Is Coffee, Aspirin & a Statin the "Breakfast of Champions"?

The FDA (Federal Drug Administration) recently announced as a result of their ongoing disagreement with Bayer Aspirin over the prophylactic benefit of Aspirin to avoid heart attacks and strokes even if the patient has a positive family history of heart disease.  The recent FDA article, Can an Aspirin a Day Help Prevent a Heart Attack?, states "Since the 1990s, clinical data has shown that in people who have experienced a heart attack, stroke or who have a disease of the blood vessels in the heart, a daily low dose of aspirin can help prevent a reoccurrence, Temple says." (A dose ranges from the 80 milligrams (mg) in a low-dose tablet to the 325 mg in a regular strength tablet.  This use is known as secondary prevention.

However, after carefully examining scientific data from major studies, the FDA has concluded that the data does not support the use of aspirin as a preventive medication by people who have not had a heart attack, stroke or cardiovascular problems- a use that is called primary prevention.  In such people, the benefit has not been established but risks such as dangerous bleeding into the brain or stomach are still present.

The number needed to treat website (theNNT.com) concurs with this data.  In summary, Aspirin to Prevent Cardiovascular Disease in Patients with Known Heart Disease or Strokes, 98% saw no benefit.  0.3% were helped by preventing a fatal heart attack, 1.3% were helped by preventing a non-fatal heart attack and 0.5% in preventing a non-fatal stroke.  For those who took aspirin daily for a year, Aspirin to Prevent a First Heat Attack or Stroke, 99.94% saw no benefit, 0% helped by avoiding a fatal heart attack or stroke, 0.05% helped by preventing a non-fatal heart attack and 0.01 were helped by preventing a non-fatal stroke.

So then we have coffee- Coffee is bad for us or is it??  The Mayo clinic published a consumer article- Coffee and health:  Is coffee good or bad for me?, The recommendation is that Coffee has a long history of being blamed for many ills from stunting your growth to claims that it causes heart disease and cancer.  But recent research indicates that coffee may not be so bad after all. 

So which is it- good, bad, ugly??  The best answer may be that for most people the health benefits outweigh the risks.

In a prior blog, I analyzed the virtues of statins with the following NNT.com data.  Statins Given for 5 Years for Heart Disease Prevention With Known Heart Disease, 96% saw no benefit, 1.2% helped being saved from death, 2.6% helped by preventing a repeat heart attack, 0.8% helped by preventing a stroke.  For patient with no known heart disease, Statin Drugs Given for 5 Years for Heart Disease Prevention, 98% saw no benefit, 0% were saved from death, 1.6% helped prevent a heart attack and 0.4% helped prevent a stroke.

 

 

The bottom line is that coffee in moderation is OK.   In the view that my daily aspirin makes me, "less creaky".   All these studies seem to change all the time with inconsistent results.  My non-scientific analysis allows me to continue my aspirin regimen without guilt.