Tuesday, March 13, 2007

Rethink Aspirin New guidelines from the American Heart Association view more women as at risk of heart disease and advise a daily dose of aspirin for most healthy older women -- a change from the organization's last guidelines, issued in 2004. The AHA now recommends that all women with heart disease take aspirin (75 to 325 milligrams) and that most healthy women older than 65 take a daily baby aspirin (81 milligrams). (Previously, the upper limit advised for women was 162 milligrams.) Aspirin is not advised for healthy younger women because new research shows it doesn't lower the risk of heart attack for women who haven't had one while it raises the risk of stomach bleeding.

For healthy women younger than 65, "there is no evidence that it protects the heart," said Lori Mosca, director of preventive cardiology at NewYork-Presbyterian Hospital and chair of the AHA panel that wrote the guidelines. New American Heart Association guidelines recommend all patients with or at risk for heart disease who need painkillers take aspirin, acetaminophen (Tylenol) and even prescription opioids (narcotic analgesics) before nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen. Although aspirin is a type of NSAID, it doesn't increase risk of heart attack.

Mosca warned that aspirin "needs to be considered as a powerful medication that can have serious side effects." Women at risk of bleeding, either in the brain or in the stomach, should be wary of aspirin, and all women should talk to their doctors before starting to take aspirin regularly.

Other New Advice

To help move women into the low-risk category, the AHA recommends:

· Exercise at least 30 minutes a day. Trying to lose weight? Up that to 60 to 90 minutes a day. Previous guidelines let all of us off the treadmill after 30 minutes.

· Keep saturated fats to less than 7 percent of calories, down from 10 percent in 2004.

· Eat oily fish at least twice a week (unless you're pregnant or trying to get there; in that case, be careful of mercury levels).

· Eat a variety of fruits, vegetables and protein low in saturated fat, just as the AHA recommended in 2004.

· Skip the supplements. New research suggests vitamins E, C, beta carotene and folic acid don't prevent heart disease, Mosca said, nor does hormone replacement therapy. (But women who are pregnant or thinking of becoming pregnant should take folic acid to help prevent birth defects.)

-- Elizabeth Agnvall