A heartening finding for women on aspirin.

Women who regularly take aspirin may reduce their risk of suffering a first heart attack, according to a preliminary study. The finding represents the first demonstration of aspirin's ability to ward off heart attacks in women. At the same time, two other new reports suggest that women with coronary artery disease receive less aggressive medical treatment than do men.

The cardiac battle of the sexes started back in 1988 with a study showing that middle-aged male doctors nearly halved their chances of a first heart attack by taking an aspirin every other day (SN: 1/30/88, p.68). Because the study did not include women, it offered no proof of the drug's potential for reducing women's heart attacks. Indeed, several other studies suggested that women taking aspirin gained no preventive edge.

Now, a report in the July 24/31 JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION indicates that women may reap aspirin's cardiac benefits after all. JoAnn E. Manson and her colleagues at Harvard Medical School in Boston studied 87,678 female nurses living in 11 states. In 1980, 1982 and 1984, the volunteers answered questions about their medical history and lifestyle, including aspirin use. At the outset, participants showed no evidence of coronary artery disease and ranged from 34 to 65 years of age. The researchers tracked all cases of heart attack, stroke and other cardiovascular problems from 1980 to 1986.

Manson and her co-workers found that women aged 50 and older who took one to six adult-sized aspirin per week showed a "significant" (32 percent) reduction in heart attack risk compared with women who reported no aspirin use.

"This study raises the possibility that aspirin might benefit women," says coauthor Charles H. Hennekens. However, he and his colleagues acknowledge inherent weaknesses in their observational study. For example, nurses who reported aspirin use may have also practiced other heart-healthy habits that lowered their risk of cardiovascular disease. Such unknows throw uncertainty into the findings, notes Lawrence M. Friedman of the National Heart, Lung, and Blood Institute in Bethesda, Md.

Manson advises women to see their physicians before considering a regular regimen of aspirn. "We certainly don't want people to go out and start taking aspirin on their own," she says.

While the aspirin study helps narrow the gender gap in cardiovascular research, two reports in the July 25 NEW ENGLAND JOURNAL OF MEDICINE indicate a discrepancy between the strategies used to treat men and women with heart problems.

Richard M. Steingart of the Winthrop-University Hospital in Mineota, N.Y., and his colleagues studied 1,842 men and 389 women who had suffered heart attacks. After controlling for age and severity of illness, the researchers found that the women were less likely than the men to receive bypass operations and other major, invasive procedures.

In a similar comparison, John Z. Ayanian and Arnold M. Epstein at Harvard Medical School discovered that women hospitalized for symptoms of coronary artery disease received fewer therapeutic procedures such as angioplasty, which widens clogged arteries and can reduce heart attack risk.

Taken together, these two studies "provide evidence that there is sex bias in the management of coronary heart disease," writes National Institutes of Health Director Bernadine Healy in an editorial accompanying the reports. "Decades of sex-exclusive research have reinforced the myth that coronary artery disease is a uniquely male affliction," she adds, noting that heart disease is the leading killer of both men and women in the United States (SN: 1/19/91. p.40).