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Aspirin Could Save More Women's Hearts

Less than half of those who might benefit take the cheap, effective drug, study finds

FRIDAY, Feb. 18, 2005 (HealthDay News) -- An aspirin a day helps keep heart attack and stroke at bay in women diagnosed with cardiovascular disease.

But a new study suggests that not enough of these women are taking advantage of this cheap, readily available treatment.

Less than half of women with cardiovascular disease who could benefit from daily aspirin are actually using it, according to data presented by researchers Feb. 18 at the Second International Conference on Women, Heart Disease and Stroke in Orlando, Fla.

"We don't know why," said study author Dr. Jeffrey S. Berger, chief resident at Beth Israel Medical Center in New York City. In the study, Berger and his colleagues were not able to ask the women the reasons they were not taking the potentially lifesaving drug.

The New York researchers examined data from the Women's Health Initiative Observational Study, focusing especially on the health of nearly 100,000 postmenopausal women. They then narrowed that focus to 8,928 women with a history of cardiovascular disease, including stroke and heart attack.

According to the investigators, just 4,101 women -- about 46 percent -- reported they took daily low-dose aspirin. Among those with a previous history of stroke, 43 percent were taking aspirin therapy, while 54 percent of women with a previous history of heart attack said they took the drug on a regular basis.

Ideally, Berger said, more than 90 percent of women at high cardiovascular risk should be on this cheap, safe and effective medication. Studies suggest that 95 percent of women with a history of cardiovascular disease should take aspirin or other medicines, Berger said, to reduce their risk of repeat strokes and heart attacks. The other 5 percent would be advised against taking aspirin due to increased risks for side effects, such as bleeding.

In addition, Berger found that about 70 percent of the women who did take aspirin took the higher 325-milligram daily dose, although experts now say that 81 milligrams a day is just as effective. However, the data on aspirin use was collected in the late 1990s, Berger said, "so those dosages may have declined since then."

Women who were on Medicaid were 40 percent less likely to take aspirin as those not on Medicaid, the study found, and black women were 33 percent less likely to use the treatment than were white women.

"Women are not as aware as they should be that cardiovascular disease is such a threat," Berger said. "It's not something women tend to think about."

Another possible factor explaining women's low use of aspirin is that "in the past, women have not been treated as aggressively as men for cardiovascular problems," he said. "That may be changing, and awareness may be increasing."

Another expert, Dr. Nieca Goldberg, called the study results "quite disappointing," adding that "women are getting the short end of the stethoscope."

Goldberg, who is chief of women's cardiac care at Lenox Hill Hospital in New York City and author of Women Are Not Small Men, said that for years she has advocated that closer attention be paid to women's cardiovascular health.

"We have to think about how to improve that [percentage], and one way is obviously dissemination of the importance of aspirin use in women with cardiovascular disease throughout the medial community," Goldberg said. "But we also should let women know [they should] talk to their doctors about it."

She emphasized that aspirin therapy is meant for those at high risk of heart disease. "There is still no study that shows women over 35 with no cardiovascular risk factors will benefit from an aspirin a day," Goldberg said.

Added Berger: "Women who are healthy should go see their doctor, and their doctor should assess their risk of cardiovascular disease -- high, intermediate or low." Based on that evaluation, he said, the doctor can decide whether aspirin therapy is needed.

More information

To learn more about a heart-healthy lifestyle, visit the American Heart Association.

SOURCES: Jeffrey S. Berger, M.D., chief resident, Beth Israel Medical Center, New York City; Nieca Goldberg, M.D., chief, women's cardiac care, Lenox Hill Hospital, New York City, and author of Women Are Not Small Men; Feb. 18, 2005, presentation, Second International Conference on Women, Heart Disease and Stroke, Orlando, Fla.
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