By: Thomas Pickering, MD, DPhil, FRCP, Director of Integrative and Behavioral Cardiology Program
of the Cardiovascular Institute at Mount Sinai School of Medicine, New York.

Several studies have shown that men who have coronary heart disease can reduce their risk of having a heart attack by taking one aspirin a day, but the evidence for women has been inconsistent. In a large Israeli study of the benefits of a cholesterol-lowering drug in men and women who had been diagnosed as having coronary heart disease (the Bezofibrate Infarction Prevention study), a survey was made of who was taking aspirin. Of the 2,418 women who entered the study, 45% were taking aspirin, and after three to four years, their death rate was 5.1%, as compared to 9.1% for the women who were not taking aspirin - a reduction of about 40%. The women who appeared to derive the most benefit from taking aspirin were older (up to 74 years), had diabetes, or angina. The benefit was the same whether or not they had high blood pressure. The usual dose of aspirin was between 100 and 500 milligrams (mg).

Doctor’s comments

This study was not originally set up to investigate the benefits of taking aspirin, so this is an incidental finding. Nevertheless, it strongly suggests that women who already have a diagnosis of coronary heart disease would do well to take an aspirin a day (the standard dose in the US is 325 mgs) unless there is some specific reason why they can’t tolerate it (such as a stomach ulcer).

Where it was published

Harpaz D and colleagues. Effect of aspirin on mortality in women with symptomatic or silent myocardial ischemia. American Journal of Cardiology 1996;78:1215-1219.