Aspirin may help women cut heart attack risk, study says

Report in today's JAMA shows preventive potential for both sexes

March 22, 2006|By JULIE BELL | JULIE BELL,SUN REPORTER

A new study suggests that low doses of aspirin may help prevent heart attacks in women at risk for cardiovascular disease, challenging the theory that aspirin helps men's hearts more than women's.

"Women are clearly benefiting from taking aspirin and should continue to take it to improve their cardiovascular health," said Diane Becker, the study's lead author and a professor at the Johns Hopkins University School of Medicine.

The report appears in today's Journal of the American Medical Association.

Doctors have long believed aspirin is beneficial for men and women who have had heart attacks. But the question of who should take aspirin to prevent a heart attack, and how much, has proved trickier to answer.

Although several studies have suggested aspirin helps men avoid heart attacks, the results have been murkier for women.

Some studies didn't include enough women to draw conclusions, the new study's authors noted. A 2005 study that did - involving nearly 40,000 women who took aspirin or a placebo every other day for 10 years - produced mixed results, depending on age.

The 2005 Women's Health Study concluded that aspirin lowered the overall risk of stroke for all women but significantly lowered heart attack risk only for those over 65.

The findings reported in today's JAMA were based on laboratory blood work, not medical events, and don't definitively determine whether aspirin lowers the risk of heart attack for anyone, experts said.

Still, they provide what the authors believe is the first man-to-woman comparison of how a low dose of aspirin affects a known cause of heart attack and stroke - platelet clumping.

The authors wanted to know whether aspirin, which inhibits the formation of such clot-forming clumps of blood cells, worked to the same degree in men and women.

Roughly speaking, the answer appears to be yes, researchers said, though women's platelets tended to clump more when prompted, both before and after aspirin.

To conduct the experiment, 571 men and 711 women took 81 milligrams of aspirin daily - the normal low dose sold for that purpose - for 14 days.

Their blood was drawn before they started taking the aspirin and after they were finished, 14 days later. The drawn blood was then exposed to chemicals that prompt platelets to glom together.

All the participants were at least 21 years old and healthy, but they were also siblings of people who had suffered heart attacks before the age of 60. That presumably put them at higher risk for heart attacks.

The results suggest it might be a good idea to test the effects of low-dose aspirin therapy over a long period of time in large numbers of healthy people with a family history of heart disease, said Dr. Roger Blumenthal, a Johns Hopkins cardiologist who was not involved in the study.

"I think it supports the idea that women and men with a family history of heart disease may want to consider aspirin therapy if they're over age 40, but we really still need a clinical trial to prove that," he said.

While the new findings don't settle the issue, Dr. Nauder Faraday, a Johns Hopkins associate professor and co-author, suggested the secret might be the dose.

The researchers from Hopkins and Baylor College of Medicine in Houston who conducted the study relied on the equivalent of one so-called "baby aspirin" per day, while some earlier studies gave women a lower dose.

"Overall, we can say that aspirin does what it's supposed to do, and [the study] supports the trials that show there's a protective effect," Faraday said.

For now, Dr. Patrick E. McBride, a University of Wisconsin cardiology professor who was not involved in the study, said people should still ask their doctors whether to take aspirin daily.

"The Women's Health Study showed that, for the average woman, approximately the best time to start taking aspirin is 60 to 65" years of age, McBride said. "But for individual higher-risk women, their doctor might suggest they start taking aspirin earlier."

The study was funded by the National Heart, Lung and Blood Institute, a member of the National Institutes of Health, and the Johns Hopkins Clinical Research Center.

juliana.bell@baltsun.com

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