Aspirin Protects Men and Women Differently

Fewer strokes for women, fewer heart attacks for men, study found

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By Ed Edelson
HealthDay Reporter

TUESDAY, Jan. 17, 2006 (HealthDay News) -- The battle of the sexes may even extend to aspirin: A new "study of studies" finds the cardio-protective drug benefits men very differently than it does women.

The review of six studies, involving more than 95,000 people, showed that aspirin therapy cut the incidence of stroke in women but not men.

On the other hand, when it came to heart attack the reverse was true: Daily use of aspirin reduced the incidence of those events in men but not women.

"Nobody has any ideas about the cause of the difference," said study senior author Dr. David L. Brown, chief of cardiology at the State University of New York at Stony Brook. "It needs to be an important research priority for the future."

He believes future research on the issue should center on factors such as how men and women "metabolize aspirin, and how it acts on blood platelets [cells] and blood vessels."

The report appears in the Jan. 18 issue of the Journal of the American Medical Association.

Three of the trials included only men, one included only women and two included both sexes. All the participants were free of cardiovascular conditions at the start of the studies.

Overall, there was a 12 percent reduction in all cardiovascular events in women who took aspirin as compared to those who didn't. The reduction for men was 14 percent.

But those reductions occurred in strikingly different ways, based on gender. Aspirin treatment lowered the incidence of heart attacks in men by 32 percent, but had no effect on their incidence of stroke. For women, aspirin therapy decreased the incidence of stroke by 17 percent, with no significant effect on their risk of heart attack.

"This adds to the continued research that men and women are different," noted Dr. Nieca Goldberg, chief of women's cardiac care at Lenox Hill Hospital in New York City, and author of the book Women Are Not Small Men.

Aspirin has benefits for both sexes, "particularly when it comes to healthy men and women, those without heart disease or risk factors," she added.

But risk factors such as high blood pressure and diabetes have to be taken into account when aspirin therapy is under consideration, Brown said.

"The risk-benefit ratio has to be considered for any patient," he said. "The benefit is based on the risk factor profile, and the risk is based on the presence of such things as previous bleeding events and peptic ulcers."

No one should start taking aspirin before consulting a doctor, because it can cause bleeding. Aspirin therapy resulted in a 70 percent increase in the risk of major bleeding episodes across the six studies.

Those studies offered no firm guideline on the amount of aspirin to be taken, Brown said. The dosages ranged from a high of 500 milligrams a day, "which today no one would consider," to 100 milligrams every other day, he said.

"I think a reasonable dose is 81 milligrams a day, the amount in one baby aspirin," Brown said.

More information

For more on aspirin's cardio-protective powers, head to the American Heart Association.

SOURCES: David L. Brown, M.D., chief, cardiology, State University of New York at Stony Brook; Nieca Goldberg, M.D., chief, women's cardiac care, Lenox Hill Hospital, New York City; Jan. 18, 2006, Journal of the American Medical Association

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