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Aspirin for women raises some questions

Tuesday, February 12, 2002

By Francesca Lunzer Kritz, The Washington Post

You don't need a prescription for Bayer's new aspirin-plus-calcium pill for women. Some think that's too bad.

It may be a good product for post-menopausal women who have had a formal risk assessment for heart attacks and been put on a daily aspirin regimen under their doctor's supervision -- and who are taking calcium supplements to forestall osteoporosis. But if you don't fit into that group, say some health experts, using the over-the-counter preparation may increase, not decrease, your risk of complications and maybe even death.

Bayer Women's Aspirin Plus Calcium pitches protection against two threats to women's health: heart disease (the leading cause of death for women) and osteoporosis (the fragile bone disease that targets four times as many women as men). The weapon against heart disease is 81 mg of aspirin; to target osteoporosis, the pill packs 300 milligrams of calcium.

It's the aspirin that could pose a problem for people who don't need it, who use it without consulting a doctor or who are at elevated risk of complications or side effects from it.

Recommendations issued in January by the U.S. Preventive Services Task Force advise low-dose aspirin therapy for, among other groups, post-menopausal women and those who smoke or have diabetes, elevated blood cholesterol levels or high blood pressure.

(For more information, see www.ahrq.gov/clinic/3rduspstf/aspirin. To assess your heart attack risk, see http://hin.nhlbi.nih.gov/atpiii/calculator.asp.) But the report says such therapy should be undertaken only under a physician's supervision.

At 81 milligrams, Bayer's new aspirin is in the range recommended in the new guidelines. But the latest research doesn't yet prove that aspirin therapy is as beneficial to women as to men or whether aspirin helps protect women, as it does men, against a first heart attack, says Alfred Berg, chairman of the Preventive Services Task Force. So far, it's known only that in women, aspirin can help prevent a second heart attack.

Cardiologists say it's important for doctors to supervise long-term aspirin therapy because occasional side effects can be serious. For example, taking aspirin can increase the risk of hemorrhagic stroke, says Berg. Bayer's label advises consumers to "talk to your doctor about regimen use of aspirin."

Despite its nonprescription status, aspirin can cause other problems as well, ranging from ringing in the ears to bleeding in the brain, according to the Food and Drug Administration. While the worst effects are usually linked to the highest doses, an FDA spokesman said 81 mg doses can cause side effects as well, and long-term use poses a risk.

As for the 300 mg of calcium provided by the new pill, that's not a lot. Women are generally advised to take 1,000 to 1,500 mgs per day from dietary sources and, if necessary, supplements.

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