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Women with coronary heart disease are less likely than men to use aspirin to prevent further problems

Aspirin protects against heart attack, stroke, and other vascular events and reduces deaths from coronary heart disease (CHD). In fact, daily aspirin is recommended for all patients with cardiovascular disease unless contraindicated. Yet, women with CHD are less likely than their male counterparts to use aspirin regularly, according to a new study.

This difference was not fully explained by differences in patient characteristics or reported contraindications to aspirin. These findings contribute to the growing evidence of disparate care for women with CHD, which may place them at greater risk for cardiovascular events such as stroke and heart attack and premature death. Many of these events may be prevented by greater use of low-cost aspirin.

Researchers analyzed data from the nationally representative 2000-2002 Medical Expenditure Panel Surveys to determine the prevalence of regular aspirin use among men and women with CHD. They examined 1,869 men and women 40 years of age and older who reported CHD prior to a heart attack.

Women were less likely than men to use aspirin regularly (62.4 vs. 75.6 percent), even after adjusting for demographic, socioeconomic, and clinical characteristics. Women were more likely than men to report contraindications to aspirin (20.5 vs. 12.5 percent). When the analysis was limited to those without self-reported contraindications to aspirin, the difference in aspirin use narrowed, but remained significant (79.8 vs. 86.4 percent).

Differences in aspirin use were also greater between women and men with private health insurance (61.8 vs. 79 percent) than among those with public coverage (62.5 vs. 70.7 percent). The underlying disparity in the quality of care received by men and women with CHD may help explain why younger women have poorer outcomes than men in the first few years after a heart attack.

The study was supported by the Agency for Healthcare Research and Quality (T32 HS00020).

See "Gender differences in aspirin use among adults with coronary heart disease in the United States," by Alexander R. Opotowsky, M.D., M.P.H., J. Michael McWilliams, M.D., and Christopher P. Cannon, M.D., in the January 2007 Journal of General Internal Medicine 22, pp. 55-61.

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