Doctors could help both men and women by offering diet and exercise advice
more often and patients could lower their risk of heart disease carrying
by out the advice, say Catherine Kim, M.D., M.P.H., of the University of
Michigan and Gloria L. Beckles, M.D., M.Sc., of the Centers for Disease
Control and Prevention.
Their research appears in the American Journal of
Preventive Medicine.
Only 59 percent of men and 46 percent of women at high risk regularly
took aspirin, according to a national survey of health risk factors.
Aspirin reduces the risk of heart attacks and strokes by helping to prevent
blood clots. Doctors have known of the effect for years, but only recently
have major medical organizations endorsed standard aspirin use.
Recommendations for aspirin may be less familiar than guidelines for cholesterol,
blood pressure, exercise and diet, which may account for the low overall
rate of aspirin use, Kim and Beckles say.
Also, high blood pressure, diabetes and high cholesterol
can be measured and then treated. But aspirin is prescribed on the basis
of perceived
risk, and women’s cardiovascular risk is perceived — by both women
and their doctors — as being lower than men’s risk. Women
may also experience more side effects from aspirin.
However, both men and women reported more routine tests and lifestyle
changes, although less than ideal.
“Cholesterol and blood pressure measurements were performed for
the majority of people at high risk for cardiovascular disease,” they
say. But only about three-quarters of these people reported any lifestyle
modification.
Women were slightly more likely to have their cholesterol
and blood pressure checked. They also were slightly better at remembering
their doctors’ advice
about exercising more and eating less fat and cholesterol and they followed
that advice more often than men.
One reason for the difference may be that women often see a gynecologist
as well as their regular physician, improving their chances of getting
these basic health checks and reminders, Kim and Beckles suggest.
Future researchers might look at why doctors choose to prescribe aspirin
and why patients discontinue using it, they say.
