An Aspirin A Day…Takes Your Sight Away?

SRxA’s Word on Health has frequently reported on the health benefits of aspirin.  So we were more than a little shocked to read a new study in JAMA Internal Medicine which suggested that people who regularly use aspirin may be at increased risk of age-related macular degeneration [AMD].  This eye condition is common  among people age 50 and older and is a leading cause of vision loss in older adults.  AMD gradually destroys the macula, the part of the eye that provides the sharp, central vision needed for seeing objects clearly. 

In some people, AMD advances so slowly that vision loss does not occur for a long time. In others, the disorder progresses faster and may lead to a loss of vision in one or both eyes. The vision loss makes it difficult to recognize faces, drive a car, read, or do close work, such as sewing.

But don’t go tossing out your Bayer’s just yet!

In this study, researchers at the University of Sydney looked at a large group of  people who took  daily low-dose aspirin as a preventive measure for cardiovascular disease.

Of nearly 2,400 elderly people studied over a 15-year period, 10% were regular aspirin users. Of that group, 25% developed  macular degeneration over that time frame, compared to 9% who developed it but were non-aspirin users.

While these results were statistically significant, more research needs to be done before  recommending that patients stop taking doctor recommended aspirin.   Despite their results, even the researchers admit that there’s just not enough evidence to support stopping aspirin therapy unless a person already has strong risk factors for age-related macular degeneration.

Ophthalmologist Justis Ehlers, MD, agrees, “Aspirin has clearly been shown to have good secondary prevention for different cardiovascular diseases. We need to sort this out over time to see what it means.”

Fend off a 2nd Heart Attack with Fruit and Fiber

Each year, at least 20 million people worldwide survive a heart attack or stroke. Most of them, will then be prescribed a veritable cocktail of drugs including lipid-lowering agents, beta blockers, aspirin, anti-platelet medications, and angiotensin modulators.

In the misguided belief that this polypharmacy will guard against future catastrophic cardiovascular events, many patients think they don’t need to follow a healthy diet.

However a new, 5-year study of almost 32,000 patients in 40 countries showed those who ate a heart-healthy diet rich in fruits, vegetables and fish had an average:

• 35% reduction in risk for cardiovascular death
• 14% reduction in risk for new heart attacks
• 28% reduction in risk for congestive heart failure
• 19% reduction in risk for stroke

Researchers from McMaster University were able to demonstrate, for the first time, that while drug treatments, substantially lower the risk of another heart attack, a high quality diet also significantly lowers the risk.

Mahshid Dehghan, the study’s lead author and nutritionist at McMaster University’s Population Health Research Institute (PHRI) and his team assessed the association between diet quality and the risk of cardiovascular disease using information collected from men and women who participated in two major McMaster-led global studies: ONTARGET, and TRANSCEND.

Participants with cardiovascular disease were asked how often they consumed milk, vegetables, fruits, grains, fish, nuts, meat and poultry over the past 12 months. They were also asked about lifestyle choices such as alcohol consumption, smoking and exercise. A healthy diet was indicated by a high intake of fruits, vegetables, whole grains and nuts as well as a high intake of fish compared to meat, poultry and eggs.

The results showed that a heart-healthy diet offered a “consistent benefit” over and above the benefits of taking medications to reduce the risk of heart attack and stroke.

Globally, healthy eating was associated with a lower risk of cardiovascular disease by more than 20% in all regions of the world and across all income groups.

“Physicians should advise their high-risk patients to improve their diet and eat more vegetables, fruits, grains and fish,” Dehghan said. “This could substantially reduce cardiovascular recurrence beyond drug therapy alone and save lives globally.”

A Pill to Prevent Skin Cancer?

Summer, it seems, has finally arrived.  And with it comes long lazy days at the beach, the pool… and, unfortunately, the associated risk of skin cancer.  To guard against this we all know to limit sun exposure, use high factor sunscreen and seek shade. But now it seems there’s one more thing we can do to help safeguard ourselves – take Advil!

Really?   Yes, it would appear so.  According to a case-control study published in the journal Cancer, the use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with reduced risk for skin cancer.

Using health registries, researchers identified 18,500 cases of skin cancer among adults in northern Denmark and matched them to population controls without skin cancer. Patients who had ever used NSAIDs (more than two prescriptions) had a 15% reduced risk for squamous cell carcinoma and a 13% reduced risk for malignant melanoma compared with those who had two or fewer prescriptions; especially when the drugs were taken for seven or more years or at a high intensity.

The risk reduction was seen in patients taking aspirin, NSAIDs, and COX-2 inhibitors, such as Celebrex.

Individuals who took NSAIDs did not appear to gain a generally reduced risk from developing basal cell carcinoma, although they had a 15% and 21% reduced risk of developing this kind of cancer on less-exposed sites (areas other than the head or neck) when taken long term or at a high intensity, respectively.

So how do NSAIDs do it?  The authors suggest that they reduce the risk of skin cancer by blocking COX enzymes, which are involved in the inhibition of apoptosis  and in stimulating angiogenesis. Or, in plain English, these anti-inflammatory drugs counteract the enzymes involved in the important steps of cancer development such as inhibition of cell death and suppression of the immune system.

Despite the positive results, lead author Sigrún Alba Johannesdóttir from Aarhus University Hospital cautions, “because there are also risks associated with the use of NSAIDs, we cannot give recommendations on NSAID use in general. It is up to the patient and his or her physician to balance benefits and harms associated with use of the medications.”

Nevertheless, when viewed alongside the study results fom earlier this year that showed patients who took aspirin daily for at least three years were 36% less likely to develop metastatic cancer and 15% less likely to die from the disease, this can only be good news.

Especially for people like me, who love the sun and can’t make it downstairs without a morning dose of diclofenac!

An aspirin a day keeps bowel cancer away?

Aspirin is not only an effective painkiller, it is thought to help fight conditions ranging from cardiovascular disease, cancer and stroke to migraine headache and high blood pressure in pregnancy. Some studies have suggested it can double the chances of a successful IVF pregnancy while others have suggested it may even block the spread of certain viruses.

Now, researchers at Oxford University have found that a daily aspirin tablet may help to prevent both bowel cancer and bowel cancer deaths.

The study followed over 14,000 patients for a period of 20 years.  The results, published in the current edition of The Lancet, show that low-dose aspirin reduced the risk of the incidence of bowel cancer by 24% and of dying from the disease by 35%.

“Aspirin taken for several years at doses of at least 75mg daily reduced long-term incidence and mortality due to colorectal cancer. Benefit was greatest for cancers of the proximal colon, which are not otherwise prevented effectively by screening with sigmoidoscopy or colonoscopy.” concluded the study authors.

The findings build on previous research on the issue and offer great hope for individuals with a high risk of bowel cancer, such as those with obesity or a family history of the disease.

One in 20 people in the US develops bowel cancer over their lifetime, making it the third most common cancer. Current figures from the National Cancer Institute indicate that there are more than 140,000 new cases of bowel cancer diagnosed in the US each year and more than 50,000 deaths.

Mark Flannagan, Chief Executive of Beating Bowel Cancer, said the study provided very positive findings.  “This was a big study over a long period of time and reinforces the message that aspirin may be important in significantly reducing the number of cases and deaths from bowel cancer.”

Aspirin is already one of the most widely used medications in the world.  An estimated 40,000 tons of it are consumed worldwide, each year.  SRxA’s Word on Health wonders just how much more will be sold as a result of this.

Let us know your thoughts.