;6:332-336]

In the present study, daily treatment with cinnamon–aspirin combo vs aspirin–placebo for 90 days led to significantly lower rates of unstable plaque (24.2 percent vs 53.3 percent; p<0.05) and severe vascular stenosis (3.2 percent vs 23.3 percent; p<0.05), as well as a markedly higher rate of mild vascular stenosis (56.5 percent vs 26.7 percent; p<0.05) after 90 days. [Clin Ther 2022;doi:10.1016/j.clinthera.2022.02.012]

Furthermore, the levels of low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose, glycosylated haemoglobin, plasma lipoprotein–related phospholipase A₂ (Lp-PLA₂), and high-sensitivity C-reactive protein (hs-CRP) through 90 days of treatment were all significantly lower with the combination (p<0.05 for all).

One case of mild to moderate upper gastrointestinal bleeding occurred after treatment in each group. There were no cases of rash, allergic reactions, or other serious adverse reactions, as well as no changes in vital signs.

Spice as answer to some ailments

Cinnamon is the dry bark of Cinnamomum Presl, a Lauraceae plant. Aside from being one of the most used spices to cook with, cinnamon is also commonly used in traditional Chinese medicine. It is said to help with pain and promote menstruation. [Liu Y, et al. Dietary Chinese Herbs: Chemistry, Pharmacology and Clinical Evidence. Springer: Vienna, 2015]

Cinnamon contains volatile oil, diterpene and its glycoside, flavanol and its polymer, flavonoids, and polyphenols. Its most important active component is cinnamaldehyde, which was previously shown to possess hypoglycaemic and hypolipidaemic effects in streptourease-induced male diabetic rats. [Phytomedicine 2007;14:15-22]

Currently, cinnamon extract and its active ingredients are used reduce the risk of cardiovascular and cerebrovascular disease, Alzheimer disease, and vascular dementia by controlling hyperglycaemia, while inhibiting apolipoprotein and improving vascular complications, according to the investigators. [J Shanxi Med Univ 2019;50:63-65; J Herb Med 2020;doi:10.1016/j.hermed.2020.100342]

“The present pilot study showed that the aspirin-cinnamon combination decreased blood lipids, blood glucose, Lp-PLA₂, and hs-CRP and increased HDL-C compared with the aspirin–placebo group. Those changes could explain, at least in part, the observation that the rate of recurrent stroke was lower in the aspirin–cinnamon group (3.2 percent vs 15.0 percent; p=0.002),” they said.

A total of 122 patients (average age 63, 33.6 percent female) participated in the study, including 62 in the aspirin-cinnamon group and 60 in the aspirin-placebo group. There were no significant between-group differences in patient characteristics, except for diabetes, which was more common in the aspirin-placebo group.

Despite being limited by the small sample size and short follow-up duration, the study paves the way for a multicentre randomized controlled trial, the investigators said.