Wednesday, November 08, 2006

For Many Women, Daily Aspirin Can Protect the Heart

(HealthDay News) -- The message is clear, but not enough women heed it: Taking an aspirin a day can help prevent heart attacks and stroke in some women, and even prevent further problems if you already have cardiovascular disease.

But it's not a one-size-fits-all prescription. Whether you should -- or shouldn't -- take a daily aspirin depends on a number of factors, including your age and your risk factors for heart disease and stroke, such as high cholesterol levels or diabetes.

One thing's clear: Fewer than half of American women who could definitely benefit -- those who already have cardiovascular disease -- actually take a daily pill, according to recent research. Doctors say the finding underscores the need for women to talk with their health-care provider about what's best for them.

"Aspirin works for women who already have cardiovascular disease, for those with multiple risk factors [for suffering a heart attack or stroke] and for healthy women over the age of 65," said Dr. Nieca Goldberg, chief of women's cardiac care at Lenox Hill Hospital in New York City, and author of The Women's Healthy Heart Program.

Goldberg was summarizing the findings of several recent studies and the latest guidelines issued by the American Heart Association. According to those guidelines, there's good reason to prescribe a daily aspirin for high-risk women. But the decision about aspirin for women at intermediate and lower risk is more difficult, the heart association said.

Doctors should take a more conservative approach with low- and intermediate-risk women, the AHA suggests, and should bear in mind that aspirin therapy has the potential for gastrointestinal bleeding and other side effects. Those side effects may outweigh the benefits in women at low and moderate risk.

Women between the ages of 45 and 65 who haven't had heart disease but do have risk factors -- including diabetes, high blood pressure and high cholesterol -- might benefit from aspirin therapy to prevent cardiovascular disease. But, they should discuss the matter with their doctor to determine their degree of risk, Goldberg said.

Once even healthy women reach the age of Medicare eligibility, it's probably wise to take a daily aspirin, doctors say. "At age 65 and over, for healthy women, it looks like aspirin prevents cardiovascular events," said Dr. Raluca Arimie, a cardiologist at the Santa Monica-UCLA Medical Center, in California.

But for healthy women between the ages of 45 and 65, doctors "haven't found any benefit to the heart, but they found a slight benefit for stroke prevention," said Arimie, who's also an assistant professor of medicine at the University of California, Los Angeles David Geffen School of Medicine.

Goldberg and Arimie agreed that it's crucial to know and understand your individual risk for heart disease and to make any decision on aspirin therapy in concert with your physician.

"Every woman should have a conversation with their own doctor," Arimie said. And, she added, don't necessarily expect to get the same advice doctors might give a man of the same age, or a woman of the same age with a different health status.

It's also important to know that doses in aspirin therapy can vary, Arimie said, with an 81 milligram tablet the typical starting dose for healthy people. "Sometimes it goes to 325 milligrams in those who have already had a heart attack," she said.

"I don't think everybody should be on aspirin," Arimie added. "But it should be decided case by case. If a healthy woman [under age 65] wants to take it to reduce stroke risk, she must be aware of the [GI] bleeding risk."

More information
To learn more about aspirin and heart health, visit the American Heart Association.

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