Bedtime aspirin could cut morning heart attack risk

The best time to take an aspirin to reduce the risk of suffering a heart attack when you wake up is at night prior to going to sleep, according to researchers involved in a new study.

Low-dose aspirin tablets are taken daily by millions of Brits who are high-risk of heart disease or other heart events as aspirin is effective at thinning the blood; meaning it is less likely to form a deadly clot.

A trial comprising of 290 heart patients found that it was more effective to take a 100mg aspirin tablet prior to going to bed instead of first thing in the morning.

The 290 participants were told to take the low-dose aspirin each morning for a duration of three months, followed by three months of taking the tablet at bedtime. Each person was monitored after each block of three months for their blood pressure and platelet levels.

Blood pressure did not seem to change according to what time the aspirin was taken, but the painkiller did manage to reduce platelet activity (a risk factor for heart attack).

Platelets are small, irregular-shaped cells that are present in the blood and form clots to prevent bleeding; for example stopping the blood flow from a wound.

However, platelet activity is usually at its highest during the morning which means you have a much bigger chance of having a heart attack either shortly prior to or shortly after waking up in the morning.

Previous studies have shown heart attacks are more common, in addition to more severe, at between 6am and midday, with up to 20% more damage to hearts during these hours.

Annually in the UK there are an estimated 103,000 people who suffer a heart attack and around 1.3 million live in the UK currently after having previously experienced one.

As previous studies have shown aspirin can reduce the risk by 10 per cent, many people who suffer with a heart attack are often advised to take a daily low-dose tablet.

Aspirin makes it more difficult for platelets to join together to form clots, as discovered in the findings by researchers at the Leiden University Medical Centre in the Netherlands, demonstrating that taking an aspirin before bedtime may help to reduce this peak period for platelet activity.

If taken before bedtime, the researchers found that aspirin could help to bring down platelet levels by up to 22 units.

Lead researcher Dr Tobias Bonten, of Leiden University Medical Centre in the Netherlands, said: “This simple intervention – switching aspirin intake from morning to bedtime – could be beneficial for the millions of patients with heart disease who take aspirin on a daily basis.”

Some British health experts stress you should not purely act on the basis on this study however.

Maureen Talbot, from the British Heart Foundation, said: “We know aspirin can be vital in reducing the risk of heart attack and stroke. Research into the best time to take a daily dose of aspirin is an interesting idea, but we would need to see much larger and longer studies before a change in practice can be recommended. For now, keep taking your daily aspirin as recommended by your doctor. If you have any concerns about your medication, talk it through with your GP.”

Think-tank want £10 prescription charges and £10 charge to see your GP

Prescription charges being increased to £10 is just one of many ideas put forth by a think-tank as a way to raise billions of pounds for financially struggling NHS services.

Reform, an independent centre-right think-tank want to raise prescription costs from the current charge of £7.85 to £10, and introduce charges to groups currently exempt from paying. The elderly and pregnant women would therefore have to pay for prescriptions with Reform’s new controversial suggestions.

In England an estimated 90% of prescriptions are dispensed free of charge, whilst Wales, Scotland and Northern Ireland have no prescription charges in place.

Prescription charges in England generate around £450 million a year, with the total government spend on prescription services standing at around £7.9 billion. However, the British Medical Association have said they believe the system is “unfair” and believe England should be like other countries in the British Isles and abolish prescription charges.

Reform say that increase of the cost of certain health services are vital though to fund improvements NHS services; surgeries opening at weekends being one example.

They say increasing prescription charges from £7.85 to £10, in addition to the cost of a Prescription Prepayment Certificate (a way for patients to obtain prescriptions in bulk to save money) rising from £104 to £120, would help to generate £134 million annually.

Reform also suggest the possibility of mimicking the French system, whereby there is a low prescription charge of £3, and only 20% of prescriptions are dispensed without charge, could raise £1.4 billion annually.

Other ways to generate money that Reform have suggested include bringing in a flat rate charge of £10 for GP consultations or £10 fines for each missed hospital appointment. They estimate this could raise £1.2 billion and £55 million a year, respectively.

Controversially, Reform also want to introduce a means-tested system for end of life care, forcing most dying patients to pay for any pain relief and nursing care they require.

Thomas Cawston, research director at the think-tank, attempted to defend Reform’s ideas, which are likely to cause outrage amongst millions of people.

He said: “The Government must find a way of generating more money for the NHS. “We currently have a system which is very generous. A lot of people who are reasonably well off wouldn’t mind paying £10 for a GP appointment on a Saturday morning, for example. Few will want to debate higher NHS charges but the funding outlook for the service makes it unavoidable. Prescription charges are the easiest route to new revenue, with exemptions for people on low incomes built in.”

Earlier in the year, a survey found that around half of GPs agree that patients should be charged for appointments, with figures of between £5 and £25 a time being put forward.

Dr Shailendra Bhatt, a GP in Hemel Hempstead in Hertfordshire, commented: “I work in a walk-in centre. The amount of people who come through the door for practically no reason at all and say “I was out and saw this sign for a walk-in centre where one can see a doctor, so I came in.” People don’t value the things if they get it cheap, worse still if they get it for nothing.”

Scientists discover gene that could lead to targeted asthma treatment

Young children with asthma may benefit from targeted treatment in the near future after US scientists discovered a ‘rogue’ gene – CDHR3 – which could be the cause of severe asthma in youngsters.

CDHR3 has been found to be particularly active within epithelial cells that line the inner surfaces of the airways. A faulty version of the gene can result in environmental triggers inducing allergic responses, the scientists found. CDHR3 is one of four genes that has been linked to the development of asthma; but the other three were already known as being associated with asthma.

The new study, published in the journal Nature Genetics involved a thorough comparison of the genetic codes, or genomes, of 3,695 Danish children and adults who have asthma. This comprised of a number of children younger than the age of six.

Data extracted children of both European and non-European ancestry was then used to replicate the findings, which are consistent with previous research suggesting other genes associated with the onset of childhood asthma are responsible for over-sensitive immune reactions.

Lead researcher Dr Hakon Hakonarson, from the Children’s Hospital of Philadelphia (Chop) in the US, said: “Because asthma is a complex disease, with multiple interacting causes, we concentrated on a specific phenotype – severe, recurrent asthma occurring between ages two and six. Identifying a risk-susceptibility gene linked to this phenotype may lead to more effective, targeted treatments for this type of childhood asthma.”

Dr Hakonarson added: “Asthma researchers have been increasingly interested in the role of the airway epithelium in the development of asthma. Abnormalities in the epithelial cells may increase a patient’s risk to environmental triggers by exaggerating immune responses and making the airway overreact. Because the CDHR3 gene is related to a family of proteins involved in cell adhesion and cell-to-cell interaction, it is plausible that variations in this gene may disrupt normal functioning in these airway cells, and make a child vulnerable to asthma.”

The researchers now hope their findings will lead to a more targeted treatment a condition which affects a staggering 5.4 million Britons; many of whom will probably be struggling in the coming months due to the fact that cold winter weather can exacerbate asthma symptoms.

Even a basic cold virus can trigger a serious asthma attack and worsen symptoms for around 90% of people with asthma and According to Asthma UK, three quarters of people with asthma blame cold for triggering their symptoms. Common symptoms are: coughing, wheezing, shortness of breath, tightness in your chest and difficulty speaking in full sentences.

Asthma UK have five important pieces of advice that are vital in controlling your asthma symptoms during the cold weather:

1. Keep taking your regular preventer medicines as prescribed by your doctor.

2. If you know that cold air triggers your asthma, take one or two puffs of your reliever inhaler before going outside.

3. Keep your blue reliever inhaler with you at all times.

4. Wrap up well and wear a scarf over your nose and mouth – this will help to warm up the air before you breathe it in.

5. Take extra care when exercising in cold weather. Warm up for 10–15 minutes and take one or two puffs of your reliever inhaler before you start.

Huge panic as new bird flu strain is found in a Taiwanese woman

A bird flu strain that health experts thought could not be contracted by humans has been detected in a woman in Taiwan.

This has now sparked panic that there could be an uncontrollable global pandemic ignited if dangerous flu symptoms are not identified at an early enough stage.

Currently, it is being downplayed as an isolated case but clearly this virus, as others have done previously, has the ability to transmit across different species.

The 20-year-old Taiwanese woman was first admitted into hospital in May of this year due to a lung infection. She was released from hospital after being treated with Tamiflu (oseltamivir) and antibiotics, according to the research published online in the journal Lancet Respiratory Medicine.

Roche’s Tamiflu reduces the severity and duration of influenza by preventing the virus from replicating within the body. It belongs to a group of medicines known as ‘neuraminidase inhibitors’.

These medicines prevent the influenza virus from spreading inside the body and so help to ease or prevent the symptoms arising from the influenza virus infection. Tamiflu came to worldwide prominence during the 2009 deadly H1N1 swine flu epidemic.

After one of the as yet unidentified woman’s throat swabs was forwarded to the Taiwan Centres for Disease Control, health experts confirmed she had the H6N1 strain of bird flu.

The patient was employed at a deli and had not apparently come into contact with any live birds, baffling investigators as to how she became infected. Numerous members of her family and friends subsequently developed flu-like symptoms, but nobody else tested positive for H6N1.

Ever since 1996 when the H5N1 bird flu strain spear in southern China in 1996, there has been a nervous tracking of its progress. After all, it has claimed the lives of over 600 people – the majority of deaths occurring in Asia.

China has been hit with various other bird flu strains to cause concern over the years, such as the H7N9 strain. There were 135 reported cases of H7N9 in eastern China between February and July of this year alone, 45 of which proved fatal. As yet though, no bird flu strains have been shown to mutate into a form that is easily transmitted among humans.

Marion Koopmans, a virologist at the National Institute for Public Health and the Environment in the Netherlands, said in a commentary accompanying the new report: “The question again is what would it take for these viruses to evolve into a pandemic strain?”

Ms Koopmans says there should be more thorough analysis of animal flu viruses and additional research into viruses that could cause a global problem. “We can surely do better than to have human beings as sentinels,” she wrote.

New guidance recommends millions more to take statins

There could soon be millions more British patients being prescribed cholesterol-lowering statins such as atorvastatin or pravastatin to safeguard against heart attack and stroke, following the publication of new guidelines in the United States of who would benefit from taking statins; the first such guidance to be released in the US in a decade.

The updated guidelines are based upon the findings of a new study conducted over four years by the American Heart Association and American College of Cardiology, who decided to ‘think outside the box’ so to speak, as to what constitutes putting someone at a risk of heart attack and/ or stroke.

The researchers, unlike many of their peers who conduct similar studies, shifted their interests away from high cholesterol and instead utilised a formula to calculate risk and looked at a person’s age, gender, race, together with certain health factors like smoking.

“This guideline represents a departure from previous guidelines because it doesn’t focus on specific target levels of LDL, or bad cholesterol, although the definition of optimal LDL cholesterol has not changed,” Dr Neil Stone, author of the report, said in a statement.

Dr Stone added: “The likely impact of the recommendations is that more people who would benefit from statins are going to be on them.”

Dr Donald Lloyd-Jones, one of the experts who help to draft the new guidelines, said: “We’ve been undertreating people who need statin therapy. Statins lower cholesterol levels, but what they really target is overall cardiovascular risk.”

More African-Americans – a demographic usually at a higher risk of stroke – could be prescribed statins in accordance to the new guidelines.

Under the guidance, there would now be approximately 44% of men and 22% of women who would be deemed suitable for taking statins – or 33 million Americans.

This is in stark contrast to previous US guidelines that meant only 15% of adults in America were recommended for statin treatment, whereby patients had to have a target set to lower their cholesterol to. These numerical targets have now seemingly been abandoned.

In creating the guidelines, the panel analysed four particular groups who they believed to need statins more than most: patients currently with heart disease, people with LDL levels of 190 or higher due to genetic risk, adults aged between 40 and 75 with type 2 diabetes and older adults with a 10-year risk of heart disease in excess of 7.5%.

Those in the panel also stressed the importance of a “diet pattern” which includes fruit, vegetables and whole grains, with all adults engaging in moderate to vigorous exercise three to four times per week.

Many of the patents on statins have expired, with significantly cheaper generic statins now available. Crestor (rosuvastatin), a statin manufactured by AstraZeneca, still remains under patent however and in 2012 alone the drug had impressive sales of $8.3bn (£5.2bn).

Statins are actually the most commonly prescribed drugs in the UK, used by almost a tenth of the population. As cholesterol is still the primary factor in the process of prescribing statins, it is worth noting that NHS guidelines state that LDL cholesterol should not be higher than 3.0 and overall cholesterol no higher than 5.0.

E-cigarettes described as life-savers – but how safe are they?

Scientists say that if all the smokers around the world converted to using e-cigarettes instead of smoking regular tobacco cigarettes, millions of deaths could be avoided.

According to public health charity Action on Smoking and Health (ASH), smoking is responsible for the deaths of around 100,000 each year just in the UK alone. Globally, 600,000 lives are lost due to secondhand smoke exposure alone.

ASH also say that an estimated 80% of deaths from lung cancer can be attributed to smoking, in addition to 80% of deaths from bronchitis and emphysema, and around 17% of deaths from heart disease can be put down to smoking.

The pros and cons of e-cigarettes were the source of discussion on Tuesday as 250 scientists, experts, policymakers and industry figures all convened for the E-Cigarette Summit at the Royal Society in London.

In the UK there are currently about 700,000 people using e-cigarettes. There are those who combine ‘vaping’, as it is usually referred to, with regular tobacco-based cigarettes, whereas others quit smoking regular cigarettes and simply use e-cigarettes.

A battery-operated e-cigarette works by vaporising a liquid solution containing nicotine. Regular cigarettes are comprised of thousands of toxic chemicals that are linked to a wide number of health problems such as many types of cancer, heart disease and stroke. Despite still containing nicotine – albeit a much lesser amount – e-cigarettes are considered substantially safer than regular cigarettes.
“Cigarettes are killing 5.4-million people per year in the world,” said health psychology professor and Cancer Research UK director of tobacco studies Robert West as he spoke to delegates.

Professor West said millions of lives could be saved each year if smokers switched to e-cigarettes and added: “The big question, and why we’re here, is whether that goal can be realized and how best to do it…and what kind of cultural, regulatory environment can be put in place to make sure that’s achieved. I think it can be achieved but that’s a hope, a promise, not a reality.”

He also commented how e-cigarettes were involved in nearly a third of all attempts to quit smoking. They are between 95% and 99% safer than regular cigarettes, yet some countries still insist on banning them. Whether or not regulation involving medicinal rules should be introduced was a hot topic for debate among the delegates, of which some voiced concerns about e-cigarettes becoming a gateway for people who have not previously smoked.

Added to the fears about e-cigarettes, is just how safe they are without necessary regulations in place. Some poorly-manufactured e-cigarettes have been reported to overheat and even combust.

ASH CE Deborah Arnott acknowledged the benefits of them for public health, but stressed there is still a certain lack of understanding about their long-term effects. She also said that perhaps worryingly, tobacco companies are buying out the major e-cigarette manufacturers.

She commented: “ASH thinks that e-cigarettes have significant potential. They are a lot less harmful than smoking. Clearly smokers find them attractive, primarily as a way of quitting and moving away from smoking, which they know will kill them. I think the jury’s out and these products need regulating because there’s a real concern that their safety and effectiveness is not guaranteed without regulation.”

Arnott added: “The tobacco companies are moving in. For them it’s potentially a ‘Kodak moment’ because if everyone moved to e-cigarettes, they’d lose their market, so they’ve got to be in there. A lot of the bigger e-cigarette companies have already been bought up. If there are carcinogens in there, you won’t see an immediate effect but 10, 15, 20 years down the line, people will be dying from that. The development of e-cigarettes is definitely running ahead of the science.”

The misunderstood mystery of the migraine

When somebody says they have a ‘migraine’, the chances are there will be those who almost dismiss their complaint as just some fancy word for headache and suggest the sufferer taking a painkiller.

However, a headache and a migraine differ in many ways and the latter is a severely debilitating condition for the estimated one in four women and one in 12 men in the UK who are affected by them on a regular basis. This equates to around 15% of adults in the UK who are suffering.

You may be surprised to learn that in fact migraine is the most common neurological condition, and the problem is actually more prevalent than epilepsy, asthma and diabetes. Migraine does not pick and choose who it targets; it can affect people regardless of age, race, culture or social class, although they are more commonly experienced by women (two thirds of sufferers are women) and attacks usually begin during teenage years.

If you are still confused as to what constitutes a migraine as opposed to merely a headache, it would be advised to understand some of the signs and symptoms of migraine.

There are actually five stages of migraine, although not everybody will experience all five. They are:

1. ‘Prodromal’ (pre-headache) stage. As well as physical symptoms such as ache and pains for hours or days prior to the migraine attack, some people may notice a change in mood, a drop in energy levels, appetite and behaviour change.

2. Aura. Some people experience a sensation, or aura, just before their migraine starts. They are neurological interruptions such as seeing flashes of light or blind spots, temporary blindness and seeing things almost like you are looking through a broken mirror. The aura stage usually lasts from anywhere between 15 minutes and an hour.

3. Headache stage. Normally a pulsating or throbbing pain that is on one particular side of the head. You will probably feel queasy and sick, followed by vomiting. There will be an increased sensitivity to bright light and loud sounds, which is why many people with migraine want to rest in a quiet, dark room. This stage can vary in length from four to 72 hours.

4. Resolution stage. Here the migraine is fading slowly but surely. If you do have a migraine, at this point you might find your headache comes to an abrupt end after you have vomited, and sleep can help to relieve the symptoms.

5. ‘Postdromal’ or recovery phase. There could be a feeling of exhaustion and weakness afterwards.

The big question therefore is why do migraines occur? The answer is believed to be due to alterations to chemicals in the brain. The chemical in question is one called serotonin, which declines during a migraine.


If serotonin levels are low, this can cause blood vessels in a certain area of your brain to spasm; suddenly contracting and becoming narrower.

Low levels of serotonin can make the blood vessels in a part of your brain spasm (suddenly contract), which makes them narrower. The symptoms of the aura stage may follow soon after and then after the blood vessels have dilated (widened), this is believed to be responsible for the headache. What causes this drop in serotonin has not yet been fully established.

It is worth remembering that severity and patterns of symptoms associated with migraines could differ from one person to the next. But the fact there usually is a pattern is important and you should be aware of this to plan how to manage your migraine.

It is vital you consult a doctor to get a diagnosis as the fact remains that around half of all cases are left without a diagnosis or treatment. Like patients with Irritable Bowel Syndrome are often advised to do, you should ideally maintain a diary, documenting when your symptoms have begun, what activities you were doing at that particular time, or what you may have eaten prior to your symptoms beginning. For example, you could find that alcohol consumption leads to you experiencing excruciating headaches – and no, not through a hangover!

If you are experiencing something that you suspect to be migraine or frequent and severe headaches, you must get your symptoms checked out by a doctor for an accurate diagnosis to start with, followed by appropriate treatment. Unfortunately, there is no cure for migraines but a variety of treatments may help to ease symptoms.

You may have to be patient in trying to find what works best at easing your migraine symptoms and if you find that over-the-counter medicines are relatively ineffective, your doctor can help with other treatment options such as prescribing stronger painkillers, anti-sickness medicines, or anti-inflammatory medicines. If you still find you are not responding well to treatment, your doctor may refer you to a specialist migraine clinic for further analysis of the cause for your symptoms.