1. Describe the problem exactly. How do you stop atherosclerosis from occurring and reduce it if it exists?
2. Write an RFP to researchers to solve that problem.
3. Fund them with foundation grants.
4. Write stroke prevention protocols based on the research.
5. Get the Nobel prize in medicine
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.
___
Marilynn Marchione can be followed at @MMarchioneAP .
___
The
Associated Press Health & Science Department receives support from
the Howard Hughes Medical Institute's Department of Science Education.
The AP is solely responsible for all content.
No comments:
Post a Comment