More from AHA Day 1-JPAD: Aspirin fails in primary prevention trial for elderly Japanese diabetics

  Like a movie from the horror genre, journalists and bloggers alike  felt as if we were trapped  behind a mirror most of the day in the Morial Convention center.  We were talking, even yelling behind the glass but not even a handprint was left to prove that we were ever here at some points during the day.  Wireless gliches and server outages have stolen some of our best work.  Suffice it to say, we are all saving and backing up everything, but even sometimes that has't worked.  So, here goes.  I'm blogging live now so forgive the lack of spell checking because I'm in a hurry to post for you.

 JPAD: A primary prevention trial with ASA 100 mg and 81 mg  in elderly Japanese diabetics. The bottom line:  It really didn't reduce events. 

 I overheard a couple of commentors say that  we should now look at our guidelines for aspirin therapy, but I hope they meant that only for Japanese patients still residing in Japan. Before we change anything, we should look at just how we differ from the Japanese with regard to exercise and dietary habits, both of which have been viewed as the holy grail by anthropologists and culturists alike for decades.  Do we practice "Hara Hachi bi" in America? (the practice of stopping eating when our belly is 80% full-a common Okinawa reminder for a population of patients who has the longest disability- free life expectancy in the world).  Do we serve ourselves first, put the food away and THEN eat?  Do we routinely utilize small plates?  Do we actually sit down to consume our food?  Do we have 2 oz snacks of nuts or do we eat mounds of chips and soft drinks?  Do we move naturally  and take a literal daily "walk of life"  as most 100 year old Japanese citizens do or do we hop in a cab, take the elevator or just sit on the couch at every opportunity? 

The bottom line is that we should practice caution with regard to applying JPAD results  to the typical elderly American population because when we Supersize Japanese citizens who relocate to America with Big Macs and fries, they die  of cardiovascular disease at the same rates that we do.  

We may be comparing apples with oranges, or perhaps more appropriately we are comparing a traditional smoke house breakfast with a nice plate of Natto (fermented soy).   

Melissa 

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