Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Aspirin underused to reduce heart disease risk in diabetic women and young adults

21.12.2004


Cardiovascular disease risk is extremely high in adults with diabetes. Yet women as well as people under 50 who have diabetes do not use aspirin, despite the fact that aspirin has been found an effective and inexpensive means to reduce risk of first and subsequent heart attack.



Previous research has demonstrated less frequent use of invasive cardiovascular procedures and effective medications for acute myocardial infarction, including thrombolytics, beta-blockers and aspirin, in women, compared with men. "A similar disparity now exists for use of aspirin for primary and secondary cardiovascular disease prevention in diabetes," said Stephen D. Persell, M.D., and David W. Baker, M.D., researchers at Northwestern University Feinberg School of Medicine.

In a study in the Dec. 13/27 Archives of Internal Medicine, Persell, an instructor in medicine, and Baker, associate professor of medicine, assessed self-reported aspirin use among those over 35 with diabetes from 1997 to 2001. It was in 1997 that the American Diabetes Association first recommended that aspirin be considered for prevention of cardiovascular disease events in any high-risk adult older than 30 years with diabetes.


Although their study found an encouraging increase in aspirin use in recent years among adults with diabetes, Persell and Baker noted a significant disparity in aspirin use between diabetic men and women that was not observed a decade earlier. Among adults with diabetes without diagnosed cardiovascular disease, 42 percent of men and 34 percent of women used aspirin regularly. Younger and middle-aged adults used aspirin less frequently than did older adults.

Among those with diabetes and diagnosed cardiovascular disease, 83 percent of men and 65 percent of women reported regular aspirin use, and age was associated with lower aspirin use only among those young than 50 years. There are several possible explanations for low use of aspirin among women, the researchers said.

Physicians may not counsel women with diabetes to use aspirin if the physicians underestimate the women’s risk for cardiovascular disease events. "However, even though women are at lower risk of new-onset cardiovascular disease than men, diabetes greatly reduces this female advantage," Persell said.

Physicians may have concerns that aspirin is less efficacious for women than men in primary prevention of cardiovascular disease events. "Observational data suggest that aspirin prevents initial myocardial infarction in women, yet women were not well represented in early randomized trials of aspirin for the prevention of initial cardiovascular disease events," Baker said. The low use of aspirin associated with younger age is also noteworthy, the authors said.

"Physicians or patients may think that the risk of cardiovascular disease in younger diabetic adults is too low to justify using aspirin. However, even without other cardiovascular disease risk factors, men and women 45 to 49 years old with diabetes have an estimated 7 percent 10-year risk of major cardiovascular disease events, a risk that is sufficient to justify the consideration of aspirin," they said.

Persell and Baker said aspirin may also be underused because many people with diabetes do not appreciate their cardiovascular disease risk, and although physicians understand the high cardiovascular disease risk associated with diabetes, they place greater importance on glucose control than on blood pressure management, cholesterol lowering or aspirin use as a means of reducing cardiovascular disease risk.

"Health professionals may have a large role to play in increasing appropriate aspirin use among adults with diabetes. Simple interventions such as offering professional advice about aspirin may be adequate to increase appropriate usage given that past studies have shown a strong association between current aspirin use and report of professional counseling," Persell said.

Health professionals are also in the position to help identify patients for whom the risk of aspirin may outweigh the benefits. Interventions that aim to increase professional counseling about aspirin for women, as well as young and middle-aged adults, may be especially helpful, the authors said.

Elizabeth Crown | EurekAlert!
Further information:
http://www.northwestern.edu

More articles from Health and Medicine:

nachricht Organ-on-a-chip mimics heart's biomechanical properties
23.02.2017 | Vanderbilt University

nachricht Researchers identify cause of hereditary skeletal muscle disorder
22.02.2017 | Klinikum der Universität München

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

Im Focus: Three Magnetic States for Each Hole

Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".

Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

Stingless bees have their nests protected by soldiers

24.02.2017 | Life Sciences

New risk factors for anxiety disorders

24.02.2017 | Life Sciences

MWC 2017: 5G Capital Berlin

24.02.2017 | Trade Fair News

VideoLinks
B2B-VideoLinks
More VideoLinks >>>