Update March 2019
Daily Low-Dose Aspirin No Longer Recommended by Doctors, if You’re Healthy New York Times
The American College of Cardiology and American Heart Association released the new guidelines
Association of Aspirin Use for Primary Prevention With Cardiovascular Events and Bleeding Events – A Systematic Review and Meta-analysis
JAMA. 2019;321(3):277-287. doi:10.1001/jama.2018.20578
It is amazing that more than half of seniors have been indoctrinated into taking daily aspirin which there is so little benefit while increasing chance of bleeding by 40%
- Risk of Cardiac failure reduced 20 percent by 800 IU of vitamin D and Calcium – meta-analysis July 2014
- 50X more reduction by taking a small amount of Vitamin D than aspirin ( 20%/0.4%)
- Heart Failure and Vitamin D meta-analyses - 2016, 2019
- Chronic Heart Failure improved with 4,000 IU daily for a year – RCT April 2016
Cardiovascular category starts with the following
- Overview Cardiovascular and vitamin D
- Hypertension and vitamin D
- Overview Metabolic Syndrome and vitamin D
- Overview Stroke and vitamin D
- Peripheral arterial disease risk is 1.5X higher if low vitamin D – meta-analysis March 2018
- Peripheral Arterial Disease 3.7 X more likely in diabetics with low vitamin D – June 2019
- Heart attack ICU costs cut in half by Vitamin D – Oct 2018
- Heart Failure and Vitamin D meta-analyses - 2016, 2019
- Cardiovascular death 1.5X more likely if less than 20 ng of Vitamin D – 22nd meta-analysis Nov 2019
- Vitamin D supplementation reduces many Cardiovascular Disease markers– meta-analysis July 2018
- Cardiovascular Prevention with Omega-3 (finally using high doses) – Sept 2019
- Higher Omega-3 index (4 to 8 percent) associated with 30 percent less risk of coronary disease (10 studies) July 2017
A poor Vitamin D Receptor can block Vitamin D in blood from getting to tissues
- Heart Failure 15X more likely if poor VDR, even if good level of vitamin D (China) – March 2019
- Coronary Artery Disease without diabetes 5 times more likely if VDR gene problems – meta-analysis May 2016
- Cholesterol is needed to produce both Vitamin D and Cortisol
- Overview Cholesterol and vitamin D
- Statins and vitamin D statins often reduce levels of vitamin D
- Statin side-effects are reduced by Vitamin D – US patent Application – April 2019
Proof that Vitamin D Works has the following
|Cardio Problem|| Treat|
by Vitamin D
|RCT = Randomized Controlled Trial |
* = link to additional RCT
CT = Clinical Trial
|Cardiovascular after attack||T||32 % fewer deaths||CT 1000 IU|
|Congestive Heart Failure||T||90 %||RCT, 1000 IU infants (also: Adults, not RCT)|
|After Heart Attack||T||+6% ejection fraction||RCT, 800,000 IU one time|
|Amount per pill to reduce heart problems||81 mg|| 1.25 mg|
|# pills to take in 2 weeks||14||1 (can add powder to food/drink)|
|Approx cost for 2 weeks||15 cent||22 cents|
|Reduction in Heart problems||0.4%||20%|
|Increased bleeding||40%||0 %|
Sean L. Zheng, BM, BCh, MA, MRCP1,2,3; Alistair J. Roddick, BSc3
- Question What is the association of aspirin use with cardiovascular events and bleeding events in individuals without cardiovascular disease?
- Findings In this meta-analysis of 13 trials with 164 225 participants without cardiovascular disease, aspirin use was associated with a lower risk of cardiovascular events, defined as cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke (hazard ratio [HR], 0.89; absolute risk reduction, 0.38%) and an increased risk of major bleeding (HR, 1.43; absolute risk increase, 0.47%).
- Meaning In individuals without cardiovascular disease, the use of aspirin was associated with a lower risk of cardiovascular events and an increased risk of major bleeding.
Importance The role for aspirin in cardiovascular primary prevention remains controversial, with potential benefits limited by an increased bleeding risk.
Objective To assess the association of aspirin use for primary prevention with cardiovascular events and bleeding.
Data Sources PubMed and Embase were searched on Cochrane Library Central Register of Controlled Trials from the earliest available date through November 1, 2018.
Study Selection Randomized clinical trials enrolling at least 1000 participants with no known cardiovascular disease and a follow-up of at least 12 months were included. Included studies compared aspirin use with no aspirin (placebo or no treatment).
Data Extraction and Synthesis Data were screened and extracted independently by both investigators. Bayesian and frequentist meta-analyses were performed.
Main Outcomes and Measures The primary cardiovascular outcome was a composite of cardiovascular mortality, nonfatal myocardial infarction, and nonfatal stroke. The primary bleeding outcome was any major bleeding (defined by the individual studies).
Results A total of 13 trials randomizing 164 225 participants with 1 050 511 participant-years of follow-up were included. The median age of trial participants was 62 years (range, 53-74), 77 501 (47%) were men, 30 361 (19%) had diabetes, and the median baseline risk of the primary cardiovascular outcome was 9.2% (range, 2.6%-15.9%). Aspirin use was associated with significant reductions in the composite cardiovascular outcome compared with no aspirin (57.1 per 10 000 participant-years with aspirin and 61.4 per 10 000 participant-years with no aspirin) (hazard ratio [HR], 0.89 [95% credible interval, 0.84-0.95]; absolute risk reduction, 0.38% [95% CI, 0.20%-0.55%]; number needed to treat, 265). Aspirin use was associated with an increased risk of major bleeding events compared with no aspirin (23.1 per 10 000 participant-years with aspirin and 16.4 per 10 000 participant-years with no aspirin) (HR, 1.43 [95% credible interval, 1.30-1.56]; absolute risk increase, 0.47% [95% CI, 0.34%-0.62%]; number needed to harm, 210).
Conclusions and Relevance The use of aspirin in individuals without cardiovascular disease was associated with a lower risk of cardiovascular events and an increased risk of major bleeding. This information may inform discussions with patients about aspirin for primary prevention of cardiovascular events and bleeding.
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