Aspirin Benefits Women at High Risk for Heart Attack
An aspirin a day helps keep heart attack and stroke at bay in women diagnosed with cardiovascular disease, say health experts. But a new study suggests that not enough of these women are taking advantage of this cheap, readily available treatment, according to a report at the International Conference on Women, Heart Disease and Stroke.
Less than half of women with cardiovascular disease who could benefit from daily aspirin are actually using it, according to researchers.
"We don't know why," says study author Dr. Jeffrey S. Berger, chief resident at Beth Israel Medical Center in New York City.
In the study, Dr. 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, Dr. Berger says, 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, Dr. Berger notes, 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, Dr. 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, Dr. Berger says, "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 African-American women were 33 percent less likely to use the treatment than were Caucasian women.
"Women are not as aware as they should be that cardiovascular disease is such a threat," Dr. Berger explains. "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 says. "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."
Dr. 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," Dr. Goldberg says. "But we also should let women know [they should] talk to their doctors about it."
She emphasizes 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," Dr. Goldberg notes.
Adds Dr. 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 says, the physician can decide whether aspirin therapy is needed.
Always consult your physician for more information.
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A new study suggests the gender gap in heart attack treatment that favored men may be closing as more women receive the same recommended care, say researchers at the Second International Conference on Women, Heart Disease and Stroke.
Researchers found that women who have had a heart attack or suffered chest pain are being given appropriate drug intervention upon discharge from a hospital, at rates similar to men.
American Heart Association and American College of Cardiology practice guidelines recommend that people with acute coronary syndrome (ACS) - which includes angina and heart attack - be treated with aspirin, beta-blocker medications, and lipid-lowering drugs called statins.
Previous research found that women with heart disease were not receiving as much of this recommended therapy as men after a heart attack or unstable angina.
"But significant progress has been made with more physicians/nurse practitioners following practice guidelines," says Shu-Fen Wung, associate professor of nursing at the University of Arizona.
"In addition, there is not a statistically significant gap in the treatment between men and women," she says.
The study included 177 men and 35 women with ACS.
It found that 90 percent of the men and women received aspirin and beta blockers when they were discharged from a hospital.
Two-thirds of women received lipid-lowering statins, compared with 78 percent of men.
The women lived an average of 179 days following their ACS hospitalization while the men lived an average of 156 days.
"More people are following the guidelines," Wung says. "Women are receiving more of the recommended medications and there are less gender disparities in the usage of these medications either as a primary or secondary prevention."
Always consult your physician for more information.
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