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HEART DISEASE

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Aspirin Proven Again to Prevent Atherosclerosis--Vitamin E Questionable

Lancet, the British medical journal* has just published a report on 4,495 patients showing a relative risk for atherosclerosis 'hardening of the arteries] of those given aspirin to be 56% of the risk for those not taking it. Researchers used a 100mg. pill, equivalent to about one-third of a conventional tablet.

Also tested were patients taking a 300 mg dose of vitamin E a day, though no conclusive benefit was seen for this group. Since previous studies have found a clear benefit for aspirin as well as for vitamin E, how come the vitamin failed in this test? The authors called this outcome a "false negative." They observed that the test was ended prematurely, since the obvious health benefit of the aspirin required, ethically, giving aspirin to those patients who had been given a placebo (plain sugar pill.)  Thus all the subjects ended up getting aspirin.

Was the early ending of the trial the real reason for vitamin E's poor showing? In our view, the physicians missed something. If this study is reported on by the major media, we suspect they might miss it too.

Buried in the report was a reference to the vitamin E.  It said that synthetic E was used. Since natural E has some twice the effectiveness of synthetic, this could be the explanation for its failure.

The success of the low-dose aspirin was found in the reduction of cardiovascular deaths, nonfatal heart attacks and nonfatal strokes. For all strokes, those taking the drug had a risk of only two-thirds of those not taking it.

Side effects? Certainly aspirin increases the risk of bleeding in the stomach. Yet only one of the entire group's bleeding was fatal. And,..."among the roughly 8000 person-years of aspirin treatment there was no suggestion of an excess risk for 'hemorrhage.]"

This report therefore unwittingly also casts some doubt over the use by physicians of exorbitantly priced aspirin substitutes intended to reduce the internal bleeding caused by aspirin.

*The study appeared in Lancet, vol. 357, 2001, and was done by the Collaborative Group of the Primary Prevention Project in Italy.

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