New Findings Change Aspirin-a-Day Guidelines

Our concierge family practice doctors in Jupiter understand the temptation to pop a pill—whether a prescription medication or a supplement—to stay healthy, instead of following more difficult suggestions regarding exercise and diet.

And to be sure, the long-standing belief that taking a daily low-dose aspirin can prevent heart attacks has some scientific basis for those who’ve already suffered a heart attack. In addition, some earlier research did seem to support daily aspirin use for reducing the risk of numerous cancers as well as Alzheimer’s disease.

Latest findings

But the good thing about science in general and medical research in particular is that researchers are constantly reviewing and refining established knowledge. In the case of the aspirin-a-day approach, for example, several new studies in the last year have challenged the practice of taking a low-dose (81 mg.) aspirin to prevent cardiovascular disease (CVD). And this month the American College of Cardiology (ACC) and the American Heart Association (AHA) released new guidelines recommending against the use of daily low-dose aspirin, based on these studies.

One study published last month in the Journal of the American Medical Association (JAMA), for example, found that people without heart trouble who took a daily dose of aspirin had a lower risk of heart attack, stroke, and death. These benefits, however, were canceled out by the increased risk of bleeding in the intestinal tract or the brain, which can often be deadly.

Researchers in that study performed a meta-analysis of 13 studies that included 164,225 participants, none of whom had CVD when the studies began.

“For every 256 patients treated with aspirin for five years, one heart attack, stroke or death from cardiovascular disease would be prevented,” Dr. Sean Zheng, lead author of the study and and academic clinical fellow in cardiology at King’s College Hospital in London, told CNN. “On the other hand, for every 210 patients treated with an aspirin over the same period, one would have a serious bleeding event.”

“This calls into question the net benefit of taking aspirin, and whether people who have not previously had cardiovascular disease should take aspirin,” Zheng said.

Another study published last fall in the New England Journal of Medicine (NEJM) reported similar results, even finding that older patients experienced no health benefits at all from daily aspirin use. These and other recent studies are what led to this month’s revised recommendations from the AHA/ACC.

“We knew there would be an increased risk of bleeding with aspirin, because there has always been,” recommendations co-author Dr. Anne Murray told NBC News. “But not only did it not decrease risk of disability or death, it did not decrease the risk of heart attack and stroke, and there was an increase in the rate of death.” Murray is also a geriatrician and epidemiologist at the Hennepin Healthcare Research Institute and the University of Minnesota, Minneapolis.

In their statement, the AHA/ACC advised against taking a preventive aspirin a day, saying it may actually cause more harm than good.

“We’re talking about healthy people who don’t have known heart disease or stroke, who might have been considering or [are] already taking an aspirin to prevent that heart attack or stroke in the first place,” said Dr. Erin Michos, another of the authors of the new AHA/ACC guidelines.

The AHA stressed that the new recommendations do not apply to people who have already had a heart attack or stroke, or who have undergone such procedures as receiving a coronary artery stent or bypass surgery. But for the elderly (people over 70) and those with a high risk of internal bleeding, the AHA cautioned that “aspirin may do more harm than good, but there are no absolutes, so these decisions need to be tailored to individuals.”

Another co-author of the revised recommendations suggested that doctors might advise their patients who have a strong family history of heart disease to take a daily aspirin. This could also apply to those whose tests reveal considerable plaque build-up in their arteries. But for those with a low or moderate risk, lifestyle changes could have a more salient effect.

“Eat a heart-healthy diet, get regular physical activity, control blood pressure and control cholesterol,” Michos said. “If [people] need a statin, take it. Those are much more important when compared to recommending aspirin.”

As with so many other over-the-counter remedies, we always recommend you check with us before taking them. Each person is different and their needs and sensitivities are also different. We can help determine the best course for you.

Take Sleep Seriously – World Sleep Day

Our concierge family practice doctors at MD 2.0 in Jupiter know that sleep is often the best medicine for any illness or injury. Conversely, lack of adequate sleep can not only interfere with recovery, but it can also trigger a host of diseases.

This Friday, March 15th, is World Sleep Day, designed to highlight the critical role sleep plays in maintaining health. World Sleep Day is hosted by the non-profit World Sleep Society (WSS) and was created because “Time and time again, sleep medicine professionals and researchers came up against the belief that sleep was not important enough in personal health and well-being to be a priority,” the WSS explains. It added that “society’s 24/7 flow” exacerbates what some medical professionals and researchers have called a national health crisis.

Several causes

The health issues associated with lack of sufficient sleep are myriad: obesity, type 2 diabetes, cancer, cardiovascular disease, dementia, depression . . . even a shorter lifespan overall.

How does poor sleep impact health? In short, the time we spend sleeping is time the body uses to repair itself, which it can’t do when we’re eating, working, playing, active, or stressed. From a medical standpoint, during sleep the immune system releases cytokines, which are a type of protein the body needs not only to sleep, but to fight the effects of stress, illness, or injury.

Research has shown that lack of sleep also reduces the number of certain antibodies used to fight infections. In addition, Japanese researchers found that losing six hours of sleep over a single night resulted in significantly elevated blood glucose and triglyceride levels, warning signs for increased risk of heart disease and diabetes.

Effects of poor sleep

According to the National Institutes of Health (NIH), here are some of the effects of insufficient sleep on adults, as well as children and teens.

Brain and emotions

Sleep helps form new pathways to enhance learning, memory, problem-solving, decision-making, and creativity. Sleep deficiency has been linked to anxiety, depression, suicide, risky behavior, and inability to cope with change. The loss of even a single night of sleep has been shown to increase formation of the proteins associated with Alzheimer’s disease. In addition, children who are sleep deficient may feel angry and impulsive, have difficulty paying attention, and get lower grades.

Physical health

Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure, diabetes, and stroke in adults. It also increases the risk of obesity in all age groups. In addition, insufficient sleep hinders the body’s ability to repair itself, including hampering the immune system. Sleep also supports healthy growth and development in children and teens, helping to boost muscle mass.

Performance and Safety

A loss of even one to two hours of sleep a night over several nights has the same effect as if you haven’t slept at all for a day or two. Sleep deficiency not only interferes with the ability to drive a car, it can affect people in all lines of work, including health care workers, pilots, students, lawyers, mechanics, and assembly-line workers. So insufficient sleep is not only affecting those who experience it, but can impact others, as well. The NIH estimates that driver sleepiness is a factor in approximately 100,000 auto accidents each year, resulting in about 1,500 deaths.

What Is Healthy Sleep?

The Centers for Disease Control and Prevention (CDC) estimates that up to a third of Americans do not get the recommended seven hours of sleep a night. If you’re sleeping well, you:

  • will fall asleep within 15 to 20 minutes of going to bed;
  • will sleep between seven and nine hours per night (longer than that is also unhealthy);
  • will remain asleep for the entire night;
  • will awaken feeling refreshed, and will remain alert and productive during the day; and,
  • will not snore, gasp for breath, or feel restless while you’re trying to sleep.

If you typically skimp on sleep during the week and try to catch up by sleeping in on the weekends, a new study published last month in the journal Current Biology has some bad news for you. Researchers found that so-called “recovery sleep” has no benefit to the body in the long term. As reported in The Washington Post, participants in a sleep laboratory who we limited to five hours of sleep on weekdays then allowed to “binge sleep” on weekends still gained nearly three pounds over two weeks and also experienced metabolic disruption that would increase the risk of diabetes later in life.

To help you obtain the proper amount of sleep, you should:

  • go to bed at the same time every night
  • don’t try to sleep on a full stomach
  • refrain from using caffeine or alcohol after dinner
  • turn off “blue-light” devices (TVs, computers, smartphones) at least an hour before bedtime; and,
  • restrict activity in the bed to sex and sleep (i.e., no working, reading, TV, etc.)

Because healthy sleep is so crucial to your health, please let us know if you have any difficulty falling asleep or staying asleep so we can help uncover the cause and provide solutions.

The Downside of Diet Soda

Our concierge family practice doctors in Jupiter, applaud any effort by our patients to avoid, or at least reduce, their dietary intake of sugar whenever possible. But one of the solutions many people turn to instead may not be an improvement. Diet soda and other drinks replace sugar with the artificial sweetener aspartame, which seems to be implicated in several health issues associated with diet soda consumption as noted in several recent studies.

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Think Twice About Dietary Supplements

Because dietary supplements are a $40-billion-a-year business in this country, our concierge family practice doctors in Jupiter, want to make you aware of the latest research on these popular products. Numerous studies have found little benefit to taking any of the thousands of dietary supplements available on the market. And the U.S. Food and Drug Administration (FDA) has recently taken action regarding some of the health claims made by their manufacturers.

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How To Lower Blood Pressure Naturally

An alarming new report from the American Heart Association (AHA) released last week found that nearly half of all Americans—nearly 121 million adults—have some form of heart disease, defined as those with coronary heart disease, stroke, heart failure, or high blood pressure. The new figures partly stem from changes in what constitutes high blood pressure or hypertension. In 2017, the cut-off point for what is considered high blood pressure was revised downward, from 140/90 to 130/80, and only about half of those who are now considered hypertensive have it under control.

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