Health for life

While aspirin has been shown to be effective in preventing heart attacks in men, it also increases the risk of gastrointestinal bleeding and possibly stroke, even at low doses. As such, national guidelines suggest that aspirin be used for prevention only in men at higher risk for cardiovascular events, so that the benefits of aspirin are greater than its adverse effects.

Recent data suggest that aspirin may also be effective for reducing cancer deaths. Would the possible combined health benefits of reducing heart attacks and cancer outweigh the risks of gastrointestinal bleeding and stroke for middle-aged men?

A research team, including UNC scientists, reports that including the positive effect of aspirin on cancer mortality influences the threshold for prescribing aspirin for primary prevention in men. The benefit of aspirin for cancer mortality prevention would help offset the risks and thus lower the age and increase the number of men for whom aspirin is recommended.

Their results were published in the June issue of the Journal of General Internal Medicine.

Michael Pignone, MD, MPH, and study lead author, says, “We found that including a risk reduction for cancer deaths had a substantial impact on the overall benefits of aspirin, especially for early middle-aged men from 45 to 55 years of age. Based on this effect, several million men who were not previously good candidates for aspirin prevention would now become eligible.

The U.S. Preventive Services Task Force, of which Dr. Pignone is a recently appointed member, recommends aspirin for primary prevention in men “when the potential benefit of a reduction in myocardial infarctions outweighs the potential harm of an increase in gastrointestinal hemorrhage.” This recommendation was issued in 2009, before the potential benefits for cancer reduction were recognized.

See update here:

http://blogspot.com/2013/10/health-benefits-of-aspirin-updated.html

See update here:

http://blogspot.com/2013/10/health-benefits-of-aspirin-updated.html

A new study has found that women who take aspirin have a reduced risk of developing melanoma -- and that the longer they take it, the lower the risk. The findings suggest that aspirins anti-inflammatory effects may help protect against this type of skin cancer. The study is published early online in Cancer, a peer-reviewed journal of the American Cancer Society.

In the Womens Health Initiative, researchers observed US women aged 50 to 79 years for an average of 12 years and noted which individuals developed cancer. At the beginning of the study, the women were asked which medications they took, what they ate, and what activities they performed.

When Jean Tang MD, PhD, of Stanford University School of Medicine in Palo Alto, and her colleagues analyzed available data from 59,806 Caucasian women in the study, they found that women who took more aspirin were less likely to develop melanoma skin cancer during the 12 years of follow up. Overall, women who used aspirin had a 21 percent lower risk of melanoma relative to non-users. Each incremental increase in duration of aspirin use (less than one year of use, one to four years of use, and five or more years of use) was associated with an 11 percent lower risk of melanoma. Thus, women who used aspirin for five or more years had a 30 percent lower melanoma risk than women who did not use aspirin. The researchers controlled for differences in pigmentation, tanning practices, sunscreen use, and other factors that may affect skin cancer risk.

"Aspirin works by reducing inflammation and this may be why using aspirin may lower your risk of developing melanoma," said Dr. Tang. Other pain medications, such as acetaminophen, did not lower womens melanoma risk. Dr. Tang noted that the findings support the design of a clinical trial to directly test whether aspirin can be taken to prevent melanoma.

Aspirin use is associated with a decreased risk of developing hepatocellular carcinoma and death from chronic liver disease (CLD), according to a study published November 28 in the Journal of the National Cancer Institute.

Hepatocellular carcinoma (HCC), the most common type of primary liver cancer, occurs mainly among patients with CLD. Previous reports have linked chronic inflammation due to CLD to cellular processes that could promote carcinogenesis. Because of their anti-inflammatory properties and widespread use to prevent cardiovascular and cerebrovascular disease, nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin and nonaspirin NSAIDs are being investigated as cancer chemopreventive agents. NSAIDs have been shown to have a beneficial effect in observational studies and clinical trials on risk of some cancers. However, the relationship between NSAID use and risk of HCC and death from CLD is unclear.

To investigate this relationship, Vikrant V. Sahasrabuddhe, M.B.B.S., Dr.P.H, from the Division of Cancer Epidemiology and Genetics at the National Cancer Institute, and colleagues, performed an observational study of 300,504 men and women aged 50 to 71 years enrolled in the National Institutes of Health-AARP Diet and Health Study who reported their aspirin and nonaspirin NSAID use and were followed-up for 10-12 years. The researchers linked the self-reported use of aspirin and nonaspirin NSAIDs to registry data on diagnoses of 250 cases of HCC and 428 deaths due to CLD to perform their study.

The researchers found that the use of NSAIDs was associated with a reduced risk of HCC and a reduced risk of death from CLD compared to non-users. Study participants who used aspirin had a 41% reduced risk of HCC and a 45% reduced risk of death from CLD, whereas those who used non-aspirin NSAIDs experienced a 26% reduced risk of CLD mortality but no reduced risk of HCC. The authors conclude that "these associations are prominent with the use of aspirin, and if confirmed, might open new vistas for chemoprevention of HCC and CLD."

In an accompanying editorial, Isra G. Levy, M.B., BCh., MSc., and Carolyn P. Pim, M.D., both from the Department of Epidemiology and Community Medicine at the University of Ottawa in Canada discuss how the known causes of chronic liver disease and primary liver cancer are hepatitis B and C virus infections, alcohol use, and a link between obesity and diabetes has been suggested. "We already have cheap, readily available interventions," such as vaccines for hepatitis B and C virus but "effective strategies for reduction of HBV and HCV are not always available or fully applied." Also, alcohol abuse and obesity are complex and multifactorial challenges that require interventions at the individual and system levels." They conclude that although we should study the potential of new chemopreventive strategies such as NSAID use, we should also continue to focus on improving the established practices and interventions.

Low dose aspirin may ward off cognitive decline in elderly women with a high risk of cardiovascular diseases such as heart disease and stroke, conclude researchers from the University of Gothenburg in Sweden who write about their five-year study in a paper published 3 October in the online journal BMJ Open.

In their introduction, corresponding author Anne Börjesson-Hanson and colleagues explain that many studies have looked at the effect of non-steroidal anti- inflammatory drugs (NSAID) on cognitive decline and dementia, but few have looked at the effect of aspirin on these conditions.

Yet, while researchers have proposed that inflammation might be important in the development of cognitive decline and cardiovascular diseases, and low dose aspirin is widely prescribed to prevent cardiovascular disease, no study has yet examined the effect of aspirin on cognitive function in people at high cardiovascular risk.

For their study, the researchers followed 681 women aged between 70 and 92 for five years. 129 of the women were already taking aspirin at daily doses ranging from 75 and 160 mg, and after undergoing baseline assessments, 601 were classed as having high cardiovascular risk.

Over the study period, the participants underwent more tests of cognitive and thinking skills, including one commonly used in the UK to diagnose dementia, the Mini Mental State Examination (MMSE).

The results showed that while the MMSE scores for the overall group fell over the five years of the study, it fell less for those women taking aspirin.

But although other tests of memory and thinking showed a similar pattern, those results were not statistically significant.

By the end of the study, 41 of the participants developed dementia, but the rate was no different between those on aspirin and those who werent.

In discussing the possible limitations of their study, the authors say they cant rule out that people with incipient cognitive decline might be less likely to take aspirin anyway.

They conclude that low-dose aspirin treatment "may have a neuroprotective effect in elderly women at high cardiovascular risk".

Simon Ridley, Head of Research at Alzheimers Research UK, says in a press release:

"The results provide interesting insight into the importance of cardiovascular health on cognition, but we would urge people not to self-medicate with aspirin to try to stave off dementia."

He points out the study found no benefit from aspirin on overall dementia rates, and that previous trials investigating potential benefits of drugs like aspirin for dementia have been negative.

"We know that keeping our heart healthy through regular exercise, a healthy diet, not smoking and keeping our blood pressure and cholesterol in check, can help to reduce the risk of dementia," says Ridley, adding that research into risk factors for cognitive decline must nevertheless become a top priority in the UK because of its increasingly aging population.