Has the BBC Health Bite 23/08/08 done it again? – perhaps putting vulnerable people at risk – by recommending aspirin from middle age for primary prevention based on a local retrospective observational study in only 12000 people;
when the latest (2006, 2006) metaanalyses of the six major aspirin primary prevention trials in over 90 000 subjects showed no significant benefit on all cause mortality, or stroke, or cardiovascular mortality; and BBC fails to mention the real aspirin problems – that 28% may be aspirin resistant, or the legion problems that can be caused by even low dose aspirin, which offset it’s trivial cost. .
This contrasts with the latest metaanalysis of fish oil prevention, from Tufts in Boston 2006 which concludes that “consumption of n–3 FAs from fish and fish-oil supplements reduces all-cause mortality, cardiac and sudden death, and stroke”– without any noteworthy linked adverse events… not to mention major benefit on behaviour, learning/ memory, arthritis, depression, eyes, skin, and reduction in obesity-diabetes- insulin resistance.
And recommending aspirin without including the dozens of multibenefit evidence-based preventative supplements – many of which can mitigate the risks of aspirin- is surely more risky – especially in a high- alcohol-intake nation?
The low benefit:risk ratio of aspirin applies also to warfarin.
Thrombolytics, heparin and then warfarin may be indispensible after highrisk thromboses, but it has yet to be proven that for chronic prevention those high-risk therapies which require regular laboratory monitoring are as safe let alone as good as fish oil and oral EDTA.
Warfarin has far more risks (than aspirin) -apart from bleeding there is – as a result of vitamin K antagonism – vascular calcinosis, osteoporosis and malignancy.
So in view of the risks, and the scant benefits, of longterm aspirin and warfarin, if any trial is needed it is one to disprove the obvious, that combining fish oil with EDTA gives far higher benefit :isk long term than warfarin and/or aspirin.
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