If you’re reading this you’re probably thinking what has cross promotional marketing to do with children. Personally when I first heard the term I was thinking what exactly is it?

Simply, cross-promotional marketing is the act of strategically aligning businesses that target the same market but do not directly compete with each other. Whenever two organizations join forces to attract their mutual customers they can more than double the number of prospects they each reach.

For example, in 1996 MacDonalds and Disney signed a ten year deal to cross-promote. Get it? Same market, but not in direct competition and double the reach. A subsequent survey by Eric Schlosser of US schoolchildren found that the only fictional character with greater recognitions than Ronald MacDonald – who had 96% recognition – was Santa Claus. Oh, by the way, MacDonalds operates more playgrounds – designed to attract children and their parents to its restaurants – than any other private entity in the US;

This sort of promotion is also seen with film tie-ins such as Burger King and Toy Story.

Sorry to be a spoilt sport, but given the obesity epidemic - currently 10% of children worldwide are either overweight or obese - it’s time to rethink cross-promotion.

Beware; next time you are out and about, particularly if you have children, you will start to see cross-promotion all around you.

At the European Society for Cardiology Congress this week, we learned about more situations where aspirin is unhelpful. Professor Gerry Fowkes and colleagues from Edinburgh looked at nearly 30000 men and women aged 50 to 80 years who had never had any cardiovascular disease, but had a low ankle-brachial pressure index, a marker of peripheral vascular disease. The ankle brachial index (ABI) is the ratio of the blood pressure in the arm to the blood pressure at the ankle, and is an indicator of subclinical atherosclerosis. The ABI predicts risk of major vascular events in healthy populations, independently of established cardiovascular risk factors, such as diabetes, smoking and cholesterol. The Edinburgh team recruited over 3000 people with low ABI from their population and randomised them to 100mg aspirin or placebo, with 8 years of follow-up.

There was no difference between aspirin and placebo whether we look at cardiovascular events or all cause mortality, and there were more major bleeds in the aspirin arm of the trial. Same bottom line as before: do not give aspirin to people before they have a vascular event.

Cardiovascular disease (CVD) causes more mortality and morbidity than any other disease in both rich countries and poor countries [1]. The risk factors have been well-known for 50 years, but the optimal prevention strategy is still elusive.

Primary prevention treats individuals before they have a heart attack, whereas secondary prevention focuses on individuals who have had a heart attack. Several classes of drugs treat cardiovascular risk factors, demonstrating benefits in both primary and secondary prevention [2]. Many of these drugs are off-patent, and therefore cheap. Six years ago, Wald and Law hypothesised that a “Polypill”, containing three anti-hypertensives, folic acid, simvastatin and aspirin, could reduce the rates of CVD by over 80%, if all adults over the age of 55 years took it [3]. This week the Lancet published the first ever trial of such a Polypill [4, 5].