Aspirin

Daily dose of aspirin … a sensible prescription?

    Professor Gerry Fowkes presented new research conducted by the University of Edinburgh at the European Society of Cardiology congress in Barcelona.
    His findings challenge calls for people over 50 to be prescribed aspirin as a matter of course because of its blood-thinning properties. It was found that instead of bringing about a significant reduction in heart attacks, a daily dose of aspirin increased the risk bleeding in the stomach.
    He said: "Our research suggests that aspirin should not be prescribed to the general population, although it does have benefits for people with established heart disease or other conditions." At least six previous studies have indicated that frequent doses of aspirin could lower the risk of heart attacks and have prompted many of the "worried well" to take the pills.
    Taking an aspirin a day appears to increase a person's risk of dangerous gastric bleeding as much as it decreases their risk of heart attack or stroke.

    The Clinical Trial Service Unit at Oxford University came up with similar findings:
    Health experts have been recommending for more than a decade that people considered at increased risk of cardiovascular disease (due to high blood pressure or cholesterol, obesity, advanced age or other risk factors) take one aspirin pill per day, as the medicine has been clinically shown to reduce the risk of serious vascular events in those people. This strategy, treating people with no symptoms of heart disease, is known as "primary prevention."
    An example of a serious vascular event is a heart attack, stroke or cardiovascular death. Many health agencies however, such as the National Institute for Health and Clinical Excellence (NICE), have shied away from issuing official recommendations. "There is no definitive guidance," said Steve Field, chair of the Royal College of General Practitioners, "and it makes it bewildering when you have a series of papers which then hint it would be beneficial to take aspirin." According to Mr Field, many patients are attracted to aspirin as a way to stave off heart attacks because the over-the-counter pills are very inexpensive. But the findings of the newest study, published in The Lancet, suggest that the risks of aspirin match the benefits in cases of primary prevention. Only in patients who have already had a heart attack or stroke does the benefit appear to outweigh the risk. "This important study does suggest people shouldn't take aspirin unless indicated by a confirmed diagnosis of heart disease", Field said.
    Because people who had already experienced a heart attack or stroke had such a heightened risk of further vascular events, however, the benefits exceeded the risks in that group -- roughly 150 serious vascular events prevented per year for every 10,000 people treated, with the same three extra gastric bleeds and one stroke from bleeding.




    Comment

    What would be enormously valuable is a long-term study comparing those taking asprin with another ‘Usual Suspects’ group who have made changes to their diet and lifestyle. Separate studies claim increasing omega 3 & 6 fats (oily fish and olive oil); selenium and other anti-oxidants; cruciate vegetables such as cabbage and brocolli; garlic and allium herbs; pomegranate, tomatoes, capscicums and foods with high lycopene content … all help reduce the levels of risk factors of heart disease… and without needing medication.

    Regular moderate to vigorous daily exercise of 30 minutes such as cycling, swimming or power walking has also been shown to increase not only feelings of general well-being, but at the same time reduce stress and cardio-vascular risk.