Confusion reigns


February is American Heart Health month. Last week was Women’s Heart Health Week, which leads me to the question: What month or week of the year hasn’t been co-opted by some darned cause or marketing cliche?

Oh well, grumbling aside, I cave into the media deluge of changed information on what’s good for women’s heart health, by writing about the topic this week. But the deluge also leads me to a second question: Why is the industry standard changing all the time? I’m no doctor, though some of my good friends are. Nonetheless, it seems to me that medicine’s foray into preventive heart health medicine must be in its infancy. Otherwise, why would the protocol for medical advice on what’s good and what’s bad for women’s hearts loop-de-loop from year to year and twist itself into pretzel-like contortions?

This week, new guidelines from the American Heart Association (AHA) and the U.S. government tell us that aspirin is “in,” even more “in” than it’s been in years when we already thought it was “in.” Now, in addition to the daily dose earlier suggested by medical brass for women at higher risk of heart disease, this week’s new and improved guidelines tell all women to take an 81-100 mg. “baby aspirin” daily.

The AHA news release advises, “Routine low-dose aspirin therapy may be considered in women age 65 or older regardless of CVD (cardiovascular disease) risk status, if benefits are likely to outweigh other risks. (Previous guidelines did not recommend aspirin in lower-risk or healthy women.) The upper dosage of aspirin for high-risk women increases to 325 mg per day rather than 162 mg.”

Believe it or not, the “aspirin a day” recommendation now falls into the “controversial”-advice category, particularly for women with uncontrolled blood pressure, not to mention women with digestive issues whose stomachs don’t take kindly to aspirin.

Other than that, the AHA recommendations fall under the duh-hey heading: Don’t smoke, don’t drink too much (more than one drink a day, which seems like too much from where I sit), exercise like a banshee, etc.

And the release repeats advice that’s been the industry standard since 2002, when the government’s Women’s Health Initiative abruptly halted a study of women on hormone-replacement therapy (HRT): “Hormone-replacement therapy and selective estrogen receptor modulators (SERMs) are not recommended to prevent heart disease in women.”

Except that, according to another new study out this week from France, another form of hormone-replacement therapy might help women with severe menopausal symptoms without adding to the risk of blood clots now associated with HRT in American women’s minds. Confused? You ought to be.

Data contradicting data is the norm, and not the exception. However, in this case it looks like it’s conflicting data, but it’s really not.

The HRT the American Heart Association is warning against is taken in pill form, and it’s made from pregnant mares’ urine. The hormone patch widely used in Europe and touted in the French study is absorbed through the skin and is made of 17-beta estradiol, a lab-made chemical twin to the estrogen found in pre-menopausal women. Torturing mares to create Premarin and Prempro (American versions of HRT) has turned out to be one of the great animal-abuse scams of all time. It’s also turned out to be bad for women, who were the alleged beneficiaries of the end product. Now that women can get the same relief from hot flashes, mood swings and night sweats with lab-made drugs, there’s no excuse for continued production of mare-urine drugs.

However, better and more distinct labeling is in order, because American women are thoroughly confused by the use of the same term (HRT) to describe a myriad of options. Also in the AHA’s news release was this little ditty: “A recent American Heart Association survey showed that women are confused about methods to prevent heart disease including the role of aspirin, hormones and dietary supplements.”

Small wonder!!!! Stop issuing conflicting, changing and contradictory guidelines, and we’ll be a lot less confused.

(Bonnie Erbe is a TV host and writes this column for Scripps Howard News Service. E-mail bonnieerbe(at)