An apple a day or an aspirin a day?

Article Abstract:

A number of studies in recent years have demonstrated that taking one aspirin per day can greatly reduce the number of deaths from heart disease in patients who have survived one heart attack, as well as in those with unstable angina (cardiac chest pain which is increasing in frequency or severity), people who are having heart attacks, patients who have had heart bypass surgery, and those having angioplasty, the procedure in which partially blocked coronary arteries are opened with a balloon. In 1948, Dr. Lawrence L. Craven published the first of several articles in which he recommended daily aspirin for men ages 40 to 65, to decrease their risk of heart attack. These articles were largely ignored. As the mechanism of action that aspirin has in preventing blood clots began to be understood in the 1970s, studies were done that showed aspirin to be effective in reducing the risk of stroke in certain patients. In the past few years, two large-scale studies of male physicians in the United States and Britain asked doctors to take aspirin on a regular basis to assess its effects in reducing disease. In the American trial, the subjects took either one aspirin or one placebo (sugar pill) every other day, while in the British trial, the doctors took either one aspirin a day or they did not (no placebo was used). Combining the results of these studies showed a 33 percent reduction in the risk of a nonfatal heart attack in the aspirin group. Current thinking, based on the combined results of several studies, is that in the absence of clear contraindication to aspirin, one aspirin a day should be recommended to all patients with coronary artery disease, and very possibly, to all those with strong risks of heart disease, such as smokers, diabetics, and those with high blood pressure or high cholesterol levels. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Heart attack, Aspirin

---

Detection and treatment of elevated blood cholesterol: what have we learned?

Article Abstract:

On the basis of decades of research about cholesterol, the National Heart, Lung, and Blood Institute (NHLBI) concluded that high blood cholesterol levels are a factor in the causation of heart disease, and recommended that attempts be made to lower cholesterol in the general population. The NHLBI also defined the cholesterol level at which dietary or drug therapy should begin. In addition, the results of the Coronary Primary Prevention Trial (CPPT) were encouraging regarding the prevention of heart disease. The NHLBI founded the National Cholesterol Education Program (NCEP) to reduce heart disease and death caused by high cholesterol. The stakes are high in terms of both dollars and lives. Drug therapy costs $329 to $1,744 per patient per year, wholesale; in 1988, 13 million prescriptions for cholesterol-lowering drugs were written. Public education has been extremely successful in apprising the population of the NCEP's message. In spite of this massive public education effort, several studies have reported that lowering cholesterol reduces the risk of heart attack, but they have not shown a reduction in mortality. The major question at this time is the age at which screening and intervention should begin. Childhood cholesterol levels are very poor predictors of heart disease risk in adulthood. There is also a problem inherent in labeling children with health risks, as well as a risk of family conflicts. The cost of screening children would be greater than any potential benefits. All the research on the effects of cholesterol and cholesterol treatment has been performed on middle-aged men. Therefore, the point at which cholesterol levels should be considered high, as well as the risks and benefits of drug therapy, are unknown for women and the elderly. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Reports, Diagnosis, Demographic aspects, Drug therapy, Hypercholesterolemia, United States. National Heart, Lung and Blood Institute, United States. National Cholesterol Education Program

---

Atrial fibrillation and embolic stroke

Article Abstract:

Atrial fibrillation is an irregular heart beat that carries a significant risk of blood clot formation within the heart. These blood clots can break away, or embolize, lodging in other parts of the circulation and causing damage. The most common and dangerous complication of this embolization is stroke. Atrial fibrillation can be caused by damage to the heart valves, particularly the mitral valve, or less commonly, by other heart problems, such as coronary artery disease. Atrial fibrillation from valvular disease seems to carry the greatest risk of stroke, but virtually all types of atrial fibrillation are dangerous. The use of the blood thinner warfarin substantially reduces the risk of stroke in atrial fibrillation, but not all physicians are convinced of this. Some doubt its effectiveness, despite many published studies, and others are concerned about the complications associated with warfarin therapy, particularly the risk of bleeding. New information has shown that lower doses of warfarin than previously recommended are equally as effective in reducing the risk of stroke from atrial fibrillation. At least one study has suggested that low-dose aspirin therapy may also be effective in reducing the risk of stroke from atrial fibrillation, but this finding requires further investigation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Editorial, Complications and side effects, Stroke (Disease), Stroke, Embolism, Atrial fibrillation, Thrombosis, Warfarin

Similar abstracts:

• Abstracts: Atrial fibrillation: thromboembolic risk and indications for anticoagulation. Physician variation in anticoagulating patients with atrial fibrillation
• Abstracts: The validity of the postcoital test. Primary prevention of gynecologic cancers. An epidemic of antiabortion violence in the United States
• Abstracts: An estimable legacy. Institutional responsibility in graduate medical education and highlights of historical data
• Abstracts: A double-blind placebo-controlled study of buspirone in diazepam withdrawal in chronic benzodiazepine users. Patterns of benzodiazepine use in Great Britain as measured by a general population survey
• Abstracts: Positron emission tomography in the study of brain metabolism in psychiatric and neuropsychiatric disorders. Structure and function in neurology and psychiatry

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.