Acarbose in prevention of stroke

Background: Atherosclerosis may be the main cause of aging and death. Methods: All patients with sickle cell diseases (SCD) were included. Results: We studied 222 males and 212 females with mean ages of 30.8 vs 30.3 years, p>0.05, respectively. Smoking (23.8% vs 6.1%, p<0.001), alcohol (4.9% vs 0.4%, p<0.001), transfused red blood cells (RBC) in their lives (48.1 vs 28.5 units, p=0.000), disseminated teeth losses (5.4% vs 1.4%, p<0.001), ileus (7.2% vs 1.4%, p<0.001), stroke (12.1% vs 7.5%, p<0.05), chronic renal disease (CRD) (9.9% vs 6.1%, p<0.05), cirrhosis (8.1% vs 1.8%, p<0.001), chronic obstructive pulmonary disease (25.2% vs 7.0%, p<0.001), coronary heart disease (18.0% vs 13.2%, p<0.05), leg ulcers (19.8% vs 7.0%, p<0.001), and clubbing (14.8% vs 6.6%, p<0.001) were all higher in males. Conclusion: As an accelerated atherosclerotic process, hardened RBC-induced capillary endothelial damage initiated at birth terminates with multiorgan failures in early decades in SCD. Excess fat may be more important than smoking and alcohol for atherosclerosis since excess weight-induced diabetes mellitus is the most common cause of the CRD. The efficacy of acarbose to lower blood glucose by preventing breakdown of starch into sugar in the small intestine is well-known. Since acarbose is a safe, cheap, oral, long-term used, and effective drug for excess weight, it should be prescribed in prevention of stroke, particularly after the age of 50 years even in cases with normal weight because there are nearly 19 kg of excess fat even between the lower and upper borders of normal weight in adults. Key words: Sickle cell diseases, stroke, acarbose, capillary endothelial inflammation, excess fat tissue, systemic atherosclerosis, smoking