Aspirin May Not Prevent Stroke in Those Already at Risk
Posted by Serena Gordon, HealthDay Reporter
In the first study, taking a daily, low-dose aspirin did little to ward off first strokes or heart attacks in people who smoked, or had high blood pressure or high cholesterol.
Meanwhile, a second set of studies discovered the news was just as grim for those with diabetes, as a higher risk for serious bleeding canceled out a modest benefit.
And for those diabetics who might turn to fish oil supplements in lieu of aspirin, those also failed to help guard against heart dangers.
“Aspirin has been our ‘go-to;’ it’s cheap and easy to get. But the benefit here was negated by the bleeding (in the diabetes study),” said Dr. James Catanese, chief of cardiology at Northern Westchester Hospital in Mount Kisco, N.Y. “We may need a better blood thinner.”
In the first study, researchers led by Dr. J. Michael Gaziano, a preventive cardiologist at Brigham and Women’s Hospital in Boston, followed more than 12,500 participants who took either 100 milligrams of aspirin or a placebo every day. All had some other risk factor for possible heart trouble.
After five years, the rate of events such as heart attack and stroke were virtually equal in both groups—269 patients (4.3 percent) in the aspirin group and 281 patients (4.5 percent) in the placebo group. The study was funded by Bayer Co. and published Aug. 26 in The Lancet.
In the diabetes research, which was reported by British researchers as two studies in the Aug. 26 issue of the New England Journal of Medicine, people with diabetes were randomly chosen to follow one of four treatments.
One group received 1 gram of fish oil and 100 milligrams of aspirin daily. Another group received fish oil and a placebo instead of aspirin. The third group was given a placebo (filled with olive oil) for fish oil and received active aspirin. The final group received two placebos.
The average follow-up time was nearly 7.5 years. During that time, 8.9 percent of those given the fish oil and 9.2 percent of those given a fish oil placebo had serious vascular events, such as a heart attack or stroke. Death rates were also similar between the two groups. Both studies received funding from the British Heart Foundation and Bayer.
“Aspirin and fish oil are not a panacea to prevent cardiovascular disease in people with diabetes,” said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.
“My message to people with diabetes is that treating high blood pressure, abnormal cholesterol and high blood sugar from the get-go — along with healthy lifestyle changes—is important,” said Zonszein, who was not involved in the research.
Dr. Louise Bowman, who led the fish oil study, said, “Previous research has shown no benefit of fish oil supplements for other types of patients at increased risk of cardiovascular events. Our findings are in line with this, and so we don’t believe that there is any justification for recommending fish oil supplements to protect against cardiovascular events.”
She added that other studies have shown that there doesn’t appear to be a benefit to fish oil supplements for people who’ve already had a heart attack either. Bowman is a professor of medicine and clinical trials at Oxford University’s Nuffield Department of Population Health in England.
Aspirin fared somewhat better among those with diabetes. The rate of serious vascular events was 8.5 percent for people taking aspirin and 9.6 percent for those taking a placebo. That means aspirin reduced the risk of a serious event by 12 percent.
However, that good news was countered by the risk of major bleeding. Slightly over 4 percent of people taking aspirin had a major bleeding event (including bleeding in the brain, eye and digestive system). Just 3.2 percent of those taking a placebo had any serious bleeding. Aspirin increased the risk of bleeding by 29 percent, the study found.
Dr. Jane Armitage, senior author of the aspirin/diabetes study, said, “We showed clearly that aspirin reduces the risk of vascular events, including heart attacks, strokes, and mini-strokes; however, it also increased the risk of major bleeds, mainly from the GI tract, so overall there was no clear benefit.”
Armitage said the finding provides “much needed clarity” about whether or not to recommend aspirin to people with diabetes who haven’t had a heart attack. She said for people already taking known safe treatments such as cholesterol and blood pressure medicine to prevent heart disease and stroke, “there is no added benefit of taking aspirin.”
Armitage noted that aspirin is still recommended for people who’ve already had events such as a heart attack or stroke. She is a professor of clinical trials and epidemiology at Oxford University.
Catanese, who wasn’t involved in any of the studies, said he wasn’t surprised by the fish oil findings.
“I think there’s a benefit to eating fish, not just fish oil. There’s something in the food that we may not be able to put in a pill or a capsule,” he said.
Like Zonszein, Catanese recommended that people with diabetes eat a healthy diet, exercise regularly and keep good control of their diabetes to prevent heart disease. Control of cholesterol and blood pressure is also very important for people with diabetes, he said.
The findings were presented at the European Society of Cardiology annual meeting, in Munich, Germany.
Copyright © 2018 HealthDay. All rights reserved.
I hate to say it, but I really thought that I didn’t do very well. It started out with the slides. I fumbled through this:
Can you guess how old I was? (PAUSE ….Wait for someone to say 51) I was 51 years old. That is amazing; I thought it and you said it. (PAUSE) We are in synch…
But I figured I would amaze them with this:
I was a young, healthy, active, non-smoking, non-drinking- mostly non- drinking – normal cholesterol man, just like this guy! (point, Laugh)
The laughs were minimal. I didn’t know what to do!
I made a few other mistakes along the way, but they weren’t intentional. I just couldn’t remember where I was in the talk. You would think that after 500 + times, I would know where I was . Nope.
Maybe that is what they expect? I don’t know. The laughs were minimal, but I did get a standing ovation. I couldn’t believe it! Do people know what to do when they see me fumbling?? Do they think they shouldn’t laugh?
Then Jill delivered a flawless presentation …and she got only a few laughs.
But crowd that gathered around us was filled with people thanking us for sharing our faith. The talk was extremely humbling.
I will find out if I was really HORRIBLE when I speak to my contacts this week. I will let you know.
WOW…I was amazed by the kind words of the people attending. They did a survey of the conference attendees…and this is what they said. I included “Gordon and Jill Viggiano were excellent” only one time because it was said by SO MANY people:
It was all good, but the Viggiano’s personal story of overcoming his stroke really drove home the importance of what we do. Very moving!
Behavioral Economics, Brain Has a Hole In It
Gordon and Jill Viggiano were excellent! (A lot of people said this!)
Great presentation. Inspirational.
Amazing story; very inspiring!
The general session with the Viggiano’s was incredible.
Spoke greatly to my day to day in communicating the importance of a DI policy.
Very inspiring. Good choice to have someone speaks who has benefited from one of our products.
Amazing and inspiring story!!
I am going through something similar with my husband so this hits home. I’m going to share the info with him.
Very thought provoking! Thank you.
Thank you for sharing your story and vulnerability. It’s a poignant reminder of why we do the work we do.
Such a powerful story! I enjoyed both aspects. Nobody is immune so being protected is so important.
Very moving and it tells as excellent story as to why insurance is so important.
Very inspiring. Good choice to have someone speaks who has benefited from one of our products.
Very inspiration, touching and motivating. People with different abilities can still be contributing members of society and Gordon is living proof. Never give up! You both are amazing! I’m glad you had the disability coverage to help you financially. Keep the faith and continue to inspire others!
This was a wonderful presentation!
I felt good after my speech, but I always wonder how people feel about me sharing my faith. I received this email:
Gordon and Jill it was a wonderful honor and blessing to hear your story and meet you in San Diego. Thank you very much for your strength and perseverance. I started reading your book last night and got to the section about day 8 post stroke. I’m looking forward to the rest of the story. As I mentioned when I met you, thank you for sharing your faith and being strong witnesses. It’s always encouraging to see God’s love at work in the lives of others. May God continue to richly bless you and your son and daughter. Best wishes for continued success! –
I kicked off Day 2 of the Supplemental Health , DI & LTC Conference. Afterwards, I got ANOTHER standing ovation.
I know what you are thinking. I you are going to keep getting standing ovations, what don’t you hire a photographer to capture that. The answer: I don’t know. As they were standing, I thought “We should be capturing this.” But then I didn’t do anything but SMILE. I have a picture of me smiling:
Fortunately, Stephanie Turgeon took a picture of me:
My friend, Jake French, Introduced my to Roni Sasaki. She does interviews with people like Jake who have gone through the unimaginable but have come back with a strong purpose. Although my experience is VERY different, Jake thought that it would be of interest to her listeners. After listening, please tell me your impression??
* The word OUR really means Jill!!!
A Leg Up On Life by Roni Sasaki
For more info about Roni, please click here
In preparing for my speech next week, the person asked how I would like the stage to be set up. This should straight forward, right? So I wrote the following:
I would like a laptop on the table with plugs for the sound system.
What am I talking about? 10 years after my stroke, I STILL have trouble with this. So I asked Jill to help me. Effortlessly, she said:
I need a podium to stand at so I can read my speech from my iPad. A lapel microphone is important so I can move around a little. Nearby, I will need a table that can hold my laptop. With that, I can see what is on the screen behind me and advance the slides. Also, my laptop needs to plug into the projector and the sound system.
Holy cow…my sentence did NOT give what I needed…even though I have given this speech over 500 times! You would think I would know that and have a work around?
When I go over my set up with the client, I have a checklist of what I need. But this time someone different ASKING me what I need again…. it is very tough to say without going through my checklist. So, I tried to say it…with funny results. Now, I have it ….just in case anyone asks!
Sergio Marchionne, 1952-2018
Sergio Marchionne, the former head of Fiat Chrysler Automobiles who died Wednesday at age 66, will be remembered as one of the auto industry’s transformational figures.
An automotive outsider groomed as an accountant and financial officer, Marchionne engineered the merger of Fiat and Chrysler in 2009. By the time he was replaced as CEO by Jeep chief Mike Manley in a hastily called board meeting Saturday, Marchionne had revived the fortunes of both companies as a growing, international conglomerate encompassing 10 brands under the corporate umbrella Fiat Chrysler Automobiles LLC.
“His unbelievable turnaround left Fiat so much healthier than when he found it,” says Jeremy Acevedo, manager of industry analysis for Edmunds. “He’ll be remembered as one of the early 21st-century’s great auto leaders along with Alan Mulally and Elon Musk.”
The holding company of Fiat’s founders, the Agnelli family, announced in a statement of Marchionne’s death due to complications from surgery in Zurich.
“Unfortunately what we feared has come to pass,” Fiat heir John Elkann said. “Sergio Marchionne, man and friend, is gone. I believe that the best way to honor his memory is to build on the legacy he left us, continuing to develop the human values of responsibility and openness of which he was the most ardent champion.”
Bill Ford, executive chairman of Ford Motor Company, said Marchionne was an admired industry leader.
“Sergio Marchionne was one of the most respected leaders in the industry whose creativity and bold determination helped to restore Chrysler to financial health and grow Fiat Chrysler into a profitable global automaker,” he said in a statement. “His extraordinary leadership, candor and passion for the industry will be missed by everyone who knew him.”
Noted for a minimalist wardrobe that seemed limited to a closet full of black sweaters, Marchionne was as colorful as his sartorial taste was monochromatic.
“He was well-known for his business prowess as well as his disdain for suits and neckties,” says Rebecca Lindland, senior auto analyst at Kelley Blue Book.
Never shy with a quip, the profane, funny, driven CEO bucked industry trends and questioned industry traditions.
He famously said of the Fiat 500e, a poor-selling electric vehicle sold in California to meet the state’s zero-emission mandates: “I hope you don’t buy it, because every time I sell one it costs me $14,000. I’m honest enough to tell you that.”
He was reticent to invest in electric vehicles at a time when competitors like General Motors Co. were rushing them to market. “Better late than sorry,” he said in 2016.
Yet, Fiat Chrysler was the first major automaker to announce a partnership with Google’s Waymo subsidiary to put hybrid, self-driving minivans on the road.
Critical of the industry business model to build lookalike, compact four-cylinder sedans, he publicly courted other automakers — most notably GM — to merge and build common automobiles to save costs. No competitor took him up on the offer.
A quick study
Marchionne’s family crossed the Atlantic from Italy to Toronto, Canada, in 1965 when Sergio was 13 years old.
After graduating from the University of Toronto with a degree in philosophy, the ambitious Italian-Canadian citizen added a bachelor of commerce degree and MBA from the University of Windsor, and a law degree from York University in Toronto.
He spent the 1990s working in financial positions with a series of international corporations culminating in his first chief executive appointment at Swiss aluminum company Algroup in 1997. In 2002 he became CEO of Geneva’s SGS, a Forbes Fortune 2000 company that works with companies to assure products meet regulatory standards.
Two years later, the Agnelli family, which holds a controlling interest in Fiat, plucked him from Switzerland to become CEO despite Marchionne’s lack of auto industry experience. He would prove a quick study and a shrewd judge of talent.
But Marchionne’s signature move was acquiring crippled Chrysler out of bankruptcy in 2009 for no cash down and commitments to the U.S. government to meet a series of sales, engineering and technology goals in return for a controlling interest in the company.
Key to that promise was bringing Fiat’s know-how to develop a 40-mpg vehicle for Chrysler. Marchione accomplished the feat with the fuel-efficient 2013 Dodge Dart. But Marchionne had his eyes on a bigger prize: unlocking the international potential of Chrysler’s Jeep brand at a time when consumers were moving toward SUVs.
“He saw the pendulum swinging away from cars and towards SUVs,” says Edmunds’ Acevedo, who notes that Maserati and Alfa Romeo also expanded their SUV offerings under Sergio’s watch. “He had the grit to make the hard decisions.”
By 2014 Jeep’s international sales crested 1 million for the first time under the leadership of Mike Manley, who Marchionne had brought in to run the off-road brand and who ultimately succeeded an ailing Sergio as CEO on July 21.
By 2016, Jeeps sales were 1.4 million globally, increasing four-fold in the U.S. alone over 2009.
Also upon assuming control of Chrysler, Marchionne spun off Ram from Dodge as a stand-alone truck brand, remade Dodge as a performance icon and re-introduced Alfa Romeo to the U.S. as a luxury automaker.
“He understood the legacy of a brand like Jeep, but at the same time he could bring back an old brand like Alfa,” says KBB’s Lindland. “He had the discipline of an accountant and the creativity of an entrepreneur.”
Marchionne’s tenure was not untouched by trouble.
Seven people have pleaded guilty in a widening corruption scandal involving Fiat Chrysler and the United Auto Workers union. Federal prosecutors describe a pattern of company officials funneling illegal payments to UAW leaders through a joint training center. The case already has ensnared former Fiat Chrysler executive Alphons Iacobelli and Monica-Morgan Holiefield, widow of former UAW Vice President General Holiefield.
Federal prosecutors say the automaker conspired with the UAW from before 2009 through 2015 to violate the Labor Management Relations Act. The law prohibits employers or those working for them from paying, lending or delivering money or other valuables to officers or employees of labor organizations — and from labor leaders from accepting such items. Prosecutors allege that Iacobelli and at least four other unnamed Fiat Chrysler officials were funneling more than $1.5 million worth of illegal payments to UAW officials.
Marchionne was questioned during a private meeting in July 2016 with the U.S. Attorney’s Office in Detroit, sources familiar with the investigation said. He was escorted to the meeting by his white-collar criminal-defense lawyer. Marchionne had not been charged with a crime during the ongoing federal grand jury investigation.
The automaker also faced allegations it cheated on pollution testing for diesel engines.
In May 2017, Fiat Chrysler said it would modify around 104,000 diesel vehicles after the U.S. Justice Department sued the the automaker, accusing it of illegally using software in diesel-powered Jeep Grand Cherokees and Ram 1500 pickups sold since 2014 to mask true pollution levels during testing. Court filings in May 2018 cited emails that diesel engine subsidiary VM Motori knew as early as 2010 that an auxiliary emissions control device would be illegal if concealed from regulators.
Marchionne’s bold plans were laid out in public five-year plans beginning in 2010 with the CEO and his team telegraphing their product moves in the normally secretive auto industry.
The ambitious plans sometimes fell short, yet Marchionne would reboot five years later with another five-year salvo.
“He was a very plain-spoken person,” says Lindland. “He was a risk-taker but also able to motivate his team to take those risks with him.”
Fiat Chrysler got an infusion of cash by spinning off Ferrari in 2015 in an IPO valued at over $12 billion. With its 9 percent stake in the prancing horse, Chrysler made off with nearly $1 billion. By the end of 2017, Fiat Chrysler’s net profit had doubled over the previous year with the company predicting its profits would outrun Ford by the end of 2018.
Presiding over a final four-year-old plan in Milan in June, Marchionne celebrated the impending elimination of the company’s industrial debt by ditching his signature sweater for a tie. He also laid plans to turn over a company radically different from the one he had inherited 13 years earlier — its namesake Fiat and Chrysler brands a shadow of their former selves, and American and luxury SUVs carrying the sales load.
“He has left FCA in a good place,” says analyst Lindland. “It will be interesting to see if Manley and his executive team can protect his legacy. Can they execute his five-year plan?”
She added: “They have large sweaters to fill.”
Henry Payne is auto critic for The Detroit News. Find him at firstname.lastname@example.org or Twitter @HenryEPayne.
Posted by Lynn Bronikowski
Spending time outdoors and enjoying nature has wide-ranging health benefits, including lower blood pressure and reduced cardiovascular disease, according to a global study.
That’s the word from researchers at the University of East Anglia in Norwich, England, who say exposure to greenspace reduces the risk of type II diabetes, cardiovascular disease, premature death, pre-term birth, stress, and high blood pressure. Diabetes and high blood pressure are leading causes of stroke.
“Spending time in nature certainly makes us feel healthier, but until now the impact on our long-term wellbeing hasn’t been fully understood,’ said Caoimhe Twohig-Bennett, lead author from UEA’s Norwich Medical School. “We gathered evidence from over 140 studies involving more than 290 million people to see whether nature really does provide a health boost.”
The research team studied data from 20 countries including the UK, the U.S., Spain, France, Germany, Australia and Japan—where Shinrin yoku or “forest bathing’”is a popular practice.
“Green space” was defined as open, undeveloped land with natural vegetation as well as urban greenspaces, which included urban parks and street greenery. The team analyzed how the health of people with little access to green spaces compared to that of people with the highest amounts of exposure.
“People living near greenspace likely have more opportunities for physical activity and socializing,” said Twohig-Bennett. “Meanwhile, exposure to a diverse variety of bacteria present in natural areas may also have benefits for the immune system and reduce inflammation. “Forest bathing is already really popular as a therapy in Japan—with participants spending time in the forest either sitting or lying down, or just walking around. Our study shows that perhaps they have the right idea.”
Study co-author professor Andy Jones of UEA, added, “We often reach for medication when we’re unwell but exposure to health-promoting environments is increasingly recognized as both preventing and helping treat disease. Our study shows that the size of these benefits can be enough to have a meaningful clinical impact.”
The research team hope that their findings will prompt healthcare professionals to recommend that patients spend more time in greenspace and natural areas. “We hope that this research will inspire people to get outside more and feel the health benefits for themselves,” said Twohig-Bennett. “Hopefully our results will encourage policymakers and town planners to invest in the creation, regeneration, and maintenance of parks and greenspaces, particularly in urban residential areas and deprived communities that could benefit the most.”
The study was published in the journal Environmental Research.