Long-term aspirin use lowers women's mortality

NEW YORK (Reuters Health) - The long-term use of aspirin, at low to moderate doses, appears to reduce all causes of mortality in women, especially in older women and those with cardiovascular risk factors, according to the results of a new study. This is primarily due to a reduction in death from cardiovascular disease.

However, an accompanying editorial questions this finding and suggests that, on the basis of previous study findings, women without a history of cardiovascular disease should not start taking aspirin to prevent death.

Previous reports have indicated that aspirin use can lower the risk of heart disease and certain types of cancer, which are major contributors to mortality in women. However, it is unclear if long-term aspirin use is actually associated with a reduced risk of mortality from all causes.

To investigate, Dr. Andrew T. Chan, from Harvard Medical School in Boston, and colleagues analyzed data from 79,439 women who were enrolled in the Nurses' Health Study. All of the women were cancer- and heart disease-free when the investigation began.

Over 24 years, 9,477 of the women died, the researchers report in the Archives of Internal Medicine. Current aspirin use was associated with a 25-percent reduced risk of mortality from any cause, compared with never using aspirin regularly.

In terms of specific causes of death, aspirin use was linked to a 38-percent reduced risk of death from cardiovascular disease and a 12-percent reduced risk of death due to cancer. The use of aspirin for 1 to 5 years seemed to provide protection against cardiovascular disease, whereas at least 10 years of use was required to prevent malignancy.

As noted, the survival benefits of long-term aspirin were most apparent in older women and in those with multiple cardiac risk factors.

In a related editorial, Dr. John A. Baron, from Dartmouth Medical School in Lebanon, New Hampshire, comments that the new findings "for cardiovascular mortality are provocative, contrasting sharply with the pattern seen in primary prevention trials."

He also notes that the observational nature of the study "may not have been able to deal with the differences between aspirin users and nonusers."

Therefore, he concludes that the study findings "cannot overcome the accumulated evidence that aspirin is not particularly effective" in preventing a death from a first-time cardiovascular event, such as a heart attack.

SOURCE: Archives of Internal Medicine, March 26, 2007.