Benefits and risks of aspirin in the context of its anti-cancer potential

Aspirin has been reported to have the potential to prevent selected cancers of the digestive tract. Aspirin also reduces the risk of serious vascular diseases in patients already at higher risk of them. A team led by researchers from the University of London has published their assessment of the risks and benefits of aspirin by analysing previous reports of the effects of aspirin.

Aspirin is a powerful drug with powerful adverse effects, including bleeding into the digestive tract or brain, causing some forms of asthma, exacerbating gout and causing rare but serious complications in children under 16 years of age ...

See more on this in Spanish on the BBC World Service website.

Below is an English version of the BBC World Service report:

" Myth and reality of aspirin to prevent disease

Writing

BBC Mundo

Aspirin is one of the world's best selling drugs. More than two thousand years ago, Hippocrates, the Father of Medicine, discovered the active ingredient in aspirin, which he extracted from the willow plant, and used to soothe fevers and headaches.

But it was not until 1897 that the German Felix Hoffman developed the drug as such. More than a century later, aspirin, acetylsalicylic acid, is one of 10 generic best sellers in the world, with annual sales of about $ 1.7 billion.

Besides being a recognized analgesic, aspirin has gained ground as way to prevent certain diseases. Multiple studies have highlighted its benefits in preventing cardiovascular disease and various cancers.
However, taking aspirin regularly involves significant risks. BBC News spoke to several experts to discuss how and when it is advisable to take a dose of this medicine each day.

Cardiovascular Benefits

Taking a daily dose of aspirin is a method widely used to prevent cardiovascular disease in people who have had this disorder already.

Mike Knapton, associate medical director at the BHF, told the BBC that for people who have had heart attacks, angina, some types of stroke and diseases of the arteries, a low dose of aspirin a day can prevent the occurrence of new episodes. This practice is well established and several studies have demonstrated these benefits.

The reason is that aspirin inhibits platelet adhesion in blood vessels reducing blood clotting.  But research also points that the drug may not prevent cardiovascular events in healthy people.  Rather, "the risks of taking a daily dose of aspirin outweigh the benefits of taking it in the case of people who have never had this kind of disorders," said Dr. Mike Knapton.

Reduction of cancer

In recent years, several studies have also pointed to the benefits of the drug as a way to prevent certain types of cancer. Experts also point out that aspirin increases the risk of bleeding. In fact, Peter Elwood, a British expert who participated in the scientific team that first showed the benefits of this analgesic in cardiovascular disease states that "the future is aspirin in reducing certain types of cancer."

Recent research by Queen Mary University of London, argues that for people between 50 and 65 years, a dose of daily aspirin can significantly reduce the risk of developing colon, esophageal and stomach cancer.
"This study showed a 35% reduction in cases of colon cancer and 40% in the number of deaths from this disease," Julie Sharp, Director of the Health Information Department of the British charity Cancer Research UK told the BBC.

"In relation to stomach cancer and esophagus, a reduction of 30% in the number of cases and between 35% and 50% in deaths was recorded, "said the expert. The study recommends that people between 50 and 65 take a dose of 75 and 100 grams of aspirin for at least 5 years, preferably 10 years.

Significant risks

But some studies in the UK have indicated that in some cases, taking the drug may have more risks than benefits. One of the side effects of this drug is the possibility of internal bleeding, including brain. Experts agree that a daily dose of aspirin helps prevent cardiovascular problems in people who already suffer from these disorders.

As he explained to the BBC, Donald Singer, professor of clinical pharmacology in the department of medicine at Yale University in the United States, "as a result of its blood thinning effect, aspirin can cause bleeding, for example in people who have a stomach or intestinal ulcer, and in some cases it can also cause bleeding in the brain. "

Research from Queen Mary University of London recognizes these risks and stresses that in the case of persons 60 years of age who take a daily dose of aspirin for 10 years, the risk of bleeding in the digestive tract increased from 2.2% to 3.6%, and in a small proportion of these cases (5%), can lead to death. " It is important that in each patient assessment is done to establish who can take aspirin and who should not".

Julie Sharp, of the British charity Cancer Research UK said the risk increases significantly for people over 70 years.

But to what extent do the risks outweigh the benefits of aspirin?

Here is a point on which not all experts agree. "I have no doubt that the balance is in favor of taking aspirin for people over 50 years," Professor Peter Elwood told the BBC. He noted that, although the risk of bleeding is increased, there is no evidence aspirin is associated with fatal bleeding. "The evidence suggests that there is minor bleeding, but not fatal."

But a study from the University of London published in 2012 concluded that the medicine, taken daily, can do more harm than good to a healthy person.
Julie Sharp notes that precisely because it is not known with certainty who may suffer side effects, "it is important that in each case testing done to establish who should take aspirin and who is not."

Consult your doctor

The active ingredient of aspirin has been used to treat headaches for centuries. With so many studies highlighting the benefits of aspirin, thousands of people in several countries take the drug to prevent disease before presenting with any symptoms, something that according to Professor Donald Singer, a member of the British Pharmacology Society, can be very dangerous. "It's very important that people are aware of the risks and consult your physician" before taking long term aspirin treatment.

He explained that people who suffer from indigestion, or asthma, or who have gout or who are taking other drugs that inhibit blood clotting are at increased risks of the side effects of aspirin.

And that also applies to children under 16 years of age. "One might be tempted to give aspirin to a child, in the case of families with a history of colon cancer, such as prevention. But this is very dangerous because in the case of minors, a daily dose may cause liver damage."

It is also important not to take more than the dose of 75 mg, or a quarter of a standard dose of aspirin.

The benefits of aspirin to prevent disease in specific cases are well established, but experts insist that consulting a doctor is essential to reduce risks of adverse effects."

Ebola VIrus Disease

The WHO Ebola Response Team have reported in the September 23 issue of the New England Journal of Medicine their analysis of 3343 confirmed and 667 probable Ebola cases collected up to September 14 in 4 of the 5 West African countries to have experienced cases of Ebola Virus Disease: Guinea, Liberia, Nigeria, and Sierra Leone. They report a typical age range of 15-44 years with no difference in gender of those affected. Their estimate of case fatality rate is higher than that noted by the Centers for Disease Control at 71% for people for whom the outcome their infection is known. Based on the number of cases to date, from this they estimate a 95% confidence interval [CI] of 69 to 73% for mortality risk.  They note that features of the disease, including a typical incubation period of 11 days to be similar to that for  previous outbreaks. Based on the initial periods of exponential growth of the outbreaks, they have modelled the doubling times are EVD to be 16 days for Guinea, 24 days for Liberia, and 30 days for Sierra Leone, with by November 2 the cumulative reported numbers of confirmed and probable cases predicted to be "5740 in Guinea, 9890 in Liberia, and 5000 in Sierra Leone", i.e. over 20,000 total cases for this EVD epidemic.
The current Ebola outbreak is the largest to date, now affecting 4 West African countries: in Guinea, Liberia, Sierra Leone and Nigeria. A further outbreak in the Democratic Republic of Congo is considered due to a separate, independent outbreak in the DRC (reported 24 suspected cases and 13 reported DRC suspected Ebola deaths to July 28 - August 28, 2014 (and to 9th September 65 suspected cases, 32 attributed deaths and 14 laboratory confirmed cases).
Risk factors include high fever with or without associated Ebola features (see below) in people from epidemic regions, and in those who have been in contact with Ebola cases, including funeral and burial related, and in those who have prepared or eaten affected bush meat. Key public health measures in unaffected countries include health questionnaires and non-invasive temperature recording at national or remote air, land, water ports of entry.
Ebola virus disease is caused by any of 4 subtypes of the thread-like Ebola RNA virus. EVD causes a

Ebola virion CDC Public Health Image Library

systemic illness in humans associated with bleeding and multi-organ failure (Ebola haemorrhagic fever). The disease was first identified around 40 years in Sub-Saharan Africa and is named after the river Ebola north of Yambuku, in what was then called Zaire, now the Democratic Republic of Congo. Mortality may be as high as 90%, highest with the Zaire strain of the virus, mortality reduced when effective supportive treatment is provided. 

Up to late July 2014, there had been around 3800 cases, with overall reported mortality of

Based on CDC reports

around 61%, in reported outbreaks over the past 4 decades, including the current West African outbreak. In the current outbreak, 1400 cases had been reported up to July 2014 and 1848 cases (1013 deaths) up to 9 August 2014 (4253 cases reported from 1976 to 9th August). A CDC update on West African cases to 22 August from the Centers for Disease Control and Prevention in Atlanta USA reports 2615 suspected cases, 1427 suspected case deaths and 1528 laboratory confirmed cases. A further CDC update to 28th August reported a suspected and confirmed case count: 3069; suspected case deaths: 1552; and laboratory confirmed cases: 1752 in 4 West African countries: Liberia, Guinea, Sierra Leone and Nigeria. One case in a patient from Guinea has been reported from Senegal, with no further cases reported there since August 29, and no further cases reported from Nigeria since September 5.
A further update from the CDC to September 18 notes an increase to a total case count of 5347, total deaths 2630 (laboratory confirmed cases 3095).
The reported mortality rate in the current outbreak was 55% both to August 9 and to August 22, and 51% to 28 August and 49% to September 18, lower than the 66% cumulative mortality rate prior to the current epidemic. Reported mortality appears to vary widely in currently affected countries. This may reflect local differences in presentation for treatment and in disease management, but may also be in part spurious due to uncertainty in case-finding ascertainment.

Ebola virus is one of several viruses, rickettsial, treponemal and other bacterial infections, and non-infectious conditions which may cause serious haemorrhagic illnesses (associated with bleeding internally and into the skin), presenting with a similar spectrum of symptoms, clinical signs and laboratory abnormalities. In the body the ebolavirus targets the lining cells of blood vessels (endothelial cells), white blood cells and liver cells (hepatocytes).
The incubation period can be short, as rapid as 2-3 days after exposure to the virus, either from animal hosts or after contact with infected blood or other human bodily fluids. Typical incubation is reported to be around 8-10 days, in some cases up to 3 weeks before an initial 'flu'-like syndrome. Around half of the affected patients develop a flat and raised (maculo-papular) rash. It has been reported that survivors of the illness may continue to carry the virus for up 2 months after the infection.
Animal vectors of the virus are thought to include the fruit bat (without developing clinical signs). Other animal hosts (through eating fruit contaminated by fruit bats) may include non-human primates, duikers (small antelopes) and pigs.
Treatment should involve a wide range of health professionals, from acute care doctors and nurses, to experts working in laboratory diagnostic services, and public health officials who have an important role in contact tracing and containment of the disease. Care needs to include effective protective clothing for health professionals, disinfection, avoiding re-use of needles, isolation of affected patients, and quarantine.
Current approaches to treatment are supportive, from effective isolation, to monitoring for biomarkers of target organ damage, maintaining fluid and electrolyte balance, if needed, providing oxygen, treating secondary infections, and providing organ support in the event of failure of major organs, often kidneys and liver.
Acquiring effective anti-ebola drugs and vaccines are the subject of current R & D efforts. 
Specific anti-viral treatments, combined with rapid point of care tests, need to be developed, with the aim of achieving medicines which are effective and safe for prophylaxis as well as for treating all stages of the disease. In view of the very high mortality of the disease, new approaches to clinical trials need to be considered. Experimental treatments have been reported to be effective in animal models but not yet tested in humans (see below for compassionate use access to experimental treatments).
An effective vaccine is also a priority, with promising developments of candidate vaccines in recent years. Vaccine programmes will need to take into account the possible development of new Ebola viral strains over time - early September said to have been the start of human clinical testing of a vaccine to prevent the disease and November the estimated start date for clinical trials.

See information on Ebola virus infection from the Centers for Disease Control and Prevention

Protection against filovirus diseases by a novel broad-spectrum nucleoside analogue BCX4430 Nature April 2014

Ebola virus vaccines: an overview of current approaches

Compassionate use provision to Liberia of experimental antibody-based anti-Ebola treatment 

Pharmacology for Africa

The latest World Congress of Basic and Clinical Pharmacology - held in July 2014 in Cape Town - has just ended. Delegates from around the world discussed the latest ideas on research and education about new and established medicines and their effective and safe use.

One of the key threads during the week long meeting was a series of lecture and discussion events hosted by  'Pharmacology for Africa' (PharfA), an initiative by African pharmacologists to promote and

organise pharmacology on the African continent. The keynote 2014 PharfA WCP lecture was given by Professor Alexander Dodoo from Ghana.

This important initiative is recognised and supported by the International Union of Basic and Clinical Pharmacology (IUPHAR), the umbrella organisation for these 4-yearly congresses on basic and clinical pharmacology.

PharfA aims to secure national and international support to improve capacity and expertise for education and training in Clinical Pharmacology and related disciplines in African medical schools and for post-graduate education in African countries. PharfA also aims to increase research activity and integration across Africa in partnership with African funding and governmental institutions, and with the WHO and other interested overseas organisations.

For more information, see the PharfA website.

Recent and pending PharfAssociated events:
- 5th All Africa Congress on Basic and Clinical Pharmacology (ACP2012) Accra, Ghana -
11-13 July 2012, 
- sessions at WCP - Cape Town 2014
-  All Africa Congress on Basic and Clinical Pharmacology, Addis Ababa, Ethiopia - 2016

Spotlight on excellent EACPT summer cardiovascular focus meeting 3-5 July in Holland

You are still in time to register for 2014 EACPT Focus Meeting on 'Drugs to Fight Cardiovascular Damage' from organised by the the European Association for Clinical Pharmacology and Therapeutics [EACPT] .

Registration  - with a preferential accommodation rate - is available through the Focus Meeting website.

The 2014 EACPT Focus Meeting takes place from July 3rd - 5th at the Radboud University Medical Center in Nijmegen in the Netherlands.

Reasons to come to this outstanding meeting

• excellent tradition of EACPT in providing outstanding meetings for young and senior clinicians and researchers
• great opportunities for networking with your peers and senior members of the international clinical pharmacology community
• easy access to senior researchers on the international speaker faculty 
• opportunity to have first hand news on major developments for EACPT
• meet Dr Richard Shader, the editor of the EACPT's Official Journal - Clinical Therapeutics 
• expert session from Dr Shader on how to publish

In addition to state-of-the-art lectures from international cardiovascular experts, over 60 delegate abstracts are due be presented  from around the world. The top 5 ranked abstracts will be provided with free registration. All abstracts presented at the meeting will be published in Clinical Therapeutics, the peer-reviewed Official Journal of the EACPT. 

This focus meeting follows on from the highly rated  EACPT international summer school in 2013 in Edinburgh.

The 2014 EACPT Focus Meeting will provide you with the opportunity to attend state of the art lectures from leading professionals and researchers, including hands-on workshops. 

Radboud University Medical Centre, Nijmegen 

Topics include ultrasound imaging of vascular injury (including a hands-on workshop), the microbiome and inflammation in the metabolic syndrome, targeting inflammation to prevent and treat atherosclerosis, diagnosis and therapy of adrenal hypertension, and protection against ischaemia-reperfusion injury.

This EACPT Cardiovascular Focus Meeting is of interest to clinical pharmacologists, pharmacologists, and other young scientists and clinicians interested in drug treatment of cardiovascular disease. 

You can listen here to podcasts with international delegates at the last EACPT summer meeting in Edinburgh in 2013.

See the Scientific Programme is now online on the Focus Meeting website. 

Visit the Clinical Therapeutics website.

Healthy heart charity CVRT and Hippocrates Initiative jointly launch Healthy Heart Poetry project by and for school children and young people

On behalf of the healthy heart charity the Cardiovascular Research Trust (CVRT), London-based poets Wendy French and Rebecca Goss will be editing a book of poems on the heart written by children for children of all ages. 

Entries are welcome from anywhere in the world from schools or individually from children and young people. 

Wendy said: “The aim is to bring to children, from an early age, awareness of the importance of keeping the heart healthy through diet and exercise. The idea for this came from a pilot poetry project in schools in and around London. Please do get your pupils writing! Our experience of this type of project in schools has shown that it can be very exciting both for pupils and teachers."

She added: "We would like as many children and older school students to enter as possible so we have a wide selection of poems to choose from. The book will be published in print and online by the Hippocrates Press for Poetry and Medicine. The book will be launched at a celebration in London on December 4th 2014, which children and older school students and their teachers will be invited to attend.”

The closing date for entries is 12 midnight GMT July 16^th 2014.

Poems may be entered on-line (see the Hippocrates website link) or sent to
Wendy French at 4 Myton Road, West Dulwich, London, SE21 8EB. 

Wendy has a quiz devised by the CVRT on the heart and can email this with lesson plan suggestions to teachers who are interested.

Kidshealth also has very helpful facts to help get started on the project.

The book will be divided into four sections, selected poems by primary children, selected poems by secondary school students, and a section devoted to heart healthy recipes supplied by anyone of school age. 

Medical professor Donald Singer said: “This looks a very interesting way to engage children and young people actively in understanding ways to prevent heart disease. I will be adding a section in the book on how to keep the heart healthy so that book could be used in schools for teaching about health as well as just for pure enjoyment of the poems."

See YouTube videos of examples of Healthy Heart Poetry by schools from the 2013 CVRT Healthy Heart Awards:

Little Red Balloon: from Chevening C.E. Primary School - read by Raphael Shirley

Heart or Else: heart poem from Chevening C.E. Primary School read by Raphael Shirley

Healthy Heart Poem during Assembly - performed by Year 6Ws at Dulwich Hamlet Junior School

You can read more about the Healthy Heart Poetry initiative on the Hippocrates website.

If you wish any further information or would like to help by involving your local school in the project, or in other ways, you can contact Wendy French on wendy.french6@btinternet.com 

2014 Hippocrates Open, NHS and Young Poet Prize for Poetry and Medicine awarded in London

The £5000 2014 Open International Hippocrates first prize has been awarded to UK-based poet Jane Draycott. The second prize was won by UK poet Ailsa Holland and the third prize was shared by New York poet Stephanie Gangi and South African poet Karen Nel. 

Jane Draycott with Philip Gross ©Hippocrates Prize

The Hippocrates Prize is one of the most valuable poetry prizes in the world, with a yearly purse of £15000. Jane Draycott’s winning poem The Return concerns the many sanatoria around the world left standing very much as the day they were abandoned decades ago, remaining as if on stand-by for whenever their time comes again. The International Hippocrates Open Awards were presented by poet Philip Gross at an International Symposium on Poetry and Medicine at the Royal Society of Medicine in London.
More on the 2014 Hippocrates Awards 

Ellen Storm with Robert Francis QC ©Hippocrates Prize

The £5000 2014 Hippocrates NHS first prize has been awarded to trainee paediatrician Ellen Storm from Liverpool for her new poem Out of Hospital Arrest. The second prize was won by Valerie Laws from Tyne and Wear and the third prize went to Belfast poet and dentist Paula Cunningham. The Hippocrates NHS Awards were presented by barrister Robert Francis QC at an International Symposium on Poetry and Medicine at the Royal Society of Medicine in London on Saturday May 10th

Now in its 5th year, winners for the 2014 Hippocrates NHS and Open Prize for Poetry and Medicine were selected by judges poet Philip Gross, barrister Robert Francis QC and Mumsnet Editor Sarah Crown from over 1000 entries from 31 countries. 

Philip Gross, Robert Francis & Sarah Crown ©Hippocrates Prize

The judges also agreed 20 commendations in the NHS category, and 21 in the Open International category, from England, Ireland, Scotland, Norway, the USA, New Zealand and Australia.

Judge Philip Gross said: ‘Reading the stronger poems in the Open and the NHS categories, I see how many of their qualities they share. Dedicated poet or health professional – maybe each needs the same disciplines of observation and exactness, care and a right handling of emotions, the ability to get up close and yet step back and see it whole.’ Judge Sarah Crown commented: ‘We think of healthcare first and foremost as a scientific arena; a realm of dosages, diagnoses, instruments and odds. The real pleasure of these poems for me was the way in which they made the case for the place, within this arena, of the personal and the beautiful, too.

‘Reading them awakened me to the stories behind the science, and I found myself in tears on more than one occasion. Congratulations to everyone who submitted a poem, and particularly to the winners.’  Judge Robert Francis QC remarked "What a celebration of the partnership between patients and those who care for them and their shared will to overcome the frailties which we all have to face!”

Donald Singer, Hippocrates Prize co-founder and President of the Fellowship of Postgraduate Medicine, the major patron of the Hippocrates Initiative said "The FPM is delighted that in its 5th year, Hippocrates Open Awards continue to reach out to poets, health professionals and the public around the world.

Hippocrates Prize co-founder poet Michael Hulse added: “The Prize’s first five years have shown how extraordinarily illuminating the complementarity of the disciplines of poetry and medicine can be.” 

Conor McKee has been awarded the inaugural 2014 International Hippocrates Young Poets £500 Prize. 18 year old Conor studies English literature at Sidney Sussex College at the University of Cambridge in England. 

Philip Gross with Conor McKee ©Hippocrates Prize

This new International Hippocrates Prize for Young Poets is for an unpublished poem in English on a medical theme by poets aged 14 to 18 years. The 2014 Prize attracted entries from England, Ireland, and Scotland, Israel, Italy, Nigeria, South Africa and the USA. It is one of the most valuable poetry awards in the world for young poets.

Commenting on the inspiration behind his poem, I Will Not Cut for Stone, Conor said: “ this poem expresses my own fears about the life of a surgeon and my interest in understanding the mechanics of the human body."

The Hippocrates International Young Poet Award and three Young Poet Commendations were presented by poet Philip Gross at an International Symposium on Poetry and Medicine at the Royal Society of Medicine in London on Saturday May 10th.

This year’s poems were judged by adult and children’s author, and winner of the Geoffrey Faber Memorial Prize, Kit Wright.

Kit Wright

Kit said of the entered poems: ‘It was a remarkable experience to judge these poems, highly various in their approaches, both stylistically and in their choice of subject. The world of medicine is an extraordinarily rich one for the writer, and these young poets have produced some extraordinarily assured and compelling responses to it.’

Donald Singer, Hippocrates Prize co-founder and President of the Fellowship of Postgraduate Medicine, the major patron of the Hippocrates Initiative said "The FPM is delighted with the success and international reach of this second year of the Hippocrates Young Poets Award. 

Hippocrates Prize co-founder poet Michael Hulse added: “We are delighted that the Hippocrates Prize for Young Poets is having a growing international impact in inspiring a new generation of poets.”

Of the inspiration for his poem Nothing Happened, commended Young Poet Joseph Davison-Duddles remarked: ‘My poem seeks to place silences and utterances in a narrative of childhood and illness’.

Joseph is sixteen and studies at Queen Elizabeth College in Darlington. In 2013 he received both a Foyle Young Poets commendation and Young People First Place in the Ledbury Poetry Competition.

Commended Young Poet Molly Garbutt said of her poem, Cadaver: ‘It stemmed from discussion with my Biology teacher about medical school, and dissecting cadavers, and from my love of writing about the supernatural.’

Molly studies at Hereford Sixth Form College and hopes to study Veterinary Medicine. She has been shortlisted for several poetry awards, including the COMPAS Schools Prize for Poetry.

Commended Young Poet poet Talin Tahajian is at school in Massachusetts in the USA. Her poem ‘Dream …’  was inspired by her grandfather’s experience of lymphoma.

Her poetry is published by PANK, Hobart and The Adroit Journal. In the autumn she plans to attend Sidney Sussex College at the University of Cambridge where she will study English. 

Notes to editors

For photos of all NHS and Open International Young Poet finalists, biographies and extracts of their poems, contact 0759 0478078, 07447 441666 or hippocrates.poetry@gmail.com

The Hippocrates Initiative – winner of the 2011 Times Higher Education Award for Innovation and Excellence in the Arts – is an interdisciplinary venture that investigates the relationship between medicine and poetry - hippocrates-poetry.org

About the Hippocrates Open Prize winner

Jane Draycott  is a UK-based poet with a particular interest in sound art and collaborative work. Her collections include No Theatre (Smith/Doorstop) and from Carcanet Press, Prince Rupert's Drop, The Night Tree and Over, short-listed for the 2009 TS Eliot Prize.  Nominated three times for the Forward Poetry Prizes, she was a PBS 'Next Generation' poet 2004 and second prize-winner in the National Poetry Competition 2012.  Other collections, from Two Rivers Press, include Christina the Astonishing, co-written with Lesley Saunders, and Tideway with images by Peter Hay. Her translation of the medieval dream-elegy Pearl (2011), was a PBS Recommended Translation and winner of a Times Stephen Spender Prize. She lives in Henley on Thames.

About the Hippocrates NHS Prize winner

Dr Ellen Storm is training in Paediatrics and Child Health in Liverpool, and is the mother of three-year-old twin girls. Ellen has had poems published in magazines including Assent, The Interpreter’s House, The Reader, Frogmore Papers, Orbis and The Warwick Review. She has one forthcoming in Obsessed with Pipework, has recently contributed two to the online collaborative arts project The Egg, The Womb, The Head and The Moon (weeks 27 and 30), and will be contributing to the forthcoming Writing Motherhood project. She was commended in the 2013 Hippocrates Prize for Poetry and Medicine. 

About the Hippocrates Young Poet Winner

Conor McKee comes from Kent and studies English literature at Sidney Sussex College, Cambridge. Poetry has been a significant force in his life since childhood when his parents frequently read to him. He was first encouraged to write poetry at the school creative writing society. In 2012 he won the Foyle Young Poets of the Year Award and was subsequently commended in 2013. He also gained second prize in the Young Persons section of the Ledbury Poetry Competition in 2012. His critical interests are focused on late medieval and modernist verse.

The Hippocrates Prize judgesPhilip Gross’s The Water Table won the T.S. Eliot Prize 2009, I Spy Pinhole Eye Wales Book of The Year 2010, and Off Road to Everywhere the CLPE Award for Children’s Poetry 2011. Deep Field (2011) deals with voice and language, explored through his father’s aphasia, and a new collection, Later, was published by Bloodaxe in Autumn 2013. He has published ten novels for young people, including The Lastling, has collaborated with artists, musicians and dancers, and since 2004 has been Professor of Creative Writing at Glamorgan University. 

Robert Francis QC is a distinguished barrister who specialises in the NHS and medical negligence. He has been a Queen's Counsel for 21 of his 40 years at the bar. He has been involved in many inquiries into the NHS, both as barrister and as chair, most recently chairing the inquiry into the Mid Staffordshire Hospital. According to Peter Walsh, chief executive of the patient safety charity Action against Medical Accidents, Robert Francis has a "passion for justice in healthcare and improving healthcare more generally". 

Sarah Crown is editor of http://www.mumsnet.com/. She was editor of the guardian.co.uk/books from 2007 to 2013. Previous poetry awards for which she has been a member of the judging panels include the Forward Prizes and the Picador Poetry Prize.

Hippocrates Young Poet judge

Kit Wright is the author of more than twenty-five books, for both adults and children, and the winner of awards including an Arts Council Writers' Award, the Geoffrey Faber Memorial Prize, the Hawthornden Prize, the Alice Hunt Bartlett Award and (jointly) the Heinemann Award. After a scholarship to Oxford, he worked as a lecturer in Canada, then returned to England and a position in the Poetry Society.  In June 2014, to mark his seventieth birthday, Kit Wright publishes a new collection of poems, Ode to Didcot Power Station, with Bloodaxe Books.

Hippocrates Prize founders

Professor Donald Singer is President of the Fellowship of Postgraduate Medicine, the main patron of the Hippocrates Prize. His interests include research on discovery of new therapies, and public understanding of drugs, health and disease. He co-authors the drug prescribing guide Pocket Prescriber, the 7th edition of which was published by Taylor & Francis in May 2014.

Michael Hulse is a poet and translator of German literature, and is Professor of creative writing and comparative literature at the University of Warwick. He is also editor of The Warwick Review. His latest collection of poetry, Half Life, was chosen as a Book of the Year by John Kinsella.

2014 Hippocrates Prize is supported by:

The Fellowship of Postgraduate Medicine, a national medical society founded in 1918 and publisher of the Postgraduate Medical Journal and Health Policy and Technology, has supported the Hippocrates Prize since its launch in 2009.

The Healthy Heart Charity the Cardiovascular Research Trust, founded in 1996, which promotes research and education for the prevention and treatment of disorders of the heart and circulation. 

More on the 2014 Hippocrates Awards 

What works for losing overweight?

Overweight is the most important reversible cause of hypertension. 
Other consequences of overweight  include heart attack and stroke through raised cholesterol and increased risk of diabetes mellitus; premature wear and tear of joints; and increased risk of some cancers and psychiatric and psychological disorders.

Comments welcome about ideas to reduce overweight that have worked - or have not worked - including 'weight-reducing' diets, selective exclusion or inclusion diets, different types of exercise, support groups, use of apps, and other approaches.

See previous blogs related to obesity:

Measuring, preventing and treating high blood pressure

Obesity and the French paradox     

Waistline and increased risk of premature death

Why worry about high blood pressure?

29.4.14: Listen to blood pressure specialist Donald Singer and pharmacist Ejaz Cheema in discussion with Annie Othen on BBC radio about blood pressure, knowing your numbers, tips on blood pressure measurement, why treatment is important, and how doctors, nurses and pharmacists can help to keep people with high blood pressure as healthy as possible.

High blood pressure is a very common preventable cause of stroke, heart attack and other serious diseases. These complications may at best cause disability and are major causes of preventable premature death in the UK and around the world.

For the public in general, the lower the blood pressure the better: most blood pressure-related heart attacks and strokes occur at blood pressure levels within what many still consider to be normal blood pressure.

A healthy lifestyle will help to keep blood pressure and other cardiovascular risk factors in check.  Keeping weight in check, regular exercise, minimising salt intake and moderation in alcohol, as well as eating healthy foods rich in fruit and vegetables all help, as does avoiding or stopping smoking.

For people with raised blood pressure, tests are important to rule out underlying causes and to identify other cardiovascular risk factors.

Blood pressure treatment is well-established as effective in helping to prevent or reduce severity of heart attack, stroke and other serious medical problems. However  blood pressure is still poorly controlled in many patients even in the most developed healthcare systems.

One of several reasons for poor blood pressure control is that many patients find it difficult to keep taking their tablets. Surprisingly, in people newly diagnosed with high blood pressure, as many as half may have stopped their tablets by 12 months.

It is as important to understand and address reasons for poor patient adherence with their medicines. These include not being sure of why blood pressure is important, reasons for choice of medicines, and concerns about possible or actual side effects of tablets.

Other contributory factors includes failure of prescribers to follow established national guidelines for choice of tablets and how they should be used singly or in combination. This risks exposing patients to avoidable side effects without achieving effective lowering of blood pressure.

An important element in approaches to improving adherence to blood pressure medicines is continuing education of health professionals and patients about high blood pressure and its treatment. Doctors, nurses and pharmacists can all play important roles in this.