Should women take aspirin to prevent heart disease?
Mitchell Ross, MD, is a cardiologist at Banner Estrella Medical Center.
Question: Should women take aspirin to prevent heart disease?
Answer: Cardiovascular disease is the leading cause of mortality in women worldwide, accounting for one third of deaths. In the Unites States, 38 million women are living with cardiovascular disease. Much of this disease is preventable through either lifestyle interventions or medical therapies. However, many women are uncertain about how best to reduce their personal risk, and whether or not aspirin can help them to prevent heart disease.
Two years ago, the results of the Women’s Health Study were released. This was the first large-scale trial of low dose aspirin in the prevention of heart attack and stroke in women. Funded by the National Heart, Lung and Blood Institute, the trial enrolled nearly 40,000 healthy women aged 45 and above. Women were randomized to receive either 100 mg of aspirin on alternate days or placebo and were then followed for ten years.
The study found that, on the whole, aspirin did not prevent first heart attacks or death from cardiovascular disease. Additionally, there was an increase in episodes of gastrointestinal bleeding, a known side effect of aspirin.
However, the study also pointed to some advantages of aspirin use among women. The risk of ischemic stroke (due to blockages of blood vessels in the brain) was 17 percent lower in the aspirin group. Additionally, in patients 65-years of age or older, aspirin was shown to reduce the risk of a first heart attack by 34 percent.
So what should a woman do?
- The American Heart Association published updated guidelines for the prevention of cardiovascular disease in women in February. They recommend that women over 65 – even healthy women – consider taking a baby aspirin once a day. For high risk women (including patients with diabetes, chronic kidney disease, stroke, peripheral arterial disease, or established coronary disease), daily aspirin is recommended regardless of age, unless contraindicated.
Before beginning aspirin therapy, all women should consult their doctors to examine their personal health situations and balance the risks and benefits.