Dr. Weeks’ Comment: Aspirin, an anti-inflammatory agent, is widely acknowledged as an effective agent for many ailments. The side-effect of too much aspirin for too long is lethal: death from internal bleeding. Medical historian are reconsidering the devastation from the 1919 Spanish Influenza and the data suggests that overdosage of aspirin, then a new medication, and not the flu was the actual killer. Even the NY Times picked up on this story – read here as did Science Daily and Lew Rockwell – but still this monumental example of iatrogenic (death by doctor) errors does not give patients pause for thought.
And so, today, aspirin is still widely used and considered one of the safer of the class of drugs called non-steroidal anti-inflammatory agents (NSAIDs). See here how the FDA, long a rubber stamp for drug companies, eventually criticizes the use of these aspirin alternatives.
- FDA Advisory Panel Votes No on Approving Cangrelor in PCI
- FDA Advisory Panels Against CV Safety Claim for Naproxen
- Company Fretted Over Dabigatran Report, Documents
- ShowCardiology 2014: Bob Harrington and Mike Gibson
But the good news is that we now have a superior natural alternative to aspirin, a drink made from 3 anti-inflammatory seeds from organic and non GMO plants: black cumin, black raspberry and Chardonnay grape. The seeds are where the nutrients are concentrated so drinking Rain SOUL is the popular choice today.
Low-dose Aspirin in Primary Prevention. Cardioprotection, Chemoprevention, Both, or Neither?
Abstract
Low-dose aspirin has been shown to be effective in preventing about one-fifth of atherothrombotic vascular complications (non-fatal myocardial infarction, non-fatal stroke, or vascular death) in a meta-analysis of 16 secondary prevention trials in patients with previous myocardial infarction, stroke, or transient cerebral ischaemia. This corresponds to an absolute reduction of about 10-20 per 1000 patients in the yearly incidence of non-fatal events, and to a smaller, but still definite, reduction in vascular death. Against this benefit, the absolute increase in major extracranial bleeding complications [mostly, gastrointestinal (GI)] is 20- to 50-fold smaller, depending on age and sex. Hence, for secondary prevention, the benefits of antiplatelet therapy substantially exceed the risks. For primary prevention, the balance between vascular events avoided and major bleeds caused by aspirin is substantially uncertain because the risks without aspirin, and hence the absolute benefits of antiplatelet prophylaxis, are at least an order of magnitude lower than in secondary prevention. The aim of this article is to review the updated evidence for the efficacy and safety of low-dose aspirin in primary prevention and to discuss additional health benefits resulting from prolonged antiplatelet therapy in apparently healthy people at low average risk of vascular events.
Introduction
Low-dose aspirin has been shown to be effective in preventing about one-fifth of atherothrombotic vascular complications (non-fatal myocardial infarction, non-fatal stroke, or vascular death) in a meta-analysis of 16 secondary prevention trials in patients with previous myocardial infarction, stroke, or transient cerebral ischaemia. [1]This corresponds to an absolute reduction of about 10-20 per 1000 patients in the yearly incidence of non-fatal events, and to a smaller, but still definite, reduction in vascular death. [1]Against this benefit, the absolute increase in major extracranial bleeding complications [mostly, gastrointestinal (GI)] is 20- to 50-fold smaller, depending on age and sex. [1]Hence, for secondary prevention, the benefits of antiplatelet therapy substantially exceed the risks. Whether this favourable benefit/risk ratio extends beyond the 2-3 year duration of randomized treatment has not been formally tested. However, in patients prescribed with low-dose aspirin for the secondary prevention of cardiovascular or cerebrovascular events, discontinuation of antiplatelet therapy was associated with a 40% increase in the relative risk of ischaemic stroke [2]and myocardial infarction [3]compared with continuation of therapy.
For primary prevention, the balance between vascular events avoided and major bleeds caused by aspirin is substantially uncertain because the risks without aspirin, and hence the absolute benefits of antiplatelet prophylaxis, are at least an order of magnitude lower than in secondary prevention. [1]The aim of this article is to review the updated evidence for the efficacy and safety of low-dose aspirin in primary prevention and to discuss additional health benefits resulting from prolonged antiplatelet therapy in apparently healthy people at low average