Aspirin: Risks and Benefits WAS Re: Oxidation/polymerization of polyunsaturates (was Re: alpha lipoic acid 
Author Message
 Aspirin: Risks and Benefits WAS Re: Oxidation/polymerization of polyunsaturates (was Re: alpha lipoic acid
All:

Quote:




> >> Except my sister, a VERY good internal-medicine doc, suggests 800-1000 IU
> >> of E and one aspirin, anywhere from the 81 mg dosage to the 325 mg
> >> standard one.
> > Aspirin causes gastric bleeding no matter how administered, including IV.

> >Not at those dosages.

> Yes, even that these dosages.  It's the antiplatelet effect on GI ulcers
> that you wouldn't ordinarily otherwise notice. In the Physician's Health
> Study (PHS) where the aspirin dose was 325 mg every other day, they had
> siginicantly more admissions to the hospital for GI bleed in the aspirin
> group.

And, in fact, the incidence of GI damage is essentially the same even
at quite low (<163, and even <100, mg/day) doses:
**************************
To assess the ... effect of dose reduction and formulation on the
incidence of such [GI] haemorrhage[, we conducted a] Meta-analysis of
24 randomised controlled trials (almost 66 000 participants).

Results: Gastrointestinal haemorrhage occurred in 2.47% of patients
taking aspirin compared with 1.42% taking placebo ... At doses below
163 mg/day, gastrointestinal haemorrhage occurred in 2.30% of patients
taking aspirin compared with 1.45% taking placebo ...

[Look at Table 1 in the study (1a). Of the 8 trials used to determine
this conclusion, 7 were at doses <=100 mg, and *6* were <81 mg].

Meta-regression showed no relation between gastrointestinal
haemorrhage and dose.

For modified release formulations of aspirin the odds ratiowas 1.93
...

No evidence exists that reducing the dose or using modified release
formulations would reduce the incidence of gastrointestinal
haemorrhage.  (1)
*******************

Quote:
> We don't know the life extending effect (if any) for aspirin ... in the
> general population

And actually, the effect even in high-risk (but not already
heart-attack-hit) folks is not too damned much (2):

**************************
To determine the effects of antiplatelet therapy among patients at
high risk of occlusive vascular events[, we conducted] Collaborative
meta-analyses (systematic overviews) [involving] 287 studies involving
135 000 patients in comparisons of antiplatelet therapy versus control
and 77 000 in comparisons of different antiplatelet regimens.

Results: ... Absolute reductions in the risk of having a serious
vascular event were 36 ... 22 (+/- 3) per 1000 treated for two years
among other high risk patients (with separately significant results
for those with stable angina (P=0.0005), peripheral arterial disease
(P=0.004), and atrial fibrillation (P=0.01)).

In each of these high risk categories, the absolute benefits
substantially outweighed the absolute risks of major extracranial
bleeding. Aspirin was the most widely studied antiplatelet drug, with
doses of 75-150 mg daily at least as effective as higher daily doses.

The effects of doses lower than 75 mg daily were less certain.

***************************

They therefore rightly conclude that "For most healthy individuals,
however, for whom the risk of a vascular event is likely to be
substantially less than 1% a year, daily aspirin may well be
inappropriate."

Quote:
> So a bit of humility is in order. The statins are presently the best-tested
> "life-extension {*filter*}" known. We know far more about their long term health
> effects that we do megadose vitamins.

Yep.

Quote:

> We don't know the life extending effect
> (if any) for ... vitamin C, nor vitamin E, ... in the
> general population, ... [or] even as secondary preventives.

And from animal evidence (as, of course, Steve knows better than
most!), the answer appears to be: they just don't have an effect,
except for surprisingly slim and inconsistent benefits in genetic
{*filter*}ups, the diseased, and the malnourished.

-Michael

1:  Derry S, Loke YK.
Risk of gastrointestinal haemorrhage with long term use of aspirin:
meta-analysis.
BMJ. 2000 Nov 11;321(7270):1183-7.
PMID: 11073508

1a. http://www.***.com/

2. [No authors listed]
Collaborative meta-analysis of randomised trials of antiplatelet
therapy for
prevention of death, myocardial infarction, and stroke in high risk
patients.
BMJ. 2002 Jan 12;324(7329):71-86.
PMID: 11786451



Fri, 27 Aug 2004 03:04:20 GMT
 Aspirin: Risks and Benefits WAS Re: Oxidation/polymerization of polyunsaturates (was Re: alpha lipoic acid


Fri, 19 Jun 1992 00:00:00 GMT
 Aspirin: Risks and Benefits WAS Re: Oxidation/polymerization of polyunsaturates (was Re: alpha lipoic acid

Quote:

> All:


>>We don't know the life extending effect
>>(if any) for ... vitamin C, nor vitamin E, ... in the
>>general population, ... [or] even as secondary preventives.

> And from animal evidence (as, of course, Steve knows better than
> most!), the answer appears to be: they just don't have an effect,
> except for surprisingly slim and inconsistent benefits in genetic
> {*filter*}ups, the diseased, and the malnourished.

No comprehensive{*filter*}tail of supplements and other chemicals with
recent positive studies (such as many people are taking) has yet
been tested for life-extending benefits in any mammal.

Nor has there been any testing of such a{*filter*}tail added to the many
other possible life-extending approaches (food choices, CR, exercise, etc).

--Tom Matthews

MoreLife for us all - http://www.***.com/
Reality based tools for More Life in quantity & quality



Fri, 27 Aug 2004 21:57:16 GMT
 
 [ 3 post ] 

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