ASPIRIN: the best NSAID
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WHICH NSAID, IBUPROFIN OR ASPIRIN?

ASPIRIN’S PRINCIPLE BENEFITS:

 

 1)      FIRST MYOCRADIAL INFRACTION 32% 

2)      CUTS COLON-CANCER DEATH RATE BY 50%

3)       BREAST CANCER 20%

4)   CESAREAN SECTION 400%

5)   LUNG CANCER 33%

6)   PANCREATIC CANCER 53%

7)   ALSHEIMER'S DISEASE 42%

8)   DIABETES CAUSED BLINDNESS, CORONARY ARTERY DISEASE, STROKE, AND KIDNEY FALURE REDUCED.

 

Laboratory studies have suggested that by inhibiting the COX-1 and COX-2 enzymes, aspirin may enhanced programmed cell death (apoptosis) and inhibit the development of blood vessels (angiogensis) that feed a tumor

FLASH (December 04), Naproxin, which has been an over-the-counter NSAID since 1976, has been shown to double the incident of coronary events (like VIOXX).  This was followed (05) by the revelation that all NSAIDs but for aspirin increase the risk of coronary events through the accelerating the development of athreoscleorsis--see last article below.  Unfortunately this research information is not widely known because of influences of the market place.  Aliv, for example is still widely prescribe

 

Second update (4/06): 

Goodman & Gilman, 11th Ed.(690):  “Although aspirin is regarded as the standard against which other drugs should be compared for treatment of rheumatoid arthritis, many clinicians favor the use of other NSAIDs perceived to have better gastrointestinal tolerability, even though this perception remains unproven by convincing clinical trials.”  {As I pointed out, most test use a coated NSAID compared to an uncoated aspirin, and often at lower therapeutic dose.--jk}

 

 

Why Take Ibuprofen

1)  it has a better reputation than aspirin among the non-medical public. 

2)     because of this doctors are more likely to proscribe ibuprofen. 

3)     it is inexpensive compared to the more exotic NSAIDS. 

4)     it works.  {NSAIDS is the Non-Steroidal Anti-Inflammatory Drugs--a family with over 20 prescription members}

 

Why Take Aspirin

1) it has been used for a longer period of time and has no major side effects other than intestinal bleeding, and this can be avoid quite effectively by taking coated aspirin, where they.

2) it costs a fraction of Ibuprofen. 

3)  those women taking aspirin regularly while pregnant have under one-forth the incident of caesarean section (5.6% versus 23.9% in a meta-study). 

4)  it lowers the incident of colon cancer approximately 50% (a retrospect study of over 600,000 people).  

5)  it lowers the incident of breast cancer

6)     it dramatically lowers the incident of heart attacks—so much so that doctors routinely recommend taking one-a-day for those who are in the high risk group.

7)     Survival rate for prostate cancer increases 

 

Gastrointestinal Bleeding

  Both Ibuprofen and aspirin cause gastrointestinal bleeding because they are chemical that are irritating and the dosages is high (325 MG or more for aspirin, 400 & 800 MG for Ibuprofen).  In one of the typical ploys to increase profits, Ibuprofen is touted as being less upsetting to the stomach and less likely to cause bleeding.  However, Ibuprofen is coated, and the comparison is to uncoated aspirin.   When comparing likes to likes (coated versus coated) there is no difference. 

 

Costs

  Aspirin can be purchased for a penny a piece in a discount store, and large pharmacies carry a low-price brand in addition to Bayer.  There is no advantage to buying a more expensive brand of acetasalasylic acid.  Ibuprofen sells for at least 10 times the price per dose when compared to those carried by a discount store.

 

Pain Relief

  In general pain diminishes over time, that even acetopmetaphin seems to work.  The family of NSAID (non-steroidal anti inflammatory drugs) is effective for pain resulting from swelling by modestly reducing swelling.  The expectations greatly exceed the reality.  They lack any effect upon the system of nerve sensor resulting in pain—an ability of the opiates.  Most pains diminish naturally within an hour—whether a drug is taken or not.

  

Ways the Two Are Essentially Equal

First, they work.  Second, they both cause stomach bleeding.  Third, on a dose basis they equally lower prostaglandins, a blood factor involved in clotting and by this mechanism they reduce blood clots and consequently the incident of strokes caused by a blood clot and heart attacks so caused.  About 85% of the strokes are a result of a blood clot and 60% of the heart attacks. 

 

But why take a drug that costs more, has not been shown to be more effective, and whose side effects have not been as carefully monitored??? 

Carefully controlled study show that all class of non-aspirin NSAIDs cause increased risk of myocardial infraction. 

 

 

ARCHIVES OF INTERNAL MEDICINE,  Vol. 165 No. 9. May 9, 2005

 

Risk of Hospitalization for Myocardial Infarction Among Users of Rofecoxib, Celecoxib, and Other NSAIDs

A Population-Based Case-Control Study

Søren P. Johnsen, MD, PhD; Heidi Larsson, MSc; Robert E. Tarone, PhD; Joseph K. McLaughlin, PhD; Bente Nørgård, MD, PhD; Søren Friis, MD; Henrik T. Sørensen, DMSc

Arch Intern Med. 2005;165:978-984.

Background  It remains uncertain if the excess cardiovascular risk of rofecoxib and celecoxib reported in clinical trials is present in routine practice and whether the use of other nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) also carries an increased cardiovascular risk. We performed a population-based case-control study to examine the risk of myocardial infarction (MI) among users of various categories of nonaspirin NSAIDs.

Methods  Using data from hospital discharge registries in the counties of North Jutland, Viborg, and Aarhus, Denmark, and the Danish Civil Registration System, we identified 10 280 cases of first-time hospitalization for MI and 102 797 sex- and age-matched non-MI population controls. All prescriptions for nonaspirin NSAIDs filled before the date of admission for MI were identified using population-based prescription databases. Relative risk estimates for MI were adjusted for a history of cardiovascular disease, hypertension, diabetes mellitus, chronic bronchitis or emphysema, alcoholism, liver cirrhosis, upper gastrointestinal bleeding, rheumatoid arthritis, systemic lupus erythematosus and the use of high-dose aspirin, platelet inhibitors, insulin or oral hypoglycemic drugs, antihypertensive drugs, lipid-lowering drugs, oral anticoagulants, nitrates, penicillamine, gold, oral glucocorticocoids, and hormone therapy before the date of admission for MI.

Results  Current users of rofecoxib had an elevated risk estimate for hospitalization for MI compared with nonusers of any category of nonaspirin NSAIDs (adjusted relative risk [ARR], 1.80; 95% confidence interval [CI], 1.47-2.21). Increased risk estimates were also found among current users of celecoxib (ARR, 1.25; 95% CI, 0.97-1.62), other cyclooxygenase-2 selective inhibitors (ARR, 1.45; 95% CI, 1.09-1.93), naproxen (ARR, 1.50; 95% CI, 0.99-2.29), and other conventional non-aspirin NSAIDs (ARR, 1.68; 95% CI, 1.52-1.85). The highest ARRs were found among new users of all examined drug categories.

Conclusions  Current and new users of all classes of non-aspirin NSAIDs had elevated relative risk estimates for MI. Although the increased risk estimates may partly reflect unmeasured bias, they indicate the need for further examination of the cardiovascular safety of all non-aspirin NSAIDs.


Author Affiliations: Department of Clinical Epidemiology, Aarhus Hospital, Aarhus University Hospital, Aarhus, Denmark (Drs Johnsen, Nørgård, and Sørensen and Ms Larsson); Center of Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark (Dr Johnsen); International Epidemiology Institute, Rockville, Md (Drs Tarone and McLaughlin); Department of Medicine, Vanderbilt University Medical Center, Vanderbilt-Ingram Cancer Center, Nashville, Tenn (Drs Tarone and McLaughlin); and Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark (Dr Friis).

 

 

From Harvard Health Publications at www.health.harvard.edu,

 

Harvard journal draws same conclusions as above article.

 

Painkillers — new and old — increase the risk for heart attack, from the Harvard Heart Letter

BOSTON — Cardiovascular side effects aren’t limited to the use of the newer painkillers called COX-2 inhibitors — a category that includes Celebrex and the recently discontinued Vioxx and Bextra. Old standbys, like ibuprofen and aspirin, aren’t entirely blameless, reports the October 2006 issue of the Harvard Heart Letter. The cardiovascular risks associated with traditional NSAIDs are small, but worth being aware of.

Ibuprofen, aspirin, and COX-2s all belong to the class of medicines called nonsteroidal anti-inflammatory drugs (NSAIDs). Most of them boost blood pressure and can counteract the effect of some blood-pressure drugs. They can also impair blood vessels’ ability to relax and may stimulate the growth of smooth muscle cells inside arteries.  All these changes can contribute to the artery-clogging process known as atherosclerosis.

Researchers have determined that use of a COX-2 inhibitor increases the chances of having a heart attack. Vioxx, which was taken off the market because of possible heart complications, may lead to or worsen heart failure — but so can traditional NSAIDs. In general, cardiovascular side effects are most likely to happen in people with existing heart disease or those at high risk for it.

It is very easy to take the safety of medications for granted, and sometimes we get a harsh reminder that even FDA-approved medications carry risks as well as benefits. Take, for example, the story of the pain relievers Vioxx and Bextra. These COX-2 specific nonsteroidal anti-inflammatory drugs (NSAIDs) were withdrawn from the market after being linked with cardiovascular problems. Now it turns out that even some of our old standby NSAIDs aspirin and ibuprofen carry some cardiovascular risks you should be aware of. This issue of HEALTHbeat explains these new concerns and who may be at particular risk.—Nancy Ferrair, Managing Editor of Harvard Health Publications. 

 

Unfortunate most doctors still are unaware that all NSAIDs promote the development of atherosclerosis—the one exception being ASPIRIN. The problem lies with the 800 pound guerrilla (big PHARMA) dominating the dissemination of medical information.  The new letter failed to address the fact that the only health risk associated from aspirin or stomach bleeds and those associated with reduced ability to form blood clots.  However this reduced ability also lowers the risk of myocardial infractions.--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.