According to researchers from the University of Michigan, adults who take an aspirin to prevent heart complications in addition to Celebrex for joint pain are counteracting their medications.

“The greatest risk is having people take Celebrex who are taking aspirin for cardiovascular problems that are known to be mitigated by aspirin, including patients with unstable angina or those at risk for a second heart attack,” said study author Minor Coon.

The study reveals that Celebrex keeps aspirin from doing its job effectively, leaving patients at risk for having a stroke. It’s reported that nearly half of all men over the age of 50 are prescribed a low-dose aspirin to help protect them against heart complications. Unfortunately, Celebrex is one of the more commonly prescribed medications for those suffering from arthritis, most of who are over the age of 50.

An alternative to Celebrex would be to take a nutritional supplement for arthritis and joint pain such as ginko and curcumin.

The study published in the journal Circulation, finds that applying capsaicin, which is the main component in chili peppers and the active ingredient in some common pain creams, to specific skin areas on mice caused sensory nerves in the skin to trigger signals in the nervous system.

These signals activate cellular “pro-survival” pathways in the heart which protect the muscle, the article further explains.

“If proven effective in humans, this therapy has the potential to reduce injury or death in the event of a coronary blockage, thereby reducing the extent and consequences of heart attack,” says Keith Jones, a researcher at the University of Cincinnati where the study was performed.

Capsaicin, which is used topically to treat pain, produces a hot feeling on the skin. It is approved for use by the Food and Drug Administration (FDA).
The research further supports the value of chili peppers as a natural health resource.

Chili peppers, which are high in vitamin C, have already been shown to help fight migraine headaches, relieve sinus congestion and aid digestion.

All men who do not openly express their anger if they are unfairly treated at work double their risk of a heart attack, Swedish research suggests.

The researchers looked at 2,755 male employees in Stockholm who had not had a heart attack when the study began.

They were asked about how they coped with conflict at work, either with superiors or colleagues.

The researchers say their study shows a strong relationship between pent-up anger and heart disease.

Writing in the Journal of Epidemiology and Community Health, the researchers called the various strategies for keeping things bottled up, covert coping.

The men were asked what methods they adopted: whether they dealt with things head-on, whether they let things pass without saying anything, walked away from conflict, developed symptoms like headache or stomach ache or got into a bad temper at home.

Hospital registers

They were checked for smoking, drinking, physical activity, education, diabetes, job demands and their freedom to take decisions.

Their blood pressure, body mass index and cholesterol levels were measured and they were aged 41 on average at the start of the study between 1992 and 1995.

Details of whether any of the men subsequently had a heart attack or died as a result of heart disease in the period up to 2003 were gathered from national registers of hospital treatment and deaths.

Up to 2003, 47 of the 2,755 men had a heart attack or died from heart disease.

The men who coped by sometimes or often walking away or who often let things pass without saying anything, had double the risk of a heart attack or dying from serious heart disease compared to men who challenged and dealt with the situation head-on.

Developing a headache or stomach ache or getting into a bad temper at home, did not increase the risk of heart attack or heart disease.

The researchers believe that anger can produce physiological tensions if it is not released and that these lead to increases in blood pressure which eventually damage the cardiovascular system.

‘Conflict situations’

Dr Constanze Leineweber, who led the study from the Stress Research Institute in Stockholm, said: “There has been research before pointing in this direction but the surprise is that the association between pent-up anger and heart disease was such a strong one.

“I think men can’t help how they behave in conflict situations – it’s not something they think about, it’s just how they react instinctively.

“If you are smoking and don’t exercise you would be much more conscious of the risk.”

Judy O’Sullivan, senior cardiac nurse for the British Heart Foundation, said: “Stress itself is not a risk factor for heart and circulatory disease, but some people’s responses to stress, such as smoking or overeating, can increase your risk.

“We all find different things stressful and symptoms of stress can vary, but the important thing is that we need to find ways of coping with it in our lives in a positive way, whether at work or home.”/bbc.co.uk/

Researchers found that the sit-and-reach test, or having patients see how far they can reach beyond their toes while in a sitting position, can be used as a measure of how flexible the arteries are. Because arterial stiffness often precedes cardiovascular disease, the results suggest that this simple test could become a quick measure of an individual’s risk for early mortality from a heart attack or stroke.

In addition, scientists say increasing flexibility can decrease your risk of heart problems by slowing the age-related stiffening of the arteries in middle-aged and older people.

“We believe that flexibility exercise, such as stretching, yoga and Pilates should be integrated as a new recommendation into the known cardiovascular benefits of regular exercise,” said study author Dr. Kenta Yamamoto.

Health practitioners have also recommended a healthy, low-fat diet and cardiovascular exercise to improve heart health.

According to the Mayo Clinic, nutritional supplements containing blond psyllium, coenzyme Q-10, flaxseed and omega-3 fatty acids may help lower cholesterol and contribute to reducing the risk of some types of heart disease.

The scientists followed 1,169 nondiabetic men and women who had been hospitalized for a first heart attack. Each filled out a standardized health questionnaire that included a question about chocolate consumption over the past 12 months. Chocolate contains flavonoid antioxidants that are widely believed to have beneficial cardiovascular effects.

The patients had a health examination three months after their discharge from the hospital, and researchers followed them for the next eight years using Swedish national registries of hospitalizations and deaths. After controlling for age, sex, obesity, physical inactivity, smoking, education and other factors, they found that the more chocolate people consumed, the more likely they were to survive. The results are reported in the September issue of The Journal of Internal Medicine.

But before concluding that a box of Godiva truffles is health food, chocolate lovers may want to consider some of the study’s weaknesses. It is an observational study, not a randomized trial, so cause and effect cannot be definitively established.

Even though the researchers controlled for many variables, chocolate consumption could be associated with factors they did not account for — mental health, for example — that might reduce the risk for death.

The scientists did not ask what kind of chocolate the patients ate, and milk chocolate has less available flavonoid than dark chocolate. Finally, chocolate consumption did not reduce the risk for any nonfatal cardiac event.

Still, Dr. David L. Katz, an associate professor of public health at Yale who was not involved in the work, said the study added “an interesting element, following a group of adults who’ve had a heart attack and noting an impressive reduction in cardiac deaths.” While the study is observational, he said, “the broader context is reassuring.”

While the chocolate eaters in the study had a statistically insignificant reduction in the risk of death from any cause over the eight-year span, the reduced risk for dying of heart disease was highly significant. And it was dose-dependent — that is, the more chocolate consumed, the lower the risk for death.

Compared with people who ate none, those who had chocolate less than once a month had a 27 percent reduction in their risk for cardiac death, those who ate it up to once a week had a 44 percent reduction and those who indulged twice or more a week had a 66 percent reduced risk of dying from a subsequent heart event. The beneficial effect remained after controlling for intake of other kinds of sweets.

A co-author of the paper, Dr. Kenneth J. Mukamal, an associate professor of medicine at Harvard, said that there was considerable data from other studies suggesting that chocolate lowered blood pressure and that this might be a cause of the lower cardiac mortality found in the study.

Dr. Katz, of Yale, agreed that “there are many reasonable biological mechanisms” for a protective effect from chocolate.

“I like the study,” he said. “It adds to the general fund of knowledge we already have.”

Dr. Mukamal sounded a note of caution about the findings.

“Although this is interesting and provocative, chocolate does not come without costs,” he said. “For people looking for a small snack to finish a meal, this is a great choice. But it should be supplementing healthy eating and replacing less healthy snacks.”

While the European study suggests long-term pill users may therefore be at increased risk of heart attack or stroke, the researchers say their findings are no need for alarm.

“Bottom line – don’t discontinue your pill suddenly. Don’t panic. Don’t call your gynaecologist tomorrow morning,” says lead researcher Dr Ernst Rietzschel of Ghent University in Belgium, whose team presented the results at an American Heart Association meeting this week.

Rietzschel’s team studied 1301 women aged 35-55. Of these, 81% had used the pill for an average 13 years.

The researchers measured plaque levels using a technique called vascular echography.

They saw a rise of 20-30% in arterial plaque in two big arteries – the carotid in the neck and the femoral in the leg – for each decade of use.

A slow build-up of plaque, made up of fat, cholesterol, calcium and other material, on the inside of artery walls can lead to atherosclerosis, when the arteries harden and narrow.

“The main concern is if you have higher plaque levels that you might develop a clot on one of these plaques and have a stroke or a [heart attack] or sudden cardiac death,” says Rietzschel.

“That’s the main risk with having plaque, with having atherosclerosis.”

Women who take the pill long term can take other steps to cut their risk of cardiovascular disease, he says, like eating a healthier diet, getting more exercise, not smoking and controlling cholesterol.

“There are other ways of doing contraception. Oral contraception is not the only possibility,” he says.

Dr Gordon Tomaselli, a Johns Hopkins University cardiologist and American Heart Association official, says he is surprised by the findings.

“It’s a bit eye-opening, I think,” says Tomaselli.

He says the findings need to be factored into the equation for women deciding whether to take the pill.

“What would I tell my daughter to do? I might suggest maybe not oral contraception,” Tomaselli says.

A wave of heart disease?

Rietzschel says the findings may indicate that there could be an upswing in heart disease among women who have taken the pill, considering that those who began in the 1960s were now reaching a peak age for such illness.

“We might be at the foot of a wave. But the wave might be a small ripple,” he says.

Many studies have looked at the medical consequences of using the pill. For example, experts say cigarette smoking raises the risk of serious side-effects, including heart attacks, blood clots and strokes.

But this is the first study to suggest atherosclerosis as a side-effect.

“We thought that once you stopped using oral contraceptives, the risk of clotting went away. That would seem to be too simplistic a view now,” Rietzschel says.

But at a conference for leading doctors, British scientists said they have found that for healthy people taking aspirin does not significantly reduce the risk of a heart attack.
At the same time they found it almost doubles the risk of being admitted to hospital due to internal bleeding.

The findings show that for otherwise healthy people the risks of taking aspirin outweigh the benefits. The doctors stressed that patients who had already suffered a heart attack should continue to take the drug.

It has been suggested that aspirin could be included in a so-called ‘polypill’ with an anti-cholesterol statin and a blood pressure drug which could be taken by everyone aged over 50.

Experts said substantial numbers of ‘worried well’ take aspirin as a ‘just in case’ measure believing that because it has been around for such a long time it is completely safe.

The results of a study carried out in Scotland and presented at the European Society of Cardiology Congress in Barcelona has added to the growing evidence that the risks outweigh the benefits for healthy people.

Prof Gerry Fowkes of the Wolfson Unit for Prevention of Peripheral Vascular Disease in Edinburgh, said: “Our research suggests that aspirin should not be prescribed to the general population at this stage.

“Aspirin probably leads to a minor reduction in future events but the problem is that has to be weighed against an increase in bleeding. Some of that bleeding can be quite serious and lead to death.”

Prof Peter Weissberg, Medical Director of the British Heart Foundation, which part-funded the study, said: “A lot of the worried well buy a small dose of aspirin over the counter not understanding that they are increasing their risk substantially of a major bleed.”

He said it is known that aspirin does reduce the risk of cardiovascular problems but this must be countered against the increased risk of internal bleeding.

In patients who have already had a heart attack the risk of a second is so much higher that the balance is in favour of taking aspirin.

However, for people who have not had a heart attack the risks do not normally outweigh the benefits.

Prof Weissberg added: “If you have not got clear cut vascular disease that has caused an event while it does reduce the risk (of a heart attack or stroke) that benefit is offset by a worse risk of haemorrhage and potentially fatal haemorrhage.”

In the study conducted in Scotland 29,000 men and women aged between 50 and 75 were screened to see if they had furred arteries in the legs, which means they are at high risk of developing heart disease but do not yet have symptoms.

More than 3,000 men were randomly assigned to receive a daily dose of aspirin or a dummy pill and were followed up for an average of eight years.

There was no difference in the rate of heart attacks or stroke between the two groups and deaths from any cause were similar.

However there were 34 major bleeds in people taking aspirin, or two per cent, compared with 20 or 1.2 per cent of those on the placebo.

He said the tablets were only taken 60 per cent of the time during the trial which reflects real life experience in people who have not had a heart attack.

He said in secondary prevention, where people have already had one attack and are trying to prevent a second one, compliance is usually better.

Earlier this year Oxford scientists found that although aspirin could cut the chances of a heart attack in patients who had never suffered one by a fifth, it also increased the risk of stomach bleeding by a third.

Nick Henderson Executive Director of the Aspirin Foundation said: “Aspirin use to prevent primary cardiovascular events is only appropriate where individual patients are considered by their doctor to be at special risk from particular factors such as obesity, lifestyle, stress and a familial history.

“The Aspirin Foundation continues to counsel individuals always to seek medical advice before embarking on a self medication prophylactic regime with Aspirin for whatever reason.

“Medical advocates of prophylactic Aspirin in the absence of previous cardiovascular events accept that potential benefits should be weighed against potential risks such as the bleeding demonstrated in the study by Professor Fowkes.”

By Rebecca Smith, Medical Editor in Barcelona

http://www.telegraph.co.uk/health