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 Long-term
aspirin use associated with reduced risk of
dying in women
Newswise — Women who take low to moderate doses
of aspirin have a reduced risk of death from any cause, and
especially heart disease–related deaths, according to a report in
the March 26 issue of Archives of Internal Medicine, one of the JAMA/Archives
journals.
Some studies have provided evidence that
aspirin may reduce the risk of heart disease and some types of
cancer, the two leading causes of death in U.S. women, according to
background information in the article. However, it is unclear
whether aspirin reduces the risk of death overall for women.
Andrew T. Chan, M.D., M.P.H., Massachusetts
General Hospital and Harvard Medical School, Boston, and colleagues
examined the association between aspirin use and death in 79,439
women enrolled in the Nurses’ Health Study, a large group of female
nurses who have been followed since 1976.
Beginning in 1980 and again every two years
through 2004, the women were asked if they used aspirin regularly
and if so, how many tablets they typically took per week. At the
beginning of the study, the women had no history of cardiovascular
disease or cancer.
A total of 45,305 women did not
use aspirin; 29,132 took low to moderate doses (one
to 14 standard 325-milligram tablets of aspirin per
week); and 5,002 took more than 14 tablets per week.
By June 1, 2004, 9,477 of the women had died, 1,991
of heart disease and 4,469 of cancer.
Women who reported using aspirin currently had
a 25 percent lower risk of death from any cause than women who never
used aspirin regularly. The association was stronger for death from
cardiovascular disease (women who used aspirin had a 38 percent
lower risk) than for death from cancer (women who used aspirin had a
12 percent lower risk).
“Use of aspirin for one to five years was
associated with significant reductions in cardiovascular mortality,”
the authors write. “In contrast, a significant reduction in risk of
cancer deaths was not observed until after 10 years of aspirin use.
The benefit associated with aspirin was confined to low and moderate
doses and was significantly greater in older participants and those
with more cardiac risk factors.”
There are several mechanisms by which aspirin
could reduce the risk of death, the authors note. “Aspirin therapy
may influence cardiovascular disease and cancer through its effect
on common pathogenic pathways such as inflammation, insulin
resistance, oxidative stress [damage to the cells caused by oxygen
exposure] and cyclooxygenase (COX) enzyme activity,” also linked to
inflammation, they write.
Because the study looked at women who made the
decision themselves whether or not to take aspirin, as opposed to a
clinical trial where women are randomly assigned to aspirin or a
placebo, the results do not suggest that all women should take
aspirin. “Nevertheless, these data support a need for continued
investigation of the use of aspirin for chronic disease prevention,”
the authors conclude.
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