Daily Aspirin a Smart Move After Menopause

Study suggests it reduced death risk in those with heart disease

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By Amanda Gardner
HealthDay Reporter

TUESDAY, Nov. 15, 2005 (HealthDay News) -- The simple act of taking aspirin appears to be a lifesaving measure for millions of women with heart disease.

New findings presented Monday at the American Heart Association's annual meeting in Dallas found that aspirin seemed to significantly reduce death rates for postmenopausal women with cardiovascular disease.

It did not seem to matter if women were taking a lower or higher dose of aspirin, just as long as they took it regularly.

"The results are consistent, and make it clear that women who have cardiovascular disease benefit from aspirin," said Dr. Nieca Goldberg, chief of women's cardiac care at Lenox Hill Hospital in New York City. "It doesn't change any of our guidelines."

Goldberg was not involved with the study.

Unfortunately, the study also found that fewer than half the participants took aspirin regularly, despite ample previous research demonstrating that aspirin reduces both fatal and nonfatal vascular events in people with cardiovascular disease.

For this study, the authors analyzed data from the Women's Health Initiative, funded by the National Institutes of Health. Of 93,676 women aged 50 to 79 participating in the study, the researchers focused on 8,928 women who had cardiovascular disease, including those who had suffered a heart attack, stroke, mini-stroke, cardiac chest pain or a procedure to open clogged coronary arteries.

Over about six-and-a-half years of follow-up, postmenopausal women taking aspirin on a regular basis had a 17 percent lower risk of death from any cause, compared to women who were not taking aspirin. The women taking aspirin also showed a 25 percent reduction in death from cardiovascular disease.

The results were identical for the 81-milligram and the 325-milligram dose.

Yet, only 46 percent of the women in the study were taking aspirin regularly; it's unclear why this figure is so low.

"This was rather surprising," said Dr. Jeffrey Berger, first author of the study and a cardiology fellow at Duke University Medical Center. "Unfortunately, we don't know why, although there are a few things to think about. Although we know that aspirin is effective, there's not much data about aspirin in women, so the message may not have come across as strong as it should have. Also, because aspirin is over-the-counter, people do not look at it as a lifesaving medication."

"We're not sure whose fault it is -- patient, physician or society," he continued. "Hopefully, this study will really demonstrate that aspirin is effective, and hopefully more women will use it."

Because the trial was observational and not randomized -- meaning it was based on a review of previous research -- it's not possible to say with certainty whether the aspirin actually caused the benefit.

"We have biological plausibility and we have size, so we're pretty comfortable saying that aspirin therapy is associated with this, and perhaps it does cause this," Berger said.

A trial directly comparing the lower and higher doses of aspirin is needed but, until that time, Berger suggests going for the lower dose. "The lower dose is just as effective, and we already know there are fewer side effects," he said.

Unless they have an allergy, women with cardiovascular disease should take aspirin, Goldberg added.

More information

The American Heart Association's Go Red For Women movement has more on women and heart disease.

SOURCES: Jeffrey S. Berger, M.D., cardiology fellow, Duke University Medical Center, Durham, N.C.; Nieca Goldberg, M.D., spokeswoman, American Heart Association, and chief, women's cardiac care, Lenox Hill Hospital, New York City, and author of Women Are Not Small Men; Nov. 14, 2005, presentation, American Heart Association annual meeting, Dallas

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