For more than a decade, doctors have been prescribing a low, daily dose of aspirin to people at risk for heart attacks and strokes. This treatment, endorsed by the FDA, has been shown to be highly effective in preventing initial and recurring heart attacks in men. However, aspirin hasn’t been shown to lower the risk of stroke in men. Interestingly, an article in the March 31, 2005 edition of the New England Journal of Medicine¹ showed that the opposite was true for women—aspirin helped prevent stroke, but not heart attacks!

As part of the ongoing Women’s Health Study conducted by Dr. Paul Ridker and colleagues at Harvard Medical School and Brigham and Women’s Hospital, researchers followed nearly 40,000 healthy women ages 45 to 80 for 10 years. Roughly half of these women were given 100 mg of aspirin every other day, and all were watched for signs of cardiovascular disease, and the occurrence of heart attack and stroke. At the study’s conclusion, Dr. Ridker and his colleagues stated that the women who took the aspirin were 17 percent less likely to have a stroke; the risk of a heart attack was unchanged.

This study took place over a long period of time and followed a significant number of participants, so the results are worth noting. I particularly like the fact that it emphasized that the male and female cardiovascular systems are different and should be treated as such! For example, men having a heart attack will typically have chest pain that begins under the breastbone and spreads to the jaw and left arm. Women suffering from a heart attack may not have chest pain at all. Instead, they may experience primarily jaw pain and indigestion, or there may just be congestive heart failure with little evidence preceding it. Although we aren’t sure, this may be attributed to the fact that women’s blood vessels are smaller than men’s. Therefore, what could be considered a minor change in plaque build-up or blood flow in a man can cause arterial damage in women.² In addition, women tend to wait and see their doctors when their heart disease is more severe than a man’s. (Could this be because so many women are socialized to put their needs last?)

Having a low HDL (the “good” cholesterol) is a more potent risk factor in women than men, although women can have higher total cholesterol levels than men and still not have an increased risk for heart disease. Still, cholesterol that’s too high (a ratio of total cholesterol/HDL greater than 4.0) may increase the risk of blood clots, which is one of the reasons that aspirin therapy (which acts as a blood thinner by decreasing platelet aggregation) reduced the risk of stroke in this study.

So, should you be taking aspirin daily? Maybe, maybe not. Understand that taking an aspirin a day is only one way to lower the risk of a stroke—and not even the most effective one. And aspirin isn’t risk free. It carries the risk of gastrointestinal bleeding and is contraindicated in those with a history of ulcers or who are already taking other nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil, Motrin, Aleve, and other similar medications available by prescription only.

Here are some healthy alternatives to aspirin that are even more effective (but less well known) and have no adverse side effects!

1. Eat carrots.One of the most dramatic findings to come out of the well-known Nurse’s Health Study in 1993 (which tracked 87,000 nurses for eight years) was that those who ate just five large carrots a week lowered their risk of stroke by 68 percent compared to those who ate only one carrot per month or none at all! (I recommend keeping a bag of those little baby organic carrots in your refrigerator and snacking on them regularly—delicious and very satisfying!)
   By the way, carrots also lower cholesterol because of their fiber content. A study from England showed that those who ate two large carrots a day for three weeks reduced their total cholesterol by 11 percent, which is roughly the same amount that’s achieved with statin drugs!³
   
2. Increase your intake of other fruits and vegetables since numerous studies have documented their many benefits. (See The Color Code by Anne Underwood, James A. Joseph, and Daniel A. Nadeau [Hyperion, 2003].) For example, a study reported in the Journal of the American Medical Association found that women (and men) who consumed five to six servings of fruits and vegetables a day lowered their risk of stroke by 31 percent. The strongest effect came from cruciferous vegetables, such as broccoli, turnip, kale, collard greens, brussels sprouts, and cabbage. Green leafy vegetables, such as bok choy and citrus fruit and juice, were also effective.⁴
   
3. Drink tea. Both black and green teas have been found to decrease the incidence of stroke. In a Japanese study, 5,910 women were followed for four years. Those who drank five or more cups of green tea suffered half as many strokes as those who didn’t.⁵ A study done in Rotterdam in the Netherlands found that Dutch men and women who drank four cups of tea a day cut their risk of severe hardening of the arteries by two-thirds. Those who drank only one to two cups a day cut their risk in half!⁶
   
4. Eat fish. The Nurse’s Health Study also found that women who ate fish once per week cut their risk of stroke by 22 percent, while those who ate fish five or more times per week cut their risk by 52 percent.⁷The evidence that the omega-3 fats in fish are heart healthy is now so compelling that the American Heart Association now recommends that all adults consume fish at least twice per week. Fatty cold-water fish such as wild Alaskan salmon contains the most omega-3 fats.
   The benefits of eating fish have been confirmed over and over again, and continue to make the headlines. For example, a recent review of 97 clinical studies on the effects of lipid-lowering agents (statins, fibrates, resins, niacin, and fish oils) showed that fish oils provided the greatest reductions in total mortality and cardiac morbidity.⁸ For those of you who don’t like fish, there are some excellent omega-3 supplements available.

 

As you can clearly see, you have many choices besides aspirin when it comes to decreasing your risk of stroke. If you haven’t done so already, please include at least one of my suggestions above in your daily routine. Better yet, drink some tea while chewing on a carrot stick! You might even lose a few pounds, and your blood vessels and heart will say, “Thank you!”

Please Note: Aspirin does have its place. I’d definitely advise taking an aspirin if you feel that you’re having a heart attack during or after your call to 911. There’s ample evidence that this can help both men and women. (I’d also take a bolus [a very large dose] of magnesium—see the March/April 2005 issue of The Dr. Christiane Northrup Newsletter!) Please understand that nature’s bounty is designed to help us keep our blood vessels in good shape naturally, if we just take advantage of it!

 

References

1. Ridker, Paul M., et. al., 2005. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women, NEJM, 352:1293–1304.
2. Northrup, Christiane, M.D., 2001. The Wisdom of Menopause, Bantam.
3. Robertson, J., et. al., 1979. The effect of raw carrot on serum lipids and colon function, Am J Clin Nutr, 32(9):1889–92.
4. Joshipura, K.J., et. al, 1999. Fruit and vegetable intake in relation to risk of ischemic stroke, JAMA, 282(13):1233–9.
5. Sato, Y., et. al., 1989. Possible contribution of green tea drinking habits to the prevention of stroke, Tohoku J of Exp Med, 157(4):337–43.
6. Geleijnse, J.M., et. al., 1999. Tea flavonoids may protect against atherosclerosis: The Rotterdam Study, Arch Intern Med, 159(18):2170–4.
7. Iso, H., et. al., 2001. Intake of fish and omega-3 fatty acids and risk of stroke in women, JAMA, 285(3):304–12.
8. Studer, M., et. al., 2005. Effect of different antilipidemic agents and diets on mortality: a systematic review, Arch Intern Med, 165(7):725–30.