January 30, 2006
A study published in the January 18 issue of the Journal of the American Medical Association shows that the daily use of aspirin reduces the risk of myocardial infarction (heart attack) in men, but not in women. On the other hand, aspirin usage reduces the risk of strokes in women but not in men. And both men and women experience an increased risk of bleeding from aspirin.
These conclusions were drawn from a meta-analysis of 6 trials evaluating the use of aspirin for the prevention of cardiovascular events. In total, these 6 trials had enrolled over 50,000 women and 40,000 men. Among women, aspirin usage reduced the risk of stroke by 17%, but no significant effect on the risk of heart attack or cardiovascular death. In men, aspirin usage resulted in a 32% reduction in heart attacks, but not in any significant reduction in stroke or cardiovascular death.
In both men and women there was a 70% increase in the risk of a major bleeding events.
DrRich Comments:
It is becoming clearer and clearer that cardiovascular disease in women is not the same as cardiovascular disease in men. This latest study on the preventative use of aspirin points out yet another difference. Making blood platelets less "sticky" with aspirin (and thus reducing the risk of blood clotting) helps to prevent heart attacks in men but not in women, and to prevent strokes in women but not in men.
In either gender, individuals with a history or clear risk of major bleeding disorders (such as gastrointestinal bleeding) should not take prophylactic aspirin without the clearance of their doctor. Men who have a high risk of heart attack based on underlying risk factors should strongly consider taking aspirin. Women with a high risk of stroke should do likewise. The problem is that, while plenty of good risk calculators are available for myocardial infarction, similar risk calculators for stroke do not yet exist. This study may very well stimulate the development of stroke risk calculators.
