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Preventive Effects Of Aspirin Compared To Outcomes Of Major Bleeding

aspirin by foolsplay07 via Flickr and a Creative Commons license

Treating 1,000 people with preventive aspirin for five years prevents 2.9 major cardiovascular events (nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death) and causes 2.8 major bleeds, according to a meta-analysis.

Nine primary prevention trials compared results for aspirin alone for the primary prevention of cardiovascular disease, and reported data on myocardial infarction, stroke and cardiovascular deaths. Aspirin doses ranged from 100 mg every other day to 500 mg/d, and seven of them studied doses from 75 mg/d to 162.5 mg/d. No dose-dependent effects were noted, the researchers said. Results appeared in the July issue of the American Heart Journal.

A total of 2,029 major cardiovascular events occurred among 52,145 (3.86%) patients allocated to aspirin compared with 2,099 major cardiovascular events among 50,476 (4.16%) patients assigned to placebo or control. Over a mean follow-up of nearly 7 years, aspirin was Read more »

*This blog post was originally published at ACP Internist*

When Is It Appropriate To Disregard Guidelines In Medical Care?


In an article appearing last week in the American Heart Journal, investigators concluded that if American doctors would prescribe for their patients with heart failure each of the six therapies which are most strongly recommended in current heart failure guidelines, 68,000 lives per year could be saved.

The following (for the interest of the reader, and for the convenience of any attorneys who may follow DrRich’s offerings), is an ordered list of these six proven, life-saving heart failure therapies, along with the number of American lives that could be saved each year if only American doctors would stop grossly under-utilizing them in violation of published guidelines:

  • aldosterone antagonist therapy – 21,407 lives
  • beta blockers – 12,922 lives
  • implantable defibrillators (ICDs) – 12,179 lives
  • cardiac resynchronization therapy (CRT) – 8317 lives
  • hydralazine plus isosorbide – 6655 lives
  • ACE inhibitors or angiotensin receptor blockers (ARBs) – 6516 lives

The authors, of course, are careful to point out that their analysis is based on statistical methods, and thus must be counted as merely estimates of the magnitude of the benefit that would actually occur should American doctors suddenly begin managing their heart failure patients appropriately. (Their presentation of these estimates to five significant figures implies a level of precision far in excess of what can be justified, and therefore must be an oversight not only by the authors, but also by the reviewers and the editors. But still, one gets the idea. A lot of preventable deaths are being left on the table.)

Several studies have reported, over and over again, that fewer than half of American patients with heart failure Read more »

*This blog post was originally published at The Covert Rationing Blog*

More Women Die Of Heart Attack Than Men Do

Several studies have shown that women have a higher mortality rate than men if they have a heart attack. A study published in the American Heart Journal helps to explain why. The researchers looked at data from 2,542 women who had a heart attack. Compared to men, the women were older, less likely to be white, and less likely to smoke. They also had more serious health conditions than the men. They had diabetes, high blood pressure (hypertension), congestive heart failure, and chronic obstructive pulmonary disease (COPD).

We’ve known for a long time that women are about 10 years older than men at the time of their first heart attack. The authors believe that the reason women are more likely to die is because of these other conditions that are present. Women in the study were also more likely to receive a blood transfusion and experience gastrointestinal bleeding, strokes, and vascular complications which lead to death.

They didn’t find any gender difference when they controlled for these other conditions. The number of diseased vessels were the same as was the severity of stenosis.

So what does this tell women? The guidelines for longevity and good health haven’t changed: Don’t smoke, control high blood pressure, and make sure your weight is healthy to prevent diabetes and other vascular problems. Stay active. Heart attacks can be prevented by good lifestyle choices.

*This blog post was originally published at EverythingHealth*

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