0
ARTICLE |

A Prospective Study of Aspirin Use and Primary Prevention of Cardiovascular Disease in Women

JoAnn E. Manson, MD; Meir J. Stampfer, MD; Graham A. Colditz, MB, BS; Walter C. Willett, MD; Bernard Rosner, PhD; Frank E. Speizer, MD; Charles H. Hennekens, MD
JAMA. 1991;266(4):521-527. doi:10.1001/jama.1991.03470040085027.
Text Size: A A A
Published online

Objective.  —The aim of the study was to examine prospectively the association between regular aspirin use and the risk of a first myocardial infarction and other cardiovascular events in women.

Design.  —Prospective cohort study including 6 years of follow-up. Setting.—Registered nurses residing in 11 US states.

Participants.  —US registered nurses (n = 87 678) aged 34 to 65 years and free of diagnosed coronary heart disease, stroke, and cancer at baseline. Follow-up was 96.7% of total potential person-years of follow-up.

Main Outcome Measures.  —Incidence of myocardial infarction, stroke, cardiovascular death, and all important vascular events.

Results.  —During 475 265 person-years of follow-up, we documented 240 nonfatal myocardial infarctions, 146 nonfatal strokes, and 130 deaths due to cardiovascular disease (total, 516 important vascular events). Among women who reported taking one through six aspirin per week, the age-adjusted relative risk (RR) of a first myocardial infarction was 0.68 (95% confidence interval [CI], 0.52 to 0.89; P =.005), as compared with those women who took no aspirin. After simultaneous adjustment for risk factors for coronary disease, the RR was 0.75 (95% CI, 0.58 to 0.99; P =.04). For women aged 50 years and older, the age-adjusted RR was 0.61 (95% CI, 0.45 to 0.84; P =.002) and the multivariate RR was 0.68 (95% CI, 0.50 to 0.93; P =.02). We observed no alteration in the risk of stroke (multivariate RR = 0.99; P =.94). The multivariate RR of cardiovascular death was 0.89 (P =.56) and of important vascular events was 0.85 (P =.12). When examined separately, the results were nearly identical for the subgroups who took one through three and four though six aspirin per week. Among women who took seven or more aspirin per week, there were no apparent reductions in risk.

Conclusions.  —The use of one through six aspirin per week appears to be associated with a reduced risk of a first myocardial infarction among women. A randomized trial in women is necessary, however, to provide conclusive data on the role of aspirin in the primary prevention of cardiovascular disease in women.(JAMA. 1991;266:521-527)

Topics

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Tables

References

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();