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.

Aspirin Use Is Clear for High-Risk Women

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.

Seek a Physician for Individual Advice

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.