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VIOXX, brothers, PROFITS: the aspirin alternatives



In their rush for profits, drug companies seek to replace the safe, cheap aspirin with exotic, different pathways, expensive products, such as VIOXX.  However, no one yet has presented clear and convincing evidence that their product works better than aspirin.   For FDA approval, all that needs to be shown is that their drug, using the manufacture’s research, provides statistically significant results—there is no requirement for greater benefits or greater safety.  Aspirin in this case results is superior to Ramipril, and coated aspirin is among the safest drugs on the market.  (Drug companies compare their coated product to uncoated aspirin to show an increased risk of stomach bleeding.)


Doctors have been condition by manufacturers and patients to provide the latest, cutting-edge drugs.  For this reason most of them will write a script for a potentially dangerous drug rather than recommend the safe, over-the-counter alternative.   Ask your doctor to direct you to a study which shows that the drug he wants to prescribe works better than aspirin.  Also mention its proven cancer reductions--jk 



Drug Reduces Cardiac Arrest by 21 Percent
It's of real value to those at high risk of heart attack or stroke, study finds
News flash 12/4:  Naproxin, the popular over-the-counter NSAID (since 1976) shown to increase coronary events 50%

by Robert Preidt | Sep 08 '04 

The drug ramipril cuts the rate of sudden cardiac death and nonfatal cardiac arrest by 21 percent in people at high risk of heart attack or stroke.

That's the conclusion of a Canadian study in the Sept. 7 issue of Circulation.

Ramipril is an angiotensin-converting enzyme (ACE) inhibitor, a class of drugs often used to treat heart failure or left ventricular systolic dysfunction. But none of the patients in this study had either condition, the study authors noted.

The researchers analyzed data on 9,297 men and women, average age 66, at high risk for heart attack or stroke who enrolled in the Heart Outcomes Prevention Evaluation (HOPE) study. They were randomly assigned to take either ramipril, vitamin E or a placebo.

After an average of 4.5 years of treatment, 3.3 percent of the people taking ramipril had suffered either sudden cardiac death or nonfatal cardiac arrest, compared to 4.2 percent of those taking the placebo. There was no significant difference in the outcomes between those taking vitamin E and those taking the placebo.

Previous studies also found similar protective effects for other ACE inhibitors.

"The new findings should remind physicians of the importance of ACE inhibitor therapy. We now know that these drugs are not only good in preventing overall cardiovascular death, but also in preventing specific causes of death," study lead author Koon K.Teo, a professor of medicine at McMaster University in Hamilton, said in a prepared statement.

The study received funding from Aventis Pharma Inc., which manufactures ramipril.

More information

The American Heart Association has more about heart attack.


These trials involved 10,859 patients, and the weighted overall effect was:

23% reduction by aspirin (P < 0.0001)

Each of these early trials suggested a beneficial effect of aspirin, but the results of none achieved an acceptable level of statistical significance. Overall, however, there is clearly convincing evidence of benefit.

The reporting of overviews of the results from all relevant published trials relating to a particular clinical intervention is becoming increasingly common throughout clinical practice and the first such overview, or meta-analysis, based on these six trials was presented by Richard Peto and his colleagues of Oxford to the inaugural meeting of the Society for Clinical Trials in Philadelphia in 1980.(31)

This overview was one strand in the thinking that led eventually to the setting up of the Cochrane Collaboration, the worldwide initiative that aims to conduct overviews within every area of clinical activity. (32)

Since that first report, the Oxford group have produced several monumental overviews of aspirin and cardiovascular disease: in 1988 (33) ,1994 (34). and 1997 (35).

The following is based on the overview published in 1994, which combines results from 145 RCTs, with a total of 102,459 patients and 10,943 outcome events. A remarkably consistent reduction in vascular events is demonstrated (22 to 32%).

An overview of RCT's of aspirin and cardiovascular disease

(BMJ 1994;308:81-106) 

BMJ is the British Journal of Medicine, one of a small group of top rated medical journals.--jk


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Disclaimer:  The information, facts, and opinions provided here is not a substitute for professional advice.  It only indicates what JK believes, does, or would do.  Always consult your primary care physician for any medical advice, diagnosis, and treatment.