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Back to Conference Highlights
13/11/05 - 16/11/05, Dallas, Texas
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Scientific Sessions, the largest cardiovascular meeting
in the world, is being held in Dallas, Texas Nov. 13–16.
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DALLAS, Nov. 15 — Aspirin can significantly reduce death
rates for postmenopausal women with cardiovascular disease (CVD),
researchers reported at the American Heart Association’s
Scientific Sessions 2005.
“It was known before, and we have shown it again: aspirin
therapy is a lifesaving therapy,” said Jeffery S. Berger, M.D.,
lead author and cardiology fellow at Duke University Medical
Center in Durham, N.C. “Women with cardiovascular disease should
be on aspirin unless there is a medical contraindication such as
hypersensitivity or gastrointestinal intolerance.”
Data from nearly 9,000 women with CVD demonstrated that those
taking aspirin had significantly lower risk of cardiovascular
death as well as from all causes of death, compared to women who
did not take the over-the-counter drug.
Women with CVD (8,928) enrolled in the Women's Health
Initiative Observational Study, a longitudinal multicenter study
of 93,676 women aged 50 to 79 years at baseline, were used for
this analysis. The primary outcome was the incidence of
cardiovascular events, which included heart attack, stroke,
cardiovascular death and all-cause mortality.
Among the 8,928 women with stable CVD, 46 percent reported
taking aspirin, of whom 30 percent were on 81mg and 70 percent
were on 325mg. Six and a half years after enrolling in the
Women’s Health Initiative’s (WHI) Observational Study, 956 of
the women with CVD had died.
During 6.5 years of follow-up, 8.7 percent of participants
died when compared to the no aspirin group, both 81mg and 325mg
groups were associated with a 17 percent reduction in all-cause
mortality and a 25 percent lower death rate from all
cardiovascular diseases.
For the prevention of cardiovascular events, both 81mg and
325mg were associated with a non-significant 11 percent
reduction in stroke, no effect on MI, and a non-significant
reduction in events. Compared to 325mg, treatment with 81mg was
not significantly different in its effect on all-cause
mortality, cardiovascular events or any individual endpoint.
“This was not a randomized trial so we could not demonstrate
cause-and-effect,” Berger said. “Aspirin was associated with a
significant reduction in death, yet we are unable to conclude
that aspirin caused the reduction.”
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Past studies have shown that aspirin can reduce fatal and
nonfatal cardiovascular problems in patients with cardiovascular
disease. Despite this well known protective effect, less than
half of all women in the study took aspirin regularly, Berger
said.
“Unfortunately, when you look at the aspirin data, you find
that women have been under-represented in many of the studies,”
he said. “There is no conclusive data that provides the optimal
dose or effect of aspirin usage in women.”
“That was surprising and disappointing. Many studies have
shown that 81 mg is just as effective in the secondary
prevention of cardiovascular events as 325 mg. And it is well
known that the higher the dose, the more likely you are to
suffer side effects. Why so many women were on the higher dose
was unclear.
“Whether a woman was taking 81 mg or 325 mg, the reduction in
death rate was the same, and that point, I think, is the most
noteworthy of the study,” Berger said. “It is difficult from
this study to say that the 81 mg dose is better than 325 mg, but
it does appear that it is as effective as 325 mg.”
He also noted that because only postmenopausal women
participated in the WHI study, the findings reported today may
not apply to young women with CVD.
“We have to do a better job of making sure that women who
need aspirin get aspirin,” Berger said. “Our study should
stimulate physicians to explain the benefits of aspirin to
select groups of female patients. For patients who worry about
aspirin’s side effects, this study shows that the smallest dose
necessary is just a baby aspirin a day.”
The study was funded by the National Heart, Lung, and Blood
Institute.
Co-authors are David L. Brown, M.D.; Gregory L. Burke, M.D.;
Albert Oberman, M.D.; John B. Kostis, M.D.; Robert D. Langer,
M.D.; Nathan D. Wong, Ph.D.; and Sylvia Wassertheil-Smoller,
Ph.D
Sources
American Heart Association - Scientific Sessions - 2005
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