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Postmenopausal Women with Heart Disease Should Take Aspirin

Postmenopausal Women with Heart Disease Should Take  Aspirin
Postmenopausal Women with Heart Disease Should Take  Aspirin


Duke Health News Duke Health News

DALLAS -- Aspirin can significantly reduce death rates for
postmenopausal women with heart disease, according to a new
analysis by Duke University Medical Center cardiologists.
Furthermore, the researchers found the same beneficial effect
for low-dose aspirin (81 mg a day) as for higher dose aspirin
(325 mg).

These findings are important because they provide a
scientific basis for recommending that more postmenopausal
women should take aspirin, the researchers said. In their
analysis of 8,928 women, the researchers found that fewer than
half were taking any aspirin at all.

"The fact that more women are not taking aspirin is very
discouraging," said Duke cardiology fellow Jeffrey Berger,
M.D., who presented the results of his analysis on Nov. 14,
2005, at the annual scientific sessions of the American Heart
Association in Dallas. "Aspirin is a drug that has been used
for many years – it is effective, inexpensive and widely

"We know that aspirin can save the lives of postmenopausal
women with cardiovascular disease, so the percentage of those
women taking aspirin should be in the high 90 percent," Berger
continued. "The only reason for these women not to be taking
aspirin is if they have an allergy or suffer severe side

For his study, Berger analyzed the data collected by the
Women's Health Initiative Observational Study, a National
Institutes of Health-funded project that has been following
93,676 postmenopausal women between the ages of 50 to 79 since
1994. The women participating in the study were not required to
take any medications, nor were they asked to change their
health habits.

Of that large cohort of women, Berger identified 8,928 women
who had cardiovascular disease, including women who had
suffered a heart attack, stroke, transient ischemic attack (TIA
or mini-stroke), or who had cardiac chest pain or a prior
procedure to open clogged coronary arteries. During the 6.5
years of the study, 8.7 percent of the women died.

Berger found that only 46 percent of these women were taking
aspirin on a regular basis. Compared to the women who did not
take aspirin, those who did showed a 17 percent reduction in
all-cause mortality. The women taking aspirin also demonstrated
a 25 percent reduction in deaths associated with cardiovascular

"When we looked at outcomes such as all-cause mortality or
any other cardiovascular event, we found no significant
difference between the two doses," Berger said. "For that
reason, we not only encourage all postmenopausal women to talk
with their doctors about taking aspirin, but if the doctor
recommends aspirin, it should be taken at the lowest possible
effective dose."

In terms of aspirin dosage, 30 percent of women took 81 mg
daily, while 70 percent took 325 mg daily. An 81 mg dose is the
equivalent of a baby aspirin. Berger also found that both
dosages were associated with non-significant reduction in the
number of cardiovascular events.

Berger pointed out that since this was an observational
study and not a randomized clinical trial, it is not possible
to state that aspirin was the actual cause of the outcome
improvements. However, he did add that the population is a
"real-world" group of patients, since the women who
participated came from across the country, from rural and urban
settings, and from all socioeconomic groups.

While the beneficial effect of aspirin for men is
well-documented, the case is different for women.

"All the major clinical trials studying the potential of
aspirin either excluded women altogether or were predominantly
men," Berger explained. "Also, elderly women have been even
less studied, and these are the women who are most likely to
benefit from aspirin as a preventative measure."

Other members of the team included David Brown, SUNY-Stony
Brook School of Medicine; Gregory Burke, Wake Forest
University, Winston-Salem, N.C., Albert Oberman, University of
Alabama-Birmingham; John Kostis, UMDNJ-Robert Wood Johnson
Medical School, New Brunswick, N.J.; Robert Langer, University
of California-San Diego; Nathan Wong, University of
California-Irvine; and Sylvia Wassertheil-Smoller, Albert
Einstein College of Medicine, NY.

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