Aspirin
to Prevent Heart Attacks in Women Recommended
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
may even prevent further problems in women who already have cardiovascular
disease.
 But it is not a one-size-fits-all prescription. Whether
you should - or should not - 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 is 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.
Physicians say the finding underscores the need for women
to talk with their health-care provider about what is 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," says Dr. Nieca Goldberg,
chief of women's cardiac care at Lenox Hill Hospital in New York City.
Dr. Goldberg summarizes findings of several recent studies
and the latest guidelines issued by the American Heart
Association (AHA).
According to those guidelines, there is 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, says the AHA.
Physicians 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 have not 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 physician
to determine their degree of risk, says Dr. Goldberg, who is author of The
Women's Healthy Heart Program.
Once even healthy women reach the age of Medicare eligibility,
it is probably wise to take a daily aspirin, physicians say.
"At age 65 and over, for healthy women, it looks like aspirin
prevents cardiovascular events," says Dr. Raluca Arimie, a cardiologist at
the Santa Monica-UCLA Medical Center.
But for healthy women between the ages of 45 and 65, physicians "haven't
found any benefit to the heart, but they found a slight benefit for stroke
prevention," says Dr. Arimie, at the University of California, Los Angeles.
Drs. Goldberg and Arimie agreed that it is crucial to know
and understand your individual risk for heart disease and to make any decision
on aspirin therapy in collaboration with your physician.
"Every woman should have a conversation with their own doctor," notes
Dr. Arimie.
And, she adds, do not necessarily expect to get the same
advice physicians might give a man of the same age, or a woman of the same
age with a different health status.
It is also important to know that doses in aspirin therapy
can vary, says Dr. Arimie, 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 says. "I don't think everybody should be on aspirin.
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."
Always consult your physician for more information.
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It is a myth that heart disease is a man's disease.
In fact, one in 14 women aged 45 to 64 has heart disease.
One in six women over the age of 65 has heart disease.
Currently, 6 million women have heart disease, states the National
Heart, Lung, and Blood Institute.
Coronary heart disease is the single largest cause of
death for females in the United States.
Almost 16 percent of girls ages six to 19 are overweight,
which is a risk factor for heart disease.
About 25 percent of girls in grades nine through 12
report using tobacco, which is also a risk factor for heart disease.
At menopause, a woman's heart disease risk starts to
increase significantly.
Each year, about 88,000 women ages 45 to 64 have a heart
attack.
Beginning at age 50, more women than men have elevated
cholesterol.
Each year, about 372,000 women age 65 and older have
a heart attack.
About 21 million women age 60 and older have high blood
pressure.
The average age for women to have a first heart attack
is about 70, and women are more likely than men to die within a few weeks
of a heart attack.
About 35 percent of women who have had a heart attack
will have another within six years.
A heart attack, or myocardial infarction, occurs when
one of more regions of the heart muscle experience a severe or prolonged
decrease in oxygen supply caused by blocked blood flow to the heart muscle.
The blockage is often a result of atherosclerosis -
a buildup of plaque, known as cholesterol, other fatty substances, and
a blood clot.
Plaque inhibits and obstructs the flow of blood and
oxygen to the heart muscle, thus reducing the flow to the rest of the body.
If the blood and oxygen supply is cut off severely or
for a long period of time, muscle cells of the heart suffer severe and
devastating damage and die.
The result is damage or death to the area of the heart
that became affected by reduced blood supply.
Always consult your physician for more information.
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