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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
Boston Globe Health and Science staff:
Karen Weintraub, Deputy Health and Science Editor, and Gideon Gil, Health and Science Editor.
Short White Coat blogger Ishani Ganguli
Monday, March 26, 2007
Aspirin linked to lower risk of death in women, but study authors urge caution
Women who regularly took low doses of aspirin had a lower risk of death from all causes, but particularly heart disease and cancer, Harvard researchers report in today's Archives of Internal Medicine.
But it's still too soon to recommend aspirin for the general prevention of disease, the lead author said.
"Women should not take this study, or any study, thus far as a license to take aspirin without any supervision," Dr. Andrew T. Chan of Massachusetts General Hospital said in an interview. "Women need to discuss with their physicians whether it makes sense for them, get a sense of what their risk is for cancer or cardiovascular disease, and strategize with them how to prevent the risk of disease through other means."
Chan and his colleagues looked at 24 years of data from nearly 80,000 healthy women enrolled in the observational Nurses Health Study. Women who said they used aspirin had a 38 percent lower risk of dying from cardiovascular disease and a 12 percent lower risk of dying from cancer. Their overall risk of death was 25 percent lower than women who never took aspirin regularly.
The reduction in cardiovascular disease became apparent after five years and in cancer after 10 years.
The findings conflict with another large study of women and aspirin use called the Women's Health Study. That clinical trial, in which 40,000 women randomly received aspirin or placebo, concluded that aspirin had no effect on mortality, from cardiovascular disease or other causes.
In an editorial, Dr. John A. Baron of Dartmouth Medical School says the nurses study may not have been able to account for the differences between aspirin users and non-users, suggesting women who decide to take aspirin may have better health in the first place.
"These new findings by Chan et al cannot overcome the accumulated evidence that aspirin is not particularly effective for the primary prevention of death from cardiovascular disease in women," he wrote.
Chan responded that he and his co-authors were able to account for health differences among the women in the nurses study because they had detailed information on risk factors. They found that women who were older and had more risk factors for cardiovascular disease were the ones who benefited the most from low to moderate aspirin use, defined as 1 to 14 325-milligram tablets per week.
Higher doses of aspirin have been linked in many studies to gastrointestinal bleeding, the authors noted.
The authors say their study confirms the importance of common mechanisms in both cancer and heart disease, such as inflammation. Aspirin is an anti-inflammatory and inflammation has been implicated in the formation of plaque that blocks arteries as well as in the transformation of normal tissue into cancer.
Proven ways to lower risk of disease are eating a healthy diet, maintaining a good body weight and exercising, Chan said.
"We know those modifications don't have risks," he said.