- The Washington Times - Monday, February 19, 2007


Nearly all American women are in danger of heart disease or stroke and should be more aggressive about lowering their risk — including asking their doctors about daily aspirin use, the American Heart Association said yesterday in new guidelines.

It is the first time that guidelines have urged all women to consider aspirin for preventing strokes, although specialists warn that it can cause ulcers and dangerous bleeding. They said it is probably not a good idea for young women with no major health problems.

“We do not want women to go to the drugstore and just start taking this themselves. It is critical that every woman talk to her doctor,” said Dr. Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital and chairwoman of the panel that wrote the guidelines.

The guidelines also advise daily exercise and less fat, and they declare vitamins C and E, beta carotene and folic acid supplements worthless for preventing heart disease.

The guidelines were published in the journal Circulation with related studies on women’s health, including one suggesting that hormone skin patches may be safer than pills for menopause symptoms.

In general, the guidelines aim to get women and doctors to focus on the long-term risks of high blood pressure, smoking, lack of exercise or being overweight — even if a woman’s current health seems fine. Even a single risk factor at age 50 greatly raises the chance of heart disease or stroke later, and only about 10 percent of American women are free of these problems.

“We do not want women to wait until they develop symptoms to begin to take action,” Dr. Mosca said.

The guidelines were drafted by dozens of groups worldwide, including the American Academy of Family Physicians and the U.S. government. Of the 33 persons who wrote the advice, 13 have financial ties to heart-drug makers, but only three of them to a large degree.

The evidence shows that many more women than previously thought are at risk of heart disease and stroke — even those whose only weakness is failure to exercise every day.

The panel advised women to:

• Get at least 30 minutes of moderately intense exercise on most and preferably all days, 60 to 90 minutes if necessary to lose weight.

• Eat mostly fruits and vegetables, whole grain and high-fiber foods, fish at least twice a week and little salt. Limit saturated fat to fewer than 10 percent of calories, 7 percent if possible, and trans fats to less than 1 percent. Limit alcohol to one drink or less a day.

• Not smoke and to use nicotine-replacement products if needed to stop.

• Keep their body-mass index at less than 25.

• Consider taking omega-3 fatty acids (fish oil) if one already has heart disease. They should not take extra folic acid or antioxidants like vitamins E, C and beta carotene, for heart disease prevention.

• Keep their blood pressure and cholesterol under control, with medicine if needed. They should keep LDL or bad cholesterol at less than 100 if at high risk of heart disease and under 70 if at very high risk.

• Use aspirin daily for women at high risk, and the guidelines now say the dose can go up to 325 milligrams. All other women should consider 81-milligram “baby aspirin” daily or 100 milligrams every other day for stroke prevention.

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