Aspirin – low doses maybe not a good idea...

Low-dose aspirin should not routinely be used to prevent heart attacks and strokes, contrary to official guidance, say UK researchers. Analysis of date from over 100,000 clinical trial participants found the risk of harm largely cancelled out the benefits of taking the drug. Only those who have already had a heart attack or stroke should be advised to take a daily aspirin, they found.

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The study should help clarify a "confusing" issue, a leading GP said. The NHS drugs watchdog, the National Institute for health and Clinical Excellence (NICE), has not made a ruling in this area. But experts in the UK, US and Europe recommend aspirin for people who have not already had a heart attack or stroke, but are at high risk of cardiovascular disease because of factors such as age, blood pressure and cholesterol level.

"We don't have good evidence that, for healthy people, the benefits of long-term aspirin exceed the risks by an appropriate margin" Professor Colin Baigent, study leader. This strategy, known as primary prevention, is based on the result of studies looking at predicted risks and benefits in this population.

But the latest research provides clearer evidence because it is based on data from individuals, the researchers said. They looked at heart attacks and strokes and major bleeds - a potential side effect of aspirin - in six primary prevention trials, involving 95,000 people at low to average risk and 16 trials involving 17,000 people at high risk - because they had already had a heart attack or stroke.

Use of aspirin in the lower-risk group was found to reduce non-fatal heart attacks by around a fifth, with no difference in the risk of stroke or deaths from vascular causes. But it also increased the risk of internal bleeding by around a third...

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However, in those patients who had already had a heart attack or stroke and were at risk of having another, the benefits clearly outweighed the chance of adverse events, the researchers said.

Study leader Professor Colin Baigent from the Clinical Trial Service Unit at the University of Oxford, UK, said drug safety was vital when making recommendations that affected tens of millions of healthy people. "We don't have good evidence that, for healthy people, the benefits of long-term aspirin exceed the risks by an appropriate margin." He added: "I think the guideline groups will find it useful to have the data analysed in that way."

Professor Steve Field, chair of the Royal College of GPs, said the issue had been confusing for GPs and patients. "There is no definitive guidance and it makes it bewildering when you have a series of papers which then hint it would be beneficial to take aspirin." He added that many patients would buy aspirin over the counter - either on the advice of their GP or under their own steam - because it was cheap.

"This important study does suggest people shouldn't take aspirin unless indicated by disease."

Ellen Mason, senior cardiac nurse at the British Heart Foundation said:
"It is better for doctors to weigh up the benefit and risk of prescribing aspirin on an individual basis, rather than develop a blanket guideline suggesting everyone at risk of heart disease is routinely given aspirin."

Story from BBC NEWS : news.bbc.co.uk/../8072215.stm


Filipendula ulmaria (Meadowsweet)

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Further comments:

I want to acknowledge that there is a lot of literature in the medical world which puts a completely opposite spin on the daily use of Aspirin but not many people hear the other side of this subject and, as it is a controversial one with quite differing opinions, I wanted to give some voice of my own to other side.

I personally quite like aspirin as a drug and it is one of the very few pharmaceuticals that I have used it for myself and my family on different occasions but would not want to take it every day.

Aspirin's history is interwoven with two great herbs that at least partially work because of their shared chemistry to this substance that was one of the very first drugs ever produced. One of those herbs is Meadowsweet, pictured above, excellent for an over-acidic stomach and many other things with a detailed write up on it here. For more on the history of aspirin and some further comparisons to aspirin there is the great Willow, pictured below and written about in some depth here!

On some related notes, when it comes to heart health I do not think you should over-worry about cholesterol (more info here) but I do think you should worry about high blood pressure (more info here)

Finally, I received the following message from a Professor in Istanbul, Turkey, that I also wanted to share to give another side to this complex and multi-faceted subject

Dear Mr. Whelan:

During my research on some plants I run into your web site. It is very good and impressive. I have read about some herbs and monographs. I personally work with plants in a R&D center in Istanbul, Turkey, we develop food supplements and cosmetics based on botanicals. I also would like to make a comment on your page of aspirin use:

Aspirin is one of those rare medicine that I keep using. It is an excellent anti-inflammatory drug. As you know all the biological declining processes towards a disease especially for the chronic diseases start with inflammation. Antiinflammatory dose of aspirin is about 250 mg per day. Hence, everyday  250 mg aspirin can protect you from several cancers, Alzheimer's, rehumatoid arthritis. Studies show that benefit results from long-time use at least for 5 years.

Stay with health and best regards.
Prof. Dr. Murat Türkoğlu


Salix alba (Willow)

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