ANN ARBOR, MI - An aspirin a day may help keep a heart attack away, but many women at risk for heart disease still don't take one, a new study finds. Men, by comparison, are more likely to pop aspirin regularly — but less likely than women to remember or follow advice about diet and exercise habits that can help their hearts.

The gender differences persisted even when researchers took into account how much heart-related risk individuals faced, and how often they went to the doctor. And large numbers of both men and women hadn't yet made diet or exercise changes, even those at high risk. But the study also finds some good news: Men and women are getting their cholesterol and blood pressure checked at about the same rates.

The findings, made by a team from the University of Michigan Health System and the Centers for Disease Control and Prevention using CDC data from telephone interviews with more than 97,000 Americans in 20 states, will be published in the June issue of the American Journal of Preventive Medicine.

It is the first study to stratify a broad population by individual heart disease risk, and to look at a range of medical and lifestyle practices that have been proven to help people reduce their risk of heart attack, stroke or other cardiovascular problems.

“We hope that these findings will help guide risk-reduction efforts for both men and women, and help remind women to speak up to their doctors about preventive measures such as aspirin that can help them if their risk is high,” says lead author Catherine Kim, M.D., M.P.H., an assistant professor in the departments of Internal Medicine and Obstetrics & Gynecology at the U-M Medical School.

Kim and co-author Gloria Beckles, M.D., MSc., of the CDC's Division of Diabetes Translation, also note that the study may help give a definitive answer to questions that have been raised by smaller studies in limited populations. Many of those studies have yielded contradictory findings about women's cardiovascular risk-reduction behavior and care.

The aspirin finding, Kim says, echoes recent evidence from the same CDC survey project that among people with diabetes — whose disease puts them at much higher risk for heart disease — women were prescribed aspirin less often than men.

In the newly published study, women were more likely than men to say they had stopped taking aspirin regularly, often because of stomach-related symptoms. But even this difference in tolerance can't account for the difference between the numbers of men and women who take aspirin every day or every other day.

Kim and Beckles made the findings using data from the CDC's Behavioral Risk Factor Surveillance System, or BRFSS, which samples the adult non-institutionalized population and asks respondents to discuss their health history and care, demographic information, and behaviors designed to reduce their risk of disease. Kim also received funding from the American Diabetes Association.

For the current paper, Kim and Beckles looked at the responses from men and women over the age of 40, in states where the survey included questions about cardiovascular risk factors and behaviors. In all, 58,548 women and 38,839 men completed the phone interview. Respondents were asked how long it had been since they had had a routine checkup, a blood pressure test or a cholesterol test. They were asked if their doctor had ever advised them to eat fewer high-fat or high-cholesterol foods, or to exercise more — and whether they were doing so.

And, the surveyors asked respondents if they had ever been told they had high blood pressure, high cholesterol, a heart attack, diabetes, angina, coronary heart disease or a stroke. All of these characteristics, along with smoking status, were used to place respondents into low, medium or high risk categories for the study's analysis.

Those who had diabetes or a history of heart attack, stroke or CHD were automatically classed as high-risk, accounting for 14 percent of the men and 12 percent of the women. Those with two or more risk factors (smoking, high blood pressure, and/or high cholesterol) were classed as medium risk (47.4 percent of men, 41.7 percent of women) and those with one risk factor or no risk factors were placed in the low-risk group (38.4 percent of men, 46.3 percent of women).

The average of the respondents was 56 years for men and 58 years for women, about 78 percent were non-Hispanic white, and 90 percent had some form of health insurance. About 70 percent of the men and 80 percent of the women had been to the doctor for a checkup in the last year.

No matter what their level of risk of heart disease, women were far less likely to take aspirin regularly: 26.2 percent overall versus 34.8 percent of men. Among high-risk respondents, the difference was larger: 45.5 percent of high-risk women took aspirin, as opposed to 58.5 percent of men. Even after adjusting for age, race, education, insurance, health status, and time since last checkup, the difference between the genders persisted.

When it came to diet and exercise, the proportions of both men and women who remembered getting advice from their doctors went up as the risk level went up. And among low- and medium-risk individuals, a larger percentage reported they had been dieting and exercising than the percentage who remembered getting advice on those matters from their doctors.

But women were slightly more likely than men to be dieting and exercising, except among high-risk people, where men barely outpaced the women in exercising. All in all, says Kim, many men and women weren't making these key lifestyle changes: only about two-thirds of either gender reported exercising, and two-thirds to three-quarters reported changing their diet. The group with the highest percent of either lifestyle change was high-risk women: 80 percent of them had made diet changes.

“This just reinforces how hard it is to change people's behavior, even among high-risk people who have lived through a heart attack, stroke, diabetes or coronary heart disease,” says Kim. “People develop these diseases because of their lifestyle, and we're asking them to change that lifestyle to avoid getting worse. There are many people who should be modifying their behavior, and who know they should be dieting and exercising, but they don't do it. We need to find ways to help them.”

Contact: Kara Gavin

E-mail this information to a friend

Recent Press Releases