Medizinonline Medizinonline
  • News
    • News
    • Market & Medicine
  • Patients
    • Disease patterns
    • Diagnostics
    • Therapy
  • Partner Content
    • Dermatology
      • Atopic dermatitis and psoriasis news
      • Dermatology News
    • Diabetes
      • Dia-Month Club – Type 2 Diabetes
      • Diabetes in Motion
      • Diabetes Podcasts
    • Gastroenterology
      • IBD matters
      • Forum Gastroenterology
      • Ozanimod: ulcerative colitis
      • Reflux Update
    • Immunology
      • Primary immunodeficiency – exchange of experience
    • Vaccinate
      • Herpes zoster
    • Infektiologie
    • Neurology
      • EXPERT ULTRASONIC: Introduction to ultrasound-guided injection
      • MS News
      • MS Therapy in Transition
    • Oncology
      • Swiss Oncology in motion
    • Orthopedics
      • Osteoporosis in motion
    • Phytotherapie
    • Practice Management
      • Aargau Cantonal Bank
      • Claraspital
    • Psychiatry
      • Geriatric Psychiatry
    • Rheumatology
  • Departments
    • Allergology and clinical immunology
    • General Internal Medicine
    • Anesthesiology
    • Angiology
    • Surgery
    • Dermatology and venereology
    • Endocrinology and Diabetology
    • Nutrition
    • Gastroenterology and Hepatology
    • Genetics
    • Geriatrics
    • Gynecology
    • Hematology
    • Infectiology
    • Cardiology
    • Nephrology
    • Neurology
    • Emergency and intensive care medicine
    • Nuclear Medicine
    • Oncology
    • Ophthalmology
    • ORL
    • Orthopedics
    • Pediatrics
    • Pharmacology and toxicology
    • Pharmaceutical medicine
    • Phlebology
    • Physical medicine and rehabilitation
    • Pneumology
    • Prevention and health care
    • Psychiatry and psychotherapy
    • Radiology
    • Forensic Medicine
    • Rheumatology
    • Sports Medicine
    • Traumatology and trauma surgery
    • Tropical and travel medicine
    • Urology
    • Dentistry
  • CME & Congresses
    • CME continuing education
    • Congress Reports
    • Congress calendar
  • Practice
    • Noctimed
    • Practice Management
    • Jobs
    • Interviews
  • Log In
  • Register
  • My account
  • Contact
  • English
    • Deutsch
    • Français
    • Italiano
    • Português
    • Español
  • Publications
  • Contact
  • Deutsch
  • English
  • Français
  • Italiano
  • Português
  • Español
Subscribe
Medizinonline Medizinonline
Medizinonline Medizinonline
  • News
    • News
    • Market & Medicine
  • Patienten
    • Krankheitsbilder
    • Diagnostik
    • Therapie
  • Partner Content
    • Dermatology
      • Atopic dermatitis and psoriasis news
      • Dermatology News
    • Diabetes
      • Dia-Month Club – Type 2 Diabetes
      • Diabetes in Motion
      • Diabetes Podcasts
    • Gastroenterology
      • IBD matters
      • Forum Gastroenterology
      • Ozanimod: ulcerative colitis
      • Reflux Update
    • Immunology
      • Primary immunodeficiency – exchange of experience
    • Vaccinate
      • Herpes zoster
    • Infektiologie
    • Neurology
      • EXPERT ULTRASONIC: Introduction to ultrasound-guided injection
      • MS News
      • MS Therapy in Transition
    • Oncology
      • Swiss Oncology in motion
    • Orthopedics
      • Osteoporosis in motion
    • Phytotherapie
    • Practice Management
      • Aargau Cantonal Bank
      • Claraspital
    • Psychiatry
      • Geriatric Psychiatry
    • Rheumatology
  • Departments
    • Fachbereiche 1-13
      • Allergology and clinical immunology
      • General Internal Medicine
      • Anesthesiology
      • Angiology
      • Surgery
      • Dermatology and venereology
      • Endocrinology and Diabetology
      • Nutrition
      • Gastroenterology and Hepatology
      • Genetics
      • Geriatrics
      • Gynecology
      • Hematology
    • Fachbereiche 14-26
      • Infectiology
      • Cardiology
      • Nephrology
      • Neurology
      • Emergency and intensive care medicine
      • Nuclear Medicine
      • Oncology
      • Ophthalmology
      • ORL
      • Orthopedics
      • Pediatrics
      • Pharmacology and toxicology
      • Pharmaceutical medicine
    • Fachbereiche 26-38
      • Phlebology
      • Physical medicine and rehabilitation
      • Phytotherapy
      • Pneumology
      • Prevention and health care
      • Psychiatry and psychotherapy
      • Radiology
      • Forensic Medicine
      • Rheumatology
      • Sports Medicine
      • Traumatology and trauma surgery
      • Tropical and travel medicine
      • Urology
      • Dentistry
  • CME & Congresses
    • CME continuing education
    • Congress Reports
    • Congress calendar
  • Practice
    • Noctimed
    • Practice Management
    • Jobs
    • Interviews
Login

Sie haben noch keinen Account? Registrieren

  • Coronary heart disease

Place of omega-3 fatty acids and aspirin in primary prevention.

    • Cardiology
    • Congress Reports
    • General Internal Medicine
    • Prevention and health care
    • RX
    • Studies
  • 2 minute read

Hypertension, elevated blood lipids or diabetes are among the risk factors of CHD. Omega-3 fatty acid substitution and aspirin administration are preferred as primary prevention. But is that still in keeping with the times?

Almost every heart attack is based on coronary artery disease. All the more important are preventive measures that can prevent its development, especially in patients at risk. A healthy lifestyle with sufficient exercise, a balanced diet, and little stress, in addition to a nicotine stop, certainly takes a high priority in primary prevention. In addition, all guidelines recommend a diet rich in fish and the intake of 1 g fish oil capsules, as Prof. Dr. med. Franz Eberli, Zurich, explained. This was based on study results from the 1980s [1–6], in which omega-3 fatty acid substitution was associated with a reduction in cardiovascular mortality.

However, this hypothesis could not be confirmed in the follow-up studies. Only in open-label studies was there a trend toward an effect. A 2018 Cochrane Review [7] analyzed the results of 79 randomized clinical trials and found little or no effect of omega-3 fatty acids with respect to all-cause mortality, cardiovascular mortality, cardiovascular events, stroke, and arrhythmias. A recently published study [8] in 25,871 patients without cardiovascular disease confirmed the new findings. Taking 1 g fish oil capsule vs. placebo showed no difference in terms of reduction in cardiovascular events.

Aspirin brings no benefit

Similar results were obtained in several studies with different patient groups that investigated the benefits of aspirin in primary prevention. A multicenter study [9] randomized 12,546 patients in a 1:1 ratio to receive 100 mg/day ASA or placebo. The primary end point was a combination of cardiovascular death, myocardial infarction, unstable angina, or stroke/transient ischemic attack. One of these events was observed in 269 patients (4.29%) in the verum group versus 281 patients (4.48%) in the placebo group. Accordingly, there was no clear advantage.

A second study [10] examined the protection of ASA against cardiovascular events in 15,480 diabetic patients with an average age of 63 years. Again, one group was given 100 mg/day of ASA or placebo. The primary efficacy end point was a severe vascular event. During the follow-up period of 7.4 years, the risk of a vascular event was actually moderately reduced by 12%. However, this benefit was offset by a high number of severe hemorrhagic complications (29% increase). “Accordingly, good treatment of hypertension and lowering cholesterol remain the most important primary preventive measures in high-risk patients,” Prof. Eberli concluded.

Source: 85th Medical Congress Davos, February 7-9, 2019.

 

Literature:

  1. NEJM 1985; 312: 1205-1209.
  2. NEJM 1985; 313: 820-824.
  3. Circulation 202; 106: 2747.
  4. Lancet 189; 334:757-761.
  5. Lancet 1999; 354: 474-455.
  6. Circulation 2017; 135: 867-884.
  7. Cochrane Database Syst Rev 2018; 7: CD03177.
  8. NEJM 2019; 380: 23-32.
  9. Lancet 10152; 392: 1036-1046.
  10. Am Heart J 2018; 198: 135-144.

 

GP PRACTICE 2019; 14(3): 40-41
CARDIOVASC 2019; 18(5): 30

 

Autoren
  • Leoni Burggraf
Publikation
  • HAUSARZT PRAXIS
Related Topics
  • Aspirin
  • CHD
  • coronary heart disease
  • Hypertension
Previous Article
  • Foramen ovale persistens

Closure as recurrence prophylaxis in stroke patients?

  • Cardiology
  • Congress Reports
  • Neurology
  • RX
  • Studies
View Post
Next Article
  • Treatment strategies for treatment-resistant depression.

The role of brain stimulation methods

  • Education
  • Neurology
  • Psychiatry and psychotherapy
  • RX
View Post
You May Also Like
View Post
  • 16 min
  • Pain and autism

Hurdles to pain treatment for autistic patients

    • CME continuing education
    • Pediatrics
    • Pharmacology and toxicology
    • Psychiatry and psychotherapy
    • RX
    • Studies
View Post
  • 4 min
  • Pathophysiological mechanisms and therapeutic perspectives

Metabolic syndrome in patients with schizophrenia

    • Cardiology
    • Education
    • Psychiatry and psychotherapy
    • RX
    • Studies
View Post
  • 6 min
  • Hand eczema: from diagnosis to treatment

Implementing sustainable, stage-appropriate measures

    • Allergology and clinical immunology
    • Congress Reports
    • Dermatology and venereology
    • Pharmacology and toxicology
    • RX
    • Studies
View Post
  • 4 min
  • Cystic fibrosis

Small spray – big footprint

    • Education
    • General Internal Medicine
    • Pediatrics
    • Pneumology
    • RX
    • Studies
View Post
  • 4 min
  • From symptom to diagnosis

Abdominal pain – Gastric outlet stenosis

    • Cases
    • Education
    • Gastroenterology and Hepatology
    • General Internal Medicine
    • Radiology
    • RX
    • Surgery
View Post
  • 6 min
  • When the bones become more fragile: “Case Finding”

Fracture risk reduction in osteoporosis

    • Congress Reports
    • Endocrinology and Diabetology
    • General Internal Medicine
    • Geriatrics
    • Rheumatology
    • RX
    • Studies
View Post
  • 6 min
  • Biologics for plaque psoriasis

What increases the chance of a sustained remission?

    • Congress Reports
    • Dermatology and venereology
    • Rheumatology
    • RX
    • Studies
View Post
  • 12 min
  • Findings from the ALS Symposium 2024 in Montreal

Current and future approaches in the treatment of amyotrophic lateral sclerosis (ALS)

    • CME continuing education
    • Congress Reports
    • Interviews
    • Neurology
    • RX
    • Studies
Top Partner Content
  • Forum Gastroenterology

    Zum Thema
  • Herpes zoster

    Zum Thema
  • Dermatology News

    Zum Thema
Top CME content
  • 1
    Hurdles to pain treatment for autistic patients
  • 2
    Current and future approaches in the treatment of amyotrophic lateral sclerosis (ALS)
  • 3
    Treatment of comorbidities in older people
  • 4
    New nomenclature for non-alcoholic fatty liver disease
  • 5
    Rare malignancy from a dermatological perspective

Newsletter

Sign up and stay up to date

Subscribe
Medizinonline
  • Contact
  • General terms and conditions
  • Imprint

Input your search keywords and press Enter.