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Many Not Doing Enough to Prevent Heart Disease

Women also less likely than men to take aspirin as preventive measure, report finds

WEDNESDAY, June 2, 2004 (HealthDayNews) -- From taking aspirin to exercise and diet, many Americans are still not doing nearly enough to prevent heart disease or prevent second heart attacks and stroke, a new study finds.

In a surprise twist, the researchers also found women are not taking aspirin to prevent heart disease as much as men are, despite the fact that it is the leading killer of women.

Data on 97,000 men and women from 20 states reveal that only 26 percent of women and 35 percent of men take aspirin to prevent heart attacks and stroke. Only about two-thirds of men and women reported exercising, and two-thirds to three-quarters reported changing their diet.

The sample was made up of a cross-spectrum of people at various levels of risk for heart disease, who participated in the U.S. Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System, according to a report in the June issue of the American Journal of Preventive Medicine.

The data are especially worrying among the 14 percent of men and 12 percent of women who are at the greatest risk because they are diabetics or have a history of heart attack, stroke or heart disease.

"Woman and men who are at high risk for heart disease don't take aspirin as much as they should," said study author Dr. Catherine Kim, an assistant professor in the departments of internal medicine and obstetrics and gynecology at the University of Michigan Medical School.

It is generally recommended that people who have had a heart attack or diabetes or a stroke take a daily aspirin to prevent further events, she added.

"Only about half the people who actually had one of these problems actually took aspirin," Kim noted.

There was a significant difference between men and women, she said. For women at high risk, only 46 percent took aspirin compared with 59 percent of men.

Kim said that she is not sure why this difference exists. But women were prescribed aspirin less often than men, she noted.

Kim and her colleague, Dr. Gloria Beckles, from the CDC's Division of Diabetes Translation, also found doctors failed to give advice on diet and exercise often enough.

"The reports of people actually dieting and exercising were not as good as they could have been," Kim said.

The research team found women were slightly more likely than men to diet and exercise, except among high-risk patients, where men were almost equal to women in exercising.

Physicians need to discuss aspirin use with their patients, the researchers urged.

Even though diet and exercise advice from a doctor has never been shown to affect behavior, "it's cheap advice, it's probably not harmful, and should be brought up in the context of a checkup," Kim said.

On the patient's side, Kim believes that people are not hearing the discussion about aspirin. "The way to bring it to the doctor's attention is to bring it up yourself," she advised.

In terms of diet and exercise, people aren't doing it. "It is really something that has been shown to lower your risk of disease. Folks need to make major lifestyle changes," Kim said.

"If you don't feel that you can do that, you need to ask for help from your doctor or nutritionist or a weight loss program," she added.

Dr. David L. Katz, an associate clinical professor and director of the Prevention Research Center at Yale University School of Medicine, said "it is remarkably difficult to convince women that heart disease affects them, too."

Even though 10 times as many women die of heart disease as die of breast cancer, "breast cancer remains a far more feared and provocative topic for women than heart disease," he said.

"Until recently, the only real reason to take aspirin was for heart disease prevention. Thus, it comes as no surprise that women have neglected aspirin use for the most part. Men accept they are at risk for heart disease, and aspirin is an easy way to reduce that risk," Katz said.

That women make a greater effort with lifestyle -- particularly diet -- is not surprising either, Katz said. "Diet offers many potential benefits, including weight control, and thus this effort may be related to concerns quite distinct from heart disease prevention."

"The challenge is getting the right people to apply the right preventive strategies at the right times for the right reasons," Katz said.

More information

The National Heart, Lung, and Blood Institute can tell you more about reducing your risk of heart attack.

SOURCES: Catherine Kim, M.D., M.P.H., assistant professor, departments of internal medicine and obstetrics and gynecology, University of Michigan Medical School, Ann Arbor; David L. Katz, M.D., M.P.H., associate clinical professor, director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; June 1, 2004, American Journal of Preventive Medicine
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