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" HSI - Jenny Thompson " <HSIResearch

 

 

HSI e-Alert - Wonder Goes Under

Wed, 16 Mar 2005 08:36:28 -0500

HSI e-Alert - Wonder Goes Under

 

 

 

 

Health Sciences Institute e-Alert

****************************************************

March 16, 2005

****************************************************

 

Dear Reader,

 

The Wonder Drug of the 20th Century will probably not finish out the

21st Century with its " wonder-ful " reputation intact.

 

You may have heard about a recent New England Journal of Medicine

study concluding that aspirin " therapy " may prompt serious digestive

problems but very little cardiovascular protection for middle-aged women.

This study is worth a closer look - especially for those who have been

sold on the idea of aspirin as the silver bullet of heart health -

because as other studies have revealed, there are a number of

potential pitfalls for those who sign on for the Wonder Drug treatment.

 

-----------

Risks revised

-----------

 

The scope of his newest aspirin study is impressive.

 

Researchers at the Brigham and Women's Hospital recruited well over

39,000 healthy women over the age of 45 who had experienced no

cardiovascular events (such as heart attack or stroke). For a period

of 10 years, half the group took 100 mg of aspirin every other day and

half the group took a placebo.

 

Now, if we're to believe the ads we see on television, the result of

this study is a no-brainer, right? Aspirin surely proved to be

protective. Right?

Well...not exactly. Several hundred major cardiovascular events were

reported in both groups - not surprising in a cohort of nearly 40,000

over a decade. But the placebo group reported only 45 more cardio

events than the aspirin group - a statistically insignificant

difference. Aspirin provided virtually no protection from heart

attack, although those in the aspirin group had a 24 percent reduced

risk of ischemic stroke.

 

In a study of this size, those are significant results. But here's the

troubling part: Women in the aspirin group were found to have a 40

percent increased risk of gastrointestinal bleeding. But this was not

just any bleeding: it was bleeding severe enough to require transfusions.

 

This sharply increased risk of internal bleeding sort of takes the

edge off the good news: Women over the age of 65 who took aspirin were

found to have a 30 percent reduced risk of ischemic stroke and a 34

percent reduced risk of heart attack.

 

-----------

Benefits outweighed

-----------

 

The Brigham and Women's research is by no means the first to find

aspirin on wobbly footing.

 

This past July the American Heart Journal published a UK study in

which nearly 280 subjects who had suffered a first heart attack were

given 300 mg aspirin daily, warfarin (a blood thinner) or a placebo.

 

After two years, researchers reported that neither the aspirin nor the

warfarin therapies provided any greater protection against death,

nonfatal stroke, or nonfatal heart attacks than the placebo. Subjects

that received aspirin therapy, however, were nearly twice as likely to

suffer a heart attack or stroke as were those who took warfarin or

placebo. Gastrointestinal problems were also elevated in the aspirin

group.

In an interview with Reuters Health, the lead researcher of the study,

Dr. John G.F. Cleland, stated that any theoretical benefit of using

aspirin after a heart attack " is outweighed by real evidence of harm. "

 

-----------

Cold turkey

-----------

 

But the problems linked with aspirin don't stop there.

 

In the e-Alert " Under the Gun " (11/10/03), I told you about a French

study that showed how severe angina and fatal heart attacks might be

prompted by the sudden halt of regular aspirin intake.

 

In reviewing more than 1,200 cases of coronary episodes, researchers

found 51 patients who suffered heart attacks or other severe coronary

problems less than one week after they stopped using aspirin. Subjects

with a history of heart disease were at particularly high risk.

 

One of the troubling concerns of this outcome is the fact that

patients preparing for surgery are regularly advised to discontinue

aspirin therapy to avoid excess bleeding during their operations. The

French team told Reuters news service that doctors should not advise

their coronary patients to stop using aspirin, and even stated that

aspirin therapy " cannot be safely stopped in any case. "

 

Aspirin is generally regarded as so benign that most people would find

it hard to imagine that you could actually experience withdrawal

symptoms by quitting an aspirin regimen.

 

-----------

Side note

-----------

 

The lead author of the Brigham and Women's research, Paul M. Ridker,

M.D., told Reuters Health that the study clearly illustrates, " the

importance of studying women as well as men in major cardiovascular

clinical trials. "

 

I'm trying to suppress the urge to say something like, " Well DUH! " And

I shouldn't take Dr. Ridker to task; after all, he's the one who

headed up this revealing study. But it's been clear for many years now

that cardiovascular fitness is not exclusively a male health issue.

Studies that specifically examine cardiovascular issues among women

are long overdue.

 

****************************************************

 

....and another thing

 

If you're trying to lose weight, here's something you might add to

your diet: 20 minutes of extra sleep each night.

 

In a study reported in a recent issue of Archives of Internal

Medicine, researchers compared body mass index (BMI) to sleep habits

in about 1,000 subjects. After taking medical problems and sleep

disorders into account, the researchers found that overweight and

obese subjects slept less than those with a normal BMI.

 

So what's going on in the body that might cause sleep time to affect

weight? The most likely suspects are a couple of hormones called

ghrelin and leptin. Rising leptin levels trigger a feeling of being

" full. " Rising ghrelin levels trigger feelings of hunger. Previous

research has shown that among people who average only five hours of

sleep each night, ghrelin tends to go up while leptin goes down. The

opposite is generally true for people who average eight hours per night.

 

The good news is that it may not take several hours of additional

sleep for overweight people to bring their ghrelin and leptin levels

in line. In this most recent study, the results suggest that many

overweight people may experience benefits by adding just an additional

20 minutes of sleep each night.

 

These results confirm a study reported last year that demonstrated how

obesity risk may increase by as much as 50 percent among subjects who

average five hours of sleep each night. Among subjects who averaged

only six hours per night, obesity risk was increased by about 25 percent.

 

To Your Good Health,

 

Jenny Thompson

Health Sciences Institute

 

 

 

****************************************************

 

 

Sources:

 

" A Randomized Trial of Low-Dose Aspirin in the Primary Prevention of

Cardiovascular Disease in Women " The New England Journal of Medicine,

published online 3/7/05, content.nejm.org

" Aspirin Therapy Affects Men, Women Differently " Gene Emery, Reuters

Health, 3/7/05, reutershealth.com

" The Warfarin/Aspirin Study in Heart Failure (WASH): a Randomized

Trial Comparing Antithrombotic Strategies for Patients with Heart

Failure " American Heart Journal, Vol. 148, No. 1, July 2004,

ncbi.nlm.nih.gov

" Aspirin Not Good for People with Heart Failure " Will Boggs, M.D.,

Reuters Health, 7/7/04, reutershealth.com

" Halting Aspirin Suddenly can Cause Heart Attack " Reuters, 10/29/03,

reuters.com

" Overweight and Obese Patients in a Primary Care Population Report

Less Sleep Than Patients With a Normal Body Mass Index " Archives of

Internal Medicine, Vol. 165, No. 1, 1/10/05, archinte.ama-assn.org

" Sleep Deprivation Becomes New Factor in Obesity Debate "

NutraIngredients.com, 1/11/05, nutraingredients.com

" Lack of Sleep Raises Obesity Risk " The Associated Press, 11/16/04,

wjz.com

 

*************

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