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updated 3/26/2007 5:35:12 PM ET 2007-03-26T21:35:12

Aspirin in low to moderate doses may lower the risk of death in women, particularly those who are older and prone to heart disease, a 24-year study of nearly 80,000 women suggests.

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However, experts cautioned that the results are not definitive and that women should not take aspirin as a health preventive without talking to their doctor.

In this long-running study of nurses who were middle-aged and older, women who took aspirin had a 25 percent lower risk of death compared with those who never took it. Aspirin-takers had a 38 percent lower risk of death from cardiovascular disease and a 12 percent lower risk of death from cancer.

Many doctors advise people who’ve had heart attacks and strokes to take a daily 81-milligram baby aspirin, costing less than 50 cents a week. The new study suggests aspirin may help healthy women, too.

“Use of aspirin for one to five years was associated with significant reductions in cardiovascular mortality,” Dr. Andrew Chan's team at Massachusetts General Hospital and Harvard Medical School wrote in this week’s Archives of Internal Medicine.

“In contrast, a significant reduction in risk of cancer deaths was not observed until after 10 years of aspirin use.”

Benefits were greatest in older women who took low to moderate doses. No benefit was found for high doses, which the study defined as two or more standard 325-milligram aspirin tablets a day.

“This confirms what we already know: Aspirin is good for you, whether you’re a man, whether you’re a woman,” said Dr. Jeffrey Berger of Duke University Medical Center who studies aspirin’s effects. He was not involved in the new research and receives no money from aspirin makers.

However, since aspirin can cause ulcers and bleeding, Berger said, women should talk to their doctors before taking it to prevent disease.

“It’s not a little vitamin; it’s not a sugar pill,” he said.

Most of the best-designed studies have not found that aspirin lowers the risk of death. But they have found that aspirin helps to prevent heart attacks in men and strokes in women.

Aspirin is thought to prevent heart attacks and strokes by blocking platelets from forming blood clots. Its anti-inflammatory properties may also play a role in preventing cancer.

The average age of the women was about 46 at the start of the study and about 70 by its end. At the beginning of the study, the women had no history of heart disease. Those at risk for heart attacks and strokes, and older women, got the most benefit.

The women were specifically asked about standard, full-dose aspirin, and if they took 81 mg “baby” and “mini” aspirins were asked to count four of them as one standard aspirin.

In all 45,300 women did not use aspirin, 29,000 took one to 14 tablets a week and 5,000 took more. By 2004 there were 9,477 deaths, 1,991 from heart disease and 4,469 from cancer. The researchers matched the 9,477 women who died between 1980 and 2004 with women who didn’t die. They looked at which women reported taking aspirin and took into account other risk factors such as high blood pressure, diabetes, smoking and weight.

Cancer was the leading cause of death in the study. The researchers said they’d expect more deaths from heart attacks and strokes if the women in the study had been older. Cardiovascular disease is the leading cause of death in American women.

The size and length of the new study make the results compelling. But the research, based on data from the long-running Nurses Health Study, was observational, meaning the women chose whether to take aspirin, rather than being randomly assigned to take it — a gold standard in research.

The aspirin-takers could have been healthier than other women for reasons the researchers didn’t take into account. The aspirin-takers also could have been more zealous about how they took other medicine, for example.

“We cannot prove a cause-and-effect relationship, and the results should be interpreted with caution,” said study co-author Dr. JoAnn Manson at Harvard-affiliated Brigham and Women’s Hospital. “We don’t want people hearing about the study and beginning to take aspirin long-term without having a discussion with their doctor.”

In commentary also published in the Archives of Internal Medicine, Dr. John Baron of Dartmouth Medical School in New Hampshire said the study contrasts with earlier findings and that the accumulated evidence still suggests aspirin is not particularly effective for the primary prevention of death from cardiovascular disease in women.

He cited a study published in 2005 that studied almost 40,000 women during more than 11 years and found aspirin therapy had no effect on cardiovascular or other mortality.

“Which of these mega-studies is right?” he asked. “Both somehow? Neither?”

Baron said it often takes many different studies, looking at a question from different angle, to come up with good evidence about what the healthiest choice is for people.

The Associated Press and Reuters contributed to this report.


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