Aspirin reduces strokes in women and heart attacks in men

Jan 18 2006

Researchers have found in an analysis of previous studies, that the use of aspirin significantly reduces the risk of cardiovascular events in women and in men.

They say it reduces the risk of strokes in women and reduces the risk of heart attacks in men.

The researchers led by Dr. Jeffrey S. Berger, M.D., M.S., of Duke University, Durham, N.C., performed an analysis by looking at sex-specific aspirin therapy in preventing cardiovascular events in order to see whether men and women respond differently to aspirin.

The benefits of aspirin therapy for reducing the risk of heart attack, stroke, and death, among men and women with a pre-existing cardiovascular disease, is well known, but the role of aspirin in prevention is less clear.

Until now it has also been unclear whether the benefit differs between men and women.

The team conducted a search of databases to identify randomized controlled trials of aspirin therapy in participants without cardiovascular disease.

They found six trials with a total of 95,456 individuals; 3 trials included only men, 1 included only women, and 2 included both sexes.

They then looked at the combined endpoint of any major cardiovascular event and each of these individual events separately.

The researchers found that among the 51,342 women, there were 625 strokes, 469 heart attacks, and 364 cardiovascular deaths.

Aspirin therapy was found to be linked to a significant 12 percent reduction in cardiovascular events and a 17 percent reduction in stroke, which was a reflection of a 24 percent reduced rate of ischemic stroke.

There appeared to be no significant effect on heart attacks or cardiovascular deaths in women.

Regarding the 44,114 men, there were 597 strokes, 1,023 heart attacks, and 776 cardiovascular deaths.

Aspirin therapy was linked in their case to a significant 14 percent reduction in cardiovascular events and a 32 percent reduction in heart attacks.

There was however no significant effect on stroke or cardiovascular death.

Aspirin treatment resulted in an approximately 70 percent increase in the risk of major bleeding events among women and men.

The authors conclude that aspirin therapy taken over an average of 6.4 years resulted in the prevention of 3 cardiovascular events per 1,000 women and 4 cardiovascular events per 1,000 men.

They also say doctors need to consider both the beneficial and harmful effects before advising aspirin for the prevention of cardiovascular disease in both sexes.

The study is published in the January 18 issue of JAMA: The Journal of the American Medical Association.