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Previous work has shown that inhibition of cyclooxygenase with indomethacin and flurbiprofen blunts post-occlusive reactive hyperaemia in man. Patients with diabetes mellitus exhibit a similar control-related impairment in vascular response due to their underlying disease. We were therefore concerned that the use of cyclooxygenase inhibitors in these patients might further impair vascular reactivity. We studied nine insulin-dependent diabetics with retinopathy who were given either aspirin 330mg + dipyridamole 75mg tds or placebo according to a randomised double-blind cross-over protocol. Calf and digital perfusion were measured using an ECG-triggered mercury strain gauge pleth-ysmograph (Janssen, Peri flew) which provided a semi-continuous computerized calculation of blood flow. Rest flow (RF) was measured following full acclimatization in a constant temperature room. Peak flow (PF) was assessed from the reactive hyperaemia following a four minute period of arterial occlusion. The aspirin- dipyridamole combination caused a significant reduction in mean PF : RF ratio (9.2: 7.2, p&lt;0.0l) measured in the calf, and a significant prolongation of the mean time for 50% decay of peak flow (l9.7 to 26.0 seconds, p&lt;0.02). A significant reduction also occurred in digital PF : RF ratio following aspirin-dipyridamole (5-0: 3-7, p&lt;0.05). These results suggest that moderate doses of cyclooxygenase inhibitors prescribed for their platelet-inhibiting action may have profound effects on vascular reactivity. In diabetic patients the effects may add to a pre-existent abnormality.

The Influence Of Cyclooxygenase Inhibitors On Peripheral Blood Flow In Man