Low Dose or No Dose

[Guest guest]

" HSI - Jenny Thompson " <HSIResearch

HSI e-Alert - Low Dose or No Dose

Tue, 31 May 2005 07:30:00 -0400

 

 

 

HSI e-Alert - Low Dose or No Dose

 

Health Sciences Institute e-Alert

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May 31, 2005

 

Dear Reader,

 

Television advertisements that pitch aspirin to prevent heart attacks

would have you believe that low dosages of the 20th Century wonder

drug are as sweetly benign as drinking water from a high mountain stream.

 

HSI members know that this representation of aspirin is off the mark.

And now new research implies that elderly people who are taking

aspirin to help prevent heart attacks and stroke may be setting the

stage for serious health problems.

 

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Super model

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Researchers at the University of Tasmania School of Medicine (UT) in

Australia designed an epidemiological model to assess aspirin risks

and benefits among older people.

 

What's an epidemiological model? It's a method of combining clinical

trial data with observational evidence to create hypothetical

populations. In this case, the UT team established reference

populations of 10,000 men and 10,000 women who used low-dose aspirin

therapy, were aged 70-74, and had no history of cardiovascular disease.

 

Researchers measured the results by looking for first-time heart

attacks, stroke and major hemorrhage in the gastrointestinal (GI)

tract. As reported in an online edition of the British Medical

Journal, the model showed that while heart attacks and ischaemic

strokes may have been prevented, this benefit was offset by a

significant number of subjects with sharply increased risk of bleeding

in the brain and/or GI tract.

 

In a BBC News account of the study the medical director of the British

Heart Foundation, Professor Peter Weissberg, noted that given the UT

study results, a clinical trial to test effects of low-dose aspirin

therapy in older people " should be undertaken before aspirin is

advocated for primary prevention of heart disease in the elderly

community. "

 

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Stop! Don't stop!

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So, if you're over the age of 70 and you're currently taking aspirin

to help prevent a heart attack or stroke, should you discontinue the

daily dose?

 

In a word: No.

 

In three words: Call your doctor.

 

Here's why: A 2003 study demonstrated how severe angina and fatal

heart attacks might be prompted by the sudden halt of daily aspirin

intake.

 

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

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. 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. "

 

How's that for a " wonder drug " ! You begin an aspirin regimen to

protect your heart, but if you stop, you stand a chance of prompting a

dangerous coronary episode. So if you're taking a daily aspirin and

you're over the age of 70, share these study results with your doctor

to assess your personal risk/benefit ratio.

 

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Hungry for prevention

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Ironically, many people who are taking a daily aspirin to help their

heart may already be getting plenty of heart attack protection from

the foods they eat.

 

In the e-Alert " Pain Takes a Holiday " (9/8/03) I told you about a

15-month study of almost 2,000 subjects that showed how those whose

diets included the highest fruit intake had more than 70 percent

reduced risk of heart attack and other cardiac problems compared with

those who ate the least amount of fruit. On average, for every

additional piece of fruit consumed each day, subjects showed a 10

percent reduction in coronary risk.

 

And vegetable intake produced a similar effect. Subjects who consumed

vegetables three or more times each week had approximately 70 percent

lower heart attack risk than those who ate no vegetables at all.

 

These heart protective benefits are most likely due to flavonoids, the

substance that gives fruits and vegetables their color. Flavonoids

have both antioxidant and anti-inflammatory qualities; two benefits

that are believed to help curb chronic diseases, including heart

disease, lung cancer, stroke, asthma, and type 2 diabetes.

 

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....and another thing

 

I have an uncle who, well, let's say he has a substantial girth. He's

a big man and has been most of his life. And that's the way my aunt

likes him. After several decades of marriage, she's still crazy about

him and wouldn't change a thing. She describes him as " comfy. "

 

The last thing I'd want to do is take away any of my aunt's comfort.

But the fact is that my uncle would be healthier if he removed some of

that comfy padding around his waist.

 

In the e-Alert " Extra Baggage " (5/18/05) I told you about a study that

found middle-aged men with excessive abdominal fat to be one and a

half times more likely to have a stroke compared to subjects of the

same age who were trim in the middle.

 

For my uncle and others like him, here's another incentive for

trimming the waist.

 

When researchers at Johns Hopkins University collected medical and

body measurement data for more than 27,000 men over a 13-year period

they found that subjects with the largest waist size (40-62 inches)

were 12 times more likely to develop type 2 diabetes compared to men

with the smallest waist size (29-34 inches). Waist size was also found

to be a more accurate predictor of type 2 diabetes than using body

mass index (BMI), which gives a ratio of weight to height.

 

Excessive abdominal fat has also been shown to raise the risk of high

blood pressure and heart disease. So, how can my uncle drop some of

that comfy area around his waistline? He can read the " Extra Baggage "

e-Alert on our web site (hsibaltimore.com) where he'll find

information about the way protein intake and exercise may help guys

like him pull their belt size in a couple of notches.

 

To Your Good Health,

 

Jenny Thompson

Health Sciences Institute

 

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Sources:

 

" Epidemiological Modelling of Routine Use of Low Dose Aspirin for the

Primary Prevention of Coronary Heart Disease and Stroke in Those Aged

70 or Greater " British Medical Journal, published online 5/20/05,

bmj.bmjjournals.com

" Aspirin for Over 70s in Question " BBC News, 5/19/05, news.bbc.co.uk

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

reuters.com

" Waist Size Linked to Diabetes Risk in Adult Men " Johns Hopkins

University Bloomberg School of Public Health press release, 3/17/05,

eurekalert.org

 

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