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An Editorial Update: Should She Take Aspirin?

Cynthia Mulrow, MD, MSc, Deputy Editor; and Michael Pignone, MD, MPH
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From the American College of Physicians, Philadelphia, PA 19106-1572, and University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.

Acknowledgments: The authors thank Russell Localio and Colin Baigent for their careful review and helpful comments during preparation of this editorial.

Potential Financial Conflicts of Interest: Honoraria/Grants received: M. Pignone (Bayer Pharmaceuticals).

Requests for Single Reprints: Customer Service, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106-1572.

Current Author Addresses: Dr. Mulrow: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106-1572.

Dr. Pignone: Division of General Internal Medicine, University of North Carolina at Chapel Hill, 5039 Old Clinic Building, UNC Hospital, Chapel Hill, NC 27599-7110.

Ann Intern Med. 2005;142(11):942-943. doi:10.7326/0003-4819-142-11-200506070-00015
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In 2002, we published a systematic review of aspirin for the primary prevention of cardiovascular disease for the U.S. Preventive Services Task Force (1). The review suggested the following: “For 1000 patients with a 5% risk for coronary heart disease events over 5 years, aspirin would prevent 6 to 20 myocardial infarctions but would cause 0 to 2 hemorrhagic strokes and 2 to 4 major gastrointestinal bleeding events.” Because few women participated in the trials summarized in the review, we could not reliably determine whether sex modifies the beneficial effects of aspirin. We looked forward to the publication of the Women's Health Study (WHS), a large, double-blind, randomized, placebo-controlled trial examining the effect of low-dose aspirin on cardiovascular events in women 45 years of age or older, expecting that it would clarify the benefits and risks of aspirin among women. The study was published in March 2005 (2). Here's our take on how it clarifies the use of aspirin to prevent cardiovascular disease in women.



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