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Straight Talk from 'Dr. Stephanie' - November 2012


  More Women Should Take Aspirin 
En español

Stephanie Coulter, MD

Can an aspirin a day really keep the doctor away? There is, of course, no guarantee, but studies show the daily use of aspirin for women at increased risk for cardiovascular disease is beneficial. The problem? Only 41-48% of you are actually taking it after your doctor recommends it, according to a recent study. We need to get those numbers up.

What is aspirin?  

Aspirin is a medication used to reduce pain, inflammation, and fever. Aspirin is an "antiplatelet," which means that it stops blood cells called platelets from sticking together and forming a blood clot. Aspirin also reduces the substances in the body that cause pain and inflammation.

When is aspirin used for the heart?

Because aspirin helps prevent the formation of blood clots, aspirin is often used to help the cardiovascular system including:

  • Preventing a first heart attack;
  • Helping patients during recovery after a heart attack;
  • Treating known heart disease;
  • Treating and preventing stroke, a “heart attack of the brain.”

How does aspirin prevent heart and vascular issues?    

Clotting doesn’t just happen when you cut your skin; it can also happen in the vessels that supply your heart with blood. For those at risk of cardiovascular disease, fatty plaques grow within the artery wall. If a plaque were to suddenly rupture or burst, the blood in the artery will recognize this as an injury that needs to be repaired. Signals are released and platelets (and white blood cells) are invited to the scene of the accident. Once the platelets stick together to form a clot, they can easily block the entire artery and cut off blood flow to the heart. This can cause a cardiovascular event like a heart attack.

By taking aspirin, you are preventing the platelets that go to the scene of the accident from sticking together and forming a potentially deadly clot.

How affective is aspirin?    

Daily use of low-dose aspirin has been shown to reduce death by 18 percent and cardiovascular death by 30 percent!

Several major trials also have shown that the daily use of aspirin in people of moderate- to high-risk of cardiovascular disease can reduce their risk of a heart attack by at least 28%.

For women in particular, studies have found good evidence that aspirin use decreases strokes in women ages 55 to 79 who are at increased risk of stroke but have not yet experienced one.

Who should take aspirin?  

Less than 1/2 of the  people who should be
taking aspirin are actually taking it--
despite the estimated 50,000 lives that
could be saved every year if 9 out of 10 people listened to their doctor’s advice.
It has been recommended that aspirin be used daily in all patients with known cardiovascular disease, with a few exceptions. If you have any of the following, aspirin should be avoided entirely:

  • Active peptic ulcer
  • Aspirin allergy or intolerance
  • Bleeding disorders (e.g., hemophilia, von Willebrand disease)
  • History of recent gastrointestinal bleeding
  • History of recent intracranial bleeding
  • Kidney failure
  • Severe liver disease
  • Thrombocytopenia (low platelet count in the blood)

Talk to your doctor about your medical history before you start taking aspirin regularly. Be sure to always tell your doctor if you are taking any other medications before starting an aspirin regimen. Other medicines you take may increase or decrease the effect of aspirin.

It's complicated.    
As with any medication, the key to aspirin therapy is appropriate use. So once again, “it’s complicated,” and the best way to ensure that you’re using aspirin appropriately is to have a conversation with your doctor. Talk straight with your doctor about aspirin!

For more detailed information about aspirin therapy, visit the aspirin information page in THI's online Heart Information Center.

Until next time!
Stephanie Coulter, MD, Director of the Center for Women's Heart & Vascular Health
Stephanie Coulter, MD
 

Do you have a topic that you would like to learn more about from Dr. Stephanie? Send us an email at women@texasheart.org and your question may be the next Straight Talk topic!

For additional ways all women can take care of their hearts, visit the Straight Talk archives on the Texas Heart Institute website.

 


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Visit the Center for Women's Heart & Vascular Health at www.texasheart.org/women.

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