Many postmenopausal women with cardiovascular disease don't use lifesaving aspirin therapy

02/09/05

American Heart Association meeting report

ORLANDO, Feb.18 Low-dose aspirin therapy has been shown to reduce the chances of a secondary heart attack or stroke in women who already have cardiovascular disease (CVD). Yet, less than half of women with CVD use this over-the-counter, relatively inexpensive therapy, researchers reported today at the Second International Conference on Women, Heart Disease and Stroke.

"We know that aspirin therapy helps women who have cardiovascular disease live longer and feel better. Our study sought to characterize the extent to which women use this easily accessible therapy, as well as the disparities that exist between different groups of women," said lead author Jeffrey S. Berger, M.D., chief resident at Beth Israel Medical Center in New York.

Berger and colleagues examined data from the Women's Health Initiative Observational Study, which tracked nearly 100,000 post-menopausal women. The researchers singled out 8,928 women in the study who had a history of cardiovascular disease, including stroke and heart attack. The women had reported if they were on aspirin and other therapies.

Studies have shown that about 95 percent of the women who have cardiovascular disease should be taking aspirin, as well as other medications, to help ward off secondary heart attacks and strokes. Less than 5 percent of women with CVD might not be eligible for aspirin therapy because of side effects, such as bleeding, Berger said.

The researchers found that 4,101 (46 percent) of the women with CVD were on low-dose aspirin therapy. Only 43 percent of women with prior stroke were on aspirin therapy. And among the 2,230 patients with documented heart attacks, only 54 percent reported using aspirin.

"Ideally, the percentage of women with a known history of cardiovascular disease who take aspirin should be above 90. To find such low numbers was quite discouraging," Berger said.

Looking at the data in more detail, the researchers found that women with existing CVD who were college educated were close to 40 percent more likely to be on aspirin therapy than those who did not have a college education. The older a woman was in the study, the more likely she was on aspirin therapy.

The researchers also found that 70 percent of the women taking aspirin were on the higher dose of 325 mg daily, when research suggests that 81mg is just as effective and has fewer side effects, Berger said.

Women who were on Medicaid were 40 percent less likely to be using aspirin therapy than those who were not on Medicaid. And black women were 33 percent less likely to use the therapy than white women.

"In the late 1980s, the federal government sought to eliminate such disparities between racial and socioeconomic groups, so to find that such a divide still exists illustrates the work that still needs to be done," he said.

Berger recommends that consumers get more involved in their health care. Women who have cardiovascular disease and are not taking aspirin therapy should talk with their physicians about the pros and cons of taking low-dose aspirin daily.

"Physicians need to be cognizant of these disparities. They must be mindful always of the patient and strive to treat each patient individually, without regard for the patient's socioeconomic status, insurance type or race," he said.

Source: Eurekalert & others

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