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New Stroke Guidelines Underscore Importance of Aspirin for Women

Recommendations Highlight Aspirin as a Cornerstone in Reducing Risk of Stroke

MORRISTOWN, N.J. -- May 17, 2006 -- New professional treatment guidelines, issued by the American Heart Association (AHA) and the American Stroke Association (ASA), indicate that aspirin can be beneficial for prevention of a first stroke in women whose risk is sufficiently high for the benefits to outweigh the potential risks associated with treatment. They do not recommend similar use of aspirin in men.

The guidelines, which are to be published in the June issue of Stroke, highlight the role of aspirin as a cornerstone cardiovascular therapy. They follow upon joint guidelines, issued by the AHA and ASA earlier this year, that recommend aspirin therapy for prevention of a second ischemic stroke in patients who have previously suffered a transient ischemic attack (TIA, or "mini-stroke").

The newly issued primary prevention guidelines underscore aspirin's value in reducing the risk of ischemic stroke in both the primary and secondary prevention settings in appropriate patients. Any decision about the regular use of aspirin to prevent cardiovascular events must be made in consultation with a doctor.

Nearly twice as many women in the United States die of stroke and other forms of heart disease as from all forms of cancer, including breast cancer. In fact, each year about 40,000 more women than men have strokes, and more than 60% of total stroke deaths occur in women.

The most common form of stroke is an ischemic stroke, which accounts for an estimated 83% of all stroke cases. Ischemic stroke occurs as a result of an obstruction within a blood vessel supplying blood to the brain. The U.S. Food and Drug Administration (FDA) has approved regular aspirin use to prevent an ischemic stroke in people who have suffered a previous ischemic stroke or a TIA.

Hemorrhagic stroke, which results from a weakened vessel that ruptures and bleeds into the surrounding brain, accounts for about 17% of stroke cases. Aspirin is contraindicated in anyone with a history of hemorrhagic stroke or other major bleeding disorder.

The new guidelines reflect a greater understanding of aspirin's benefits in women, as demonstrated in the Women's Health Study (WHS), in which aspirin was associated with a 17% reduction in the overall risk of stroke (P = 0.04) and a 24% reduction in the risk of ischemic stroke (P = 0.009) in a population of nearly 40,000 apparently healthy women. The guidelines are consistent with previous recommendations issued by the U.S. Preventive Services Task Force (USPSTF), which endorse the use of aspirin for cardioprevention in individuals whose 10-year risk of coronary heart disease is 6% or greater.

"The new stroke primary prevention guidelines reflect solid evidence that aspirin, when used appropriately, can help prevent ischemic stroke in women," commented C. Noel Bairey Merz, MD, Women's Guild Endowed Chair in Women's Health and the medical director of the Cedars-Sinai Women's Heart Program. "There is no question that aspirin is a cornerstone therapy in cardioprevention and a key weapon in the fight against stroke, an extremely debilitating condition that affects an estimated 373,000 American women each year."

The new guidelines add to the ever-evolving evidence that supports the numerous existing FDA-approved cardiovascular indications for aspirin in a range of doses, including reducing the risk of heart attack, stroke and death in both women and men who have experienced a previous heart attack or stroke, as well as reducing the risk of death in patients who are having a suspected heart attack. The guidelines do not recommend the use of aspirin for prevention of a first stroke in men. There is, however, an abundant body of evidence demonstrating aspirin's benefits in men, particularly in terms of preventing a first heart attack. Consumers are advised not to start or stop any medication, including an aspirin regimen, without consulting a healthcare professional.

"Whether you're a woman or a man, if you fear you may be at risk of having a stroke or heart attack, you should ask your doctor about aspirin therapy, which can work wonders for people at risk," said Dr. Bairey Merz.


SOURCE: Bayer Consumer Care

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