Baby Aspirin Better for Your Health, University of Kentucky Study Says

Nearly a quarter of a million Americans each year may be hospitalized with bleeding complications caused by needlessly taking a daily dose of an adult-sized aspirin rather than a baby aspirin to prevent a heart attack or stroke.

A study by a group of UK HealthCare Linda and Jack Gill Heart Institute cardiologists found that the commonly prescribed 325 mg adult tablet may be more than many people need each day. The study, which is published in the Journal of the American Medical Association, found that doses higher than a baby aspirin, 75 to 81 mg, are no better at preventing cardiovascular events long-term and are associated with increased risk of gastrointestinal bleeding.

Gill Heart Institute cardiologists and University of Kentucky College of Medicine faculty Dr. Charles Campbell, Dr. Steven Steinhubl and Dr. Susan Smyth, along with Dr. Gilles Montalescot of the Instjtut de Cardiologie-Centre Hospitalier Universitaire Pitié--Salpêtrière in Paris, France, systematically reviewed published data regarding clinical studies involving aspirin dosing. Even in patients with diabetes, who may be more difficult to treat, they found no large-scale studies that support higher doses of aspirin.

"While aspirin is an effective drug for the prevention of clots," says Campbell, lead author of the report, "the downside of aspirin therapy is an increased tendency for bleeding (particulary from the GI tract). We believe the minimum effective dose should be utilized (75-81 mg)." However, Campbell notes, "We also believe more study in this area is warranted to determine if the minimum dose is effective for everyone, or if dose should be adjusted from person to person."

Aspirin is the most-used drug in the world. More than 50 million people, or 36 percent of the adult population in the United States, consume 10 to 20 billion aspirin tablets each year to protect their hearts from clots, which are the leading cause of heart attacks and strokes.

"Patients should check with their doctor to be sure, but there is almost no one who needs to take more than 81 mg of aspirin a day for protection from heart attacks," Steinhubl says.

Going forward, the study notes that the greatest challenge ahead for physicians may be to determine how to identify the best blood-thinning regimen for their patients.

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Study Confirms Health Benefits of Whole Grains

A diet high in whole grain foods is associated with a significantly lower risk of developing cardiovascular disease, including heart disease and stroke, according to an analysis conducted by researchers at Wake Forest University School of Medicine.

"Consuming an average of 2.5 servings of whole grains each day is associated with a 21 percent lower risk of cardiovascular disease compared to consuming only 0.2 servings," says Philip Mellen, M.D., lead author and an assistant professor of internal medicine. "These findings suggest that we should redouble our efforts to encourage patients to include more of these foods in their diets."

These results were published on line in Nutrition, Metabolism & Cardiovascular Diseases and will appear in a future print issue.

The findings are based on an analysis of seven studies involving more than 285,000 people. By combining the data from these seven studies, researchers were able to detect effects that may not have shown up in each individual study. The studies were conducted between 1966 and April 2006.

Mellen says the findings are consistent with earlier research, but that despite abundant evidence about the health benefits of whole grains, intake remains low. A nutrition survey conducted between 1999 and 2000 found that only 8 percent of U.S. adults consumed three or more servings of whole grain per day and that 42 percent of adults ate no whole grains on a given day.

"Many consumers and health professionals are unaware of the health benefits of whole grains," says Mellen.

A grain is "whole" when the entire grain seed is retained: the bran, germ and the endosperm. The bran and germ components are rich in fiber, vitamins, minerals, antioxidants, and healthy fats. These are the parts removed in the refining process, leaving behind the energy-dense but nutrient-poor endosperm portion of the grain. Examples of whole grain foods include wild rice, popcorn, oatmeal, brown rice, barley, wheat berries and flours such as whole wheat.

In addition to protecting against cardiovascular disease, which accounts for one-third of deaths worldwide, there is evidence that whole grains also project against diabetes and other chronic conditions.

"Years ago, scientists hypothesized that the higher rates of chronic diseases we have in the West, including heart disease, are due, in part, to a diet full of processed foods," Mellen says. "Subsequent studies have born that out – especially with whole grains. Greater whole grain intake is associated with less obesity, diabetes, high blood pressure, and high cholesterol – major factors that increase the risk for heart disease and stroke."

According to nutritionists, consumers should look for "100 percent whole grain" on food labels or look for specific types of whole-grain flour as the main ingredient, such as "whole wheat."

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