Previous research has clearly demonstrated that aspirin can help stop heart attacks as they are happening in both men and women by dissolving blood clots blocking blood flow to the heart muscle. Also, men and women who have already had a heart attack can sharply cut their chances of having another by taking low doses of aspirin regularly.
But the value of having healthy people take low doses of aspirin on a regular basis to prevent a first heart attack has been less clear. Five studies have indicated it may have that effect, prompting aspirin makers to begin promoting that use and many men and women to start taking it. Very few women were involved in those studies, however, raising concerns that many women could be needlessly exposing themselves to the drug's risks.
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"We know millions of people take aspirin thinking it will prevent them from having a heart attack," said Scott M. Grundy of the University of Texas Southwestern Medical Center in Dallas. "But there are risks, and there might be a huge number of women who might be taking aspirin who shouldn't be, because the risks may outweigh the benefit. We just hadn't had the data."
In the new, federally funded Women's Health Study, about half of a group of 39,876 women age 45 and older took 100 milligrams of aspirin every other day, while the other half took a placebo. After 10 years, the researchers found that aspirin did not reduce the overall risk of heart attacks. But aspirin did reduce by 17 percent the overall risk of strokes, which tend to strike women more than men, and cut the risk for the most common type of strokes by 24 percent.
When the researchers did a separate analysis of women 65 and older, however, they found that those taking aspirin were 34 percent less likely to suffer heart attacks, and that the protection against strokes increased as well.
Other researchers said the findings represent a watershed.
"This is the definitive trial that we've been waiting for," said Lori Mosca, a women's heart expert at Columbia University. "This answers a big question about whether healthy women have benefits from taking low-dose aspirin."
Mosca and other experts emphasized that the potential risks of aspirin can be significant, particularly for women, making it especially crucial that they consult their doctors. In the study, women taking aspirin did suffer from more bleeding strokes.
"This is exactly the type of study that doctors need when they are sitting across the desk from a patient trying to decide about the best course of action," said Larry Goldstein of Duke University, speaking for the American Heart Association.
The same study also found that vitamin E does not protect women against heart disease. That finding is the latest in a series of major blows to the theory that the vitamin, an antioxidant, might provide that benefit.