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ASPIRIN AND CARDIOVASCULAR DISEASE IN WOMEN.

The Physicians' Health Study showed aspirin use to be effective for primary prevention of myocardial infarction, but this large randomized trial involved only men. To determine whether aspirin has similar effects in the lower- risk population of women, researchers from the Nurses' Health Study examined rates of aspirin use and cardiovascular events in a cohort of 87,678 nurses.

The nurses were free of diagnosed coronary heart disease, stroke, and cancer at the time of enrollment in the current study. Follow-up over six years is 97 percent complete. In a multivariate analysis that adjusted for coronary risk factors, women who reported taking one to six aspirin tablets weekly had a lower risk of MI than nonusers (relative risk, 0.75). There was no difference between these two groups in rates of stroke or cardiovascular death. Women who used more than six aspirin per week had no reduction in cardiovascular risk.

It is possible that the apparent benefit from taking one to six aspirin weekly stems from other factors associated with aspirin use. The authors conclude that a randomized trial of aspirin, analogous to the Physicians' Health Study, is needed to determine whether the benefits of routine aspirin use exceed the risks.

— THL

Published in Journal Watch General Medicine July 30, 1991

Citation(s):

Manson JE et al. A prospective study of aspirin use and primary prevention of cardiovascular disease in women. JAMA 1991 Jul 24 266 521-527.

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