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At first, we were a little concerned about our recommendations regarding aspirin, after a study on the prevention of aspirin and heart disease was published online in The Lancet. Newspapers said the results showed that taking a low-dose daily aspirin was not helpful in protecting you from heart disease. An example: "Study: Daily aspirin does not prevent the first heart attack."
But after reading the actual study – not the newsletters – we discovered that the headlines should have said, "The study shows that aspirin does not prevent the first heart attack unless it be taken as indicated. "
So, here's how we think you should talk to your doctor about the need to take or continue to take low dose aspirin to prevent a first heart attack or stroke – and to help you. other health problems.
To be clear, there is a preponderance of data that shows people – especially men over the age of 40 who do not practice extreme sports and women over the age of 50 – who take a low dose of medication. aspirin or more per day. So, in the morning and evening, the risk of nine cancers decreases by 10 to 40%, including breast cancer, colon, esophagus, rectum and more, and 10 to 35% of heart attacks or recurrent strokes.
The study in question: The study ARRIVE (Aspirin to reduce the risk of initial vascular events), presented as a vacuum-debunker, only needs members of the aspirant group (more than 6,200 people from Germany, from Italy, Ireland, Poland and Spain). , the United Kingdom and the United States) to do it 60% of the time – and many of them have not even managed to do it! The researchers admit that some people in the control group supposedly did not take aspirin did it.
In total, out of about 12,550 people who were randomly assigned to the aspirant or non-aspirant group, only 7,800 actually did what they were supposed to do! (Men were 55 years of age and older and had two risk factors for coronary artery disease, such as high LDL cholesterol or hypertension, women aged 60 and over, and three risk factors.)
But that's not the whole story.
Among patients in the ARRIVE study who took the prescribed dose of 100 mg of aspirin daily, there was a 47% reduction in initial or initial heart attacks! Aspirin had significant benefits. Obviously, being a bit compulsive about taking your medications, in this case aspirin, is a very, very good thing.
More Evidence: ARRIVE results were released the same day that the ASCEND study confirmed that taking aspirin daily prevents primary vascular events (first heart attack or stroke) in people with diabetes . For the 30.3 million Americans with diabetes – and we say the extra 69.7 million of prediabetes – it is possible to alter the risk of heart disease (the # 1 killer of diabetics). they take 100 mg of aspirin a day.
So, what is the real story? We continue to recommend (if your doctor says it's okay) to take an 81 mg aspirin twice a day with half a glass of hot water before and after, as long as you do not practice extreme sports or recreational drugs and some prescription drugs or who have medical problems, such as uncontrolled liver or kidney disease, which decrease the benefits of aspirin or increase its risks.
Be careful, stop and start! It is risky to start taking aspirin regularly and then forget about more than one dose (which participants at ARRIVE apparently did). If you do this, you will trigger an increase in the rebound in the coagulation. (A rebound also occurs in cholesterol levels if you miss more than two doses of statin and if you miss blood pressure if you skip your antihypertensive medications.) This rebound increases the risk of heart attack and stroke cerebral.
So, if you are a man of 40 years or older and a woman 50 years and older with no additional risk, and your doctor agrees, start and stick to a daily aspirin regimen.
Lester G., Columbus, Ohio
A: Yes, there are new guidelines or a realignment of the guidelines. There are a few things you and your wife need to talk to your endocrinologist.
The big change is that physicians are asked to address their type 2 diabetes care plan by starting with an assessment of the heart health of each diagnosed patient, as cardiovascular disease (heart attack and stroke) is the number one cause of death in diabetics. . While metformin remains the first-line treatment recommended for type 2 diabetes, there are two types of therapies that are becoming the drug of choice for long-term management of heart health and blood glucose: cotransport sodium-glucose-2 (SGLT2) ) glucagon-like peptide-1 receptor (GLP-1) inhibitors and agonists.
A warning: the Food and Drug Administration has issued a warning on SGLT2 inhibitors because from March 2013 to May 2018 they found that five women and seven men had been hospitalized (a case of necrotizing genital fasciitis) . bacteria) because of the medication. (1.7 million people received prescriptions for SGLT2 inhibitors in 2017). In the future, a warning label will be affixed to the medication. So, ask the doctor what are the risks and benefits for your woman.
As for the focus on cardiovascular health, it's great. But that does not only depend on drugs! She should make sure to get 10,000 steps a day, lose 10% of her weight if she is overweight, avoid all added sugars and syrups, saturated and trans fats and highly processed foods. You can reverse type 2 diabetes by adopting a healthy lifestyle. None of you will have to worry about the potential side effects of type 2 diabetes medications.
Q: My husband and I weigh about the same, are both 45 years old and about the same height and weight (5 feet, 8 inches and 150 pounds). Should we eat the same types and quantities of food?
Shirley D., St. Joseph, Mo.
A: Size and weight are not the only criteria that determine the amount and foods to eat. Your nutritional needs are also influenced by your activity level, age, and gender.
Are you active? While a 45-year-old sedentary woman who measures 5 feet 8 inches and weighs 150 pounds can burn 1,934 calories a day or less, an active woman with the same stats can consume 2,445 calories and maintain her weight. (An active man with the same statistics – 2,752 calories). So you want to adapt what you eat to your level of activity and your desired weight.
Are you in perimenopause or in menopause? This often leads to weight gain. So, you want to change what and when you eat. Smart steps: wait 13 hours or more between dinner and breakfast; eat a breakfast containing lean protein, fresh fruit and 100% whole grains; and never dine (light and lean) after 8 pm
Are you happy? A study published in Nutritional Neuroscience has shown that women's brains require a diet particularly rich in nutrients to achieve maximum happiness and mental health. As men and women have evolved, their brains have developed anatomical and functional differences that influence susceptibility to mental illness. The bottom line is that "women need a wider range of nutrients to support their mood than men," and many do not get them. According to the researchers, this could explain why women are more prone to depression and anxiety than men.
It is therefore important that women (and men too!) Avoid highly processed foods, added sugars and additives that can alter intestinal bacteria and nutritional balance in the body. They must ensure that they receive foods rich in iron (especially premenopause), such as chicken, turkey, fish, kale, spinach, beans and lentils; citrus fruits rich in folate, leafy vegetables, beans and peas; dairy products, sardines, tofu and green leafy vegetables rich in calcium and fat free; and vitamin D fatty fish such as salmon and all varieties of fungi.
Contact Drs. Oz and Roizen at [email protected].
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