Aspirin disappoints for avoiding first heart attack, stroke

Taking a low-dose aspirin every day has long been known to cut the chances of another heart attack, stroke or other heart problem in people who already have had one, but the risks don’t outweigh the benefits for most other folks, major new research finds.

Although it’s been used for more than a century, aspirin’s value in many situations is still unclear. The latest studies are some of the largest and longest to test this pennies-a-day blood thinner in people who don’t yet have heart disease or a blood vessel-related problem.


One found that aspirin did not help prevent first strokes or heart attacks in people at moderate risk for one because they had several health threats such as smoking, high blood pressure or high cholesterol.

Another tested aspirin in people with diabetes, who are more likely to develop or die from heart problems, and found that the modest benefit it gave was offset by a greater risk of serious bleeding.

Aspirin did not help prevent cancer as had been hoped.


And fish oil supplements, also tested in the study of people with diabetes, failed to help.

“There’s been a lot of uncertainty among doctors around the world about prescribing aspirin” beyond those for whom it’s now recommended, said one study leader, Dr. Jane Armitage of the University of Oxford in England. “If you’re healthy, it’s probably not worth taking it.”

The research was discussed Sunday at the European Society of Cardiology meeting in Munich. The aspirin studies used 100 milligrams a day, more than the 81-milligram pills commonly sold in the United States but still considered low dose. Adult strength is 325 milligrams.

WHO’S REALLY AT RISK?

A Boston-led study gave aspirin or dummy pills to 12,546 people who were thought to have a moderate risk of suffering a heart attack or stroke within a decade because of other health issues.

After five years, 4 percent of each group had suffered a heart problem — far fewer than expected, suggesting these people were actually at low risk, not moderate. Other medicines they were taking to lower blood pressure and cholesterol may have cut their heart risk so much that aspirin had little chance of helping more, said the study leader, Dr. J. Michael Gaziano of Brigham and Women’s Hospital.


One percent of aspirin takers had stomach or intestinal bleeding, mostly mild— twice as many as those on dummy pills. Aspirin users also had more nosebleeds, indigestion, reflux or belly pain.

Bayer sponsored the study, and many researchers consult for the aspirin maker. Results were published by the journal Lancet.

ASPIRIN FOR PEOPLE WITH DIABETES?

People with diabetes have a higher risk of heart problems and strokes from a blood clot, but also a higher risk of bleeding. Guidelines vary on which of them should consider aspirin.

Oxford researchers randomly assigned 15,480 adults with Type 1 or 2 diabetes but otherwise in good health and with no history of heart problems to take either aspirin, 1 gram of fish oil, both substances, or dummy pills every day.


After seven and a half years, there were fewer heart problems among aspirin users but more cases of serious bleeding, so they largely traded one risk for another.

FISH OIL RESULTS

The same study also tested omega-3 fatty acids, the good oils found in salmon, tuna and other fish. Supplement takers fared no better than those given dummy capsules — 9 percent of each group suffered a heart problem.

“We feel very confident that there doesn’t seem to be a role for fish oil supplements for preventing heart disease,” said study leader Dr. Louise Bowman of the University of Oxford.

The British Heart Foundation was the study’s main sponsor.  Bayer and Mylan provided aspirin and fish oil, respectively. Results were published by the New England Journal of Medicine.

Other studies are testing different amounts and prescription versions of fish oil, “but I can’t tell people go spend your money on it; we think it’s probably better to eat fish,” said Dr. Holly Andersen, a heart disease prevention specialist at New York-Presbyterian/Weill Cornell who was not involved in the study.

The new research doesn’t alter guidelines on aspirin or fish oil, said Dr. Nieca Goldberg, a cardiologist at NYU Langone Medical Center and an American Heart Association spokeswoman. They recommend fish oil only for certain heart failure patients and say it’s reasonable to consider for people who have already suffered a heart attack. /cbb

source: technology.inquirer.net

An egg a day may keep the doctor away, study claims

For decades, experts warned that eating eggs raises levels of unhealthy cholesterol. But a study claimed on Tuesday that an egg a day may actually reduce the risk of heart disease and stroke.

While outside experts cautioned against reading too much into the study, its authors claimed that Chinese adults who ate an egg every day had a lower risk of cardiovascular disease (CVD).

After studying half-a-million healthy adults aged 30-79 over almost nine years, researchers concluded that “compared with non-consumers, daily egg consumption was associated with lower risk of CVD.”

Risk of hemorrhagic stroke was 26 percent lower among egg-eaters, the Chinese-British research team also reported in the journal Heart.

And daily egg consumption was associated with an 18-percent lower risk of death from CVD, and a 28-percent lower risk for death from hemorrhagic stroke, it added.

CVD, a group of disorders of the heart and blood vessels, is the leading cause of death and disability worldwide, including in China.

According to the World Health Organization, about 17.7 million people die of CVDs each year, almost a third of all deaths worldwide.

Eighty percent of CVD deaths are caused by heart attacks and strokes.

Smoking, not exercising enough, and eating an unhealthy diet high in salt and low in fresh fruit and vegetables, increase the risk.

Chicken and egg

Eggs are rich in dietary cholesterol, long linked to a higher CVD risk, but also contain crucial protein and vitamins.

In the study group, 13 percent reported daily egg consumption while nine percent said they never or hardly ever ate them.

By the end of the study period, almost 84,000 cases of CVD and 10,000 CVD deaths were recorded and compared among the different egg-intake groups.

“The present study finds that there is an association between moderate level of egg consumption (up to 1 egg per day) and a lower cardiac event rate,” the authors concluded.

But experts not involved in the study, said the results fail to prove that eating eggs actively lowers CVD risk.

“An important limitation of this present study is that the people who consumed eggs regularly were much more affluent than those who avoided them,” University College of London nutrition specialist Tom Sanders said.

“Indeed, rates of stroke have been falling in Japan, Australia, North America, and Europe for several decades for reasons that remain uncertain but may be related to increasing affluence,” he also said via the Science Media Centre in London.

According to cardiology expert Gavin Sandercock, of the University of Essex, “to say that eating eggs is good (or bad) for you based on a study like this would be foolish as diet is much more complicated than picking on one foodstuff like eggs.”

A second paper published in Heart found that people who commute to work by walking or cycling had a risk of heart disease and stroke 11 percent lower than those who take the car.

Their risk of dying from CVD diseases was almost a third lower, found the seven-year study of more than 350,000 people in Britain.  /kga

source: technology.inquirer.net

Pepe Smith suffers stroke, now in hospital

Joey “Pepe” Smith, regarded as the symbol and inventor of Pinoy rock, suffered a stroke a few hours ago and was rushed to a hospital in Antipolo.

Music promoter Dudee Alfonso told the Inquirer that Smith–who’s turning 70 on Dec. 25–had just spent time with Willie Revillame and was in the car with his manager when Smith signaled he couldn’t speak.

Staff at Metro Antipolo Hospital, where Smith was rushed, moved him to the stroke unit, said Alfonso.

This was the third time Smith suffered a stroke, Alfonso pointed out. The first time was said to have caused an impediment in his speech

source: lifestyle.inquirer.net

Stroke specialists' group issues new guidelines for women

CHICAGO - While stroke is common in both men and women, guidelines released on Thursday for the first time address factors such as pregnancy, birth control pills and menopause that put women at particular risk for the deadly condition.

Issued by the American Heart Association and the American Stroke Association, the guidelines are designed to help doctors and patients recognize stroke risk factors early, when there is time to act.

"If you are a woman, you share many of the same risk factors for stroke with men, but your risk is also influenced by hormones, reproductive health, pregnancy, childbirth and other sex-related factors," said Dr Cheryl Bushnell, author of the new scientific statement published in the American Heart Association journal Stroke.

According to the report, stroke is the fifth-leading cause of death in men and the third-leading cause of death in women. Shared risk factors for stroke include high blood pressure, high cholesterol and smoking.

But other factors influence stroke risk in women. Many of these involve pregnancy. For example, women with a history of high blood pressure should take extra steps to control it during pregnancy, such as taking low-dose aspirin and possibly a calcium supplement. That helps reduce the risk of preeclampsia, a condition marked by high blood pressure and protein in the urine that can cause stroke during or after delivery and premature birth.

Women who have had preeclampsia have twice the risk of a stroke and four times the risk of high blood pressure later in life. As a result, they should address issues such as smoking, high cholesterol and obesity, which heighten their stroke risk even more.

Likewise, women should be screened for high blood pressure before using birth control pills, because that combination raises stroke risks.

Other risk factors more common in women than men include migraine with aura, atrial fibrillation, diabetes, depression and emotional stress.

These are signs 52-year-old Karen Rastenis from Solon, Ohio, wished she had been aware of a while back. Before her stroke two years ago, Rastenis was a smoker and more than 150 lbs overweight. When she woke up one morning with weakness on her right side, the busy single mother of two teenagers ignored the symptom. Then it kept getting worse.

By the time she went to the hospital a few days later, her blood pressure was dangerously high at 237 over 160. She had already had a stroke in her brain stem and "I was on the verge of having a massive stoke," she said.

Rastenis says she had always been overweight but she did not know she had high blood pressure before the stroke.

Still, there had been warning signs. She had had migraines with aura from the start of puberty until she had her first child. During that pregnancy, she also had preeclampsia.

Since her stroke, Rastenis has taken several steps to prevent another. She has quit smoking and had weight loss surgery. She has already lost 60 lbs.

Still, she wishes she had known about the risks earlier.

"It's about time that they looked at the differences in stroke between males and females," she said. "We've known that a woman's heart attack will present differently than a man's. It seems to follow that the same is true of stroke."

Dr Shazam Hussain, stroke section head at the Cleveland Clinic in Ohio, who was not involved in the study, said the guidelines were long overdue.

"Certainly, there is something in common between men and women in terms of stroke risk factors. It's also been recognized there are differences," he said, noting that women tend to do worse after a stroke and are also more likely to die from stroke than men.

"I think recognizing that, putting that on the table as a group that needs more focus when we do studies and when we care for women is very important," he said. — Reuters

source: gmanetwork.com

Extra fiber tied to lower risk of stroke — UK study

NEW YORK - People who get more fiber in their diet are less likely to have a stroke than those who skimp on the nutrient, according to a new review of existing research.

"A few people in the past have looked at the relationship between fiber and cardiovascular disease, which includes coronary heart disease and stroke," senior author Victoria Burley told Reuters Health.

But this is the first time all the available results from long-term studies have been pulled together into one analysis, said Burley, a senior lecturer in nutritional epidemiology at the University of Leeds in the UK.

Burley and her coauthors pooled the results of eight studies conducted since 1990 that included close to 500,000 participants. Those people reported on their dietary fiber consumption and were followed for anywhere from eight to 19 years.

The researchers found the risk of suffering a first stroke fell by 7 percent for every 7-gram increase in dietary fiber people reported each day - so that those who ate the most fiber had the lowest chance of stroke, according to findings published in the journal Stroke.


The average U.S. woman gets 13 grams of fiber per day, and the average man gets 17 grams - well below the Institute of Medicine recommendation of 24 and 35 grams, respectively.

An extra 7 grams could come from two slices of whole wheat bread and a serving of fruit, for example, Burley said. But even less than that - just 2 or 3 extra grams per day - might affect stroke risk.

Americans suffer almost 800,000 strokes annually, and strokes cause one out of every 18 U.S. deaths, or 130,000 per year, according to the Centers for Disease Control and Prevention. Most happen when a clot blocks blood flow in a brain vessel.

"Stroke is a very common and chronic disease in our society because the risk factors are growing," Dr. Dean Sherzai, a neurologist at Loma Linda University in California, told Reuters Health.

The new results are important because at the moment there are limited treatments and preventive measures available for stroke, but diet changes such as adding more fiber are relatively easy, said Sherzai, who was not involved in the study.

The report didn't look at the effects of different types of fiber on people of specific ages - so it's possible some may glean more benefit from eating extra fiber than others, he added.

The findings don't prove fiber directly prevents strokes. Researchers also don't know why fiber would be linked to a lower risk, although they have some ideas.

"There could be all sorts of things going on," Burley said.

Foods high in fiber tend to be low-calorie and help people maintain a healthy weight, which reduces stroke risk, she said. Fibrous foods also have vitamins, minerals and antioxidants including polyphenols and flavonoids, which make blood vessels more elastic.

The findings should serve as more encouragement for people to get their daily recommended fiber, Burley said. She'd like to see fiber back on the agenda - since it sometimes falls to the wayside in low-carbohydrate or gluten-free diets.

"Sometimes things like this just aren't deemed sexy enough," Sherzai said. — Reuters

source: gmanetwork.com