Aspirin Can Help Women's Hearts, But Be Cautious
The battle of the sexes may even extend to aspirin: A new meta-analysis, or "study of studies," finds the cardio-protective medication benefits men differently than it does women, according to a report in the Journal of the American Medical Association (JAMA).
The review of six studies, involving more than 95,000 persons, shows 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," says 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," says Dr. Brown.
He believes future research on the issue should center on factors such as how women and men "metabolize [break down and process in the body] aspirin, and how it acts on blood platelets [blood cells involved in blood clotting] and blood vessels."
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 did not. 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," notes 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 adds.
But risk factors such as high blood pressure and diabetes have to be taken into account when aspirin therapy is under consideration, says Dr. Brown.
"The risk-benefit ratio has to be considered for any patient," he says. "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 physician 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, Dr. Brown notes.
The dosages ranged from a high of 500 milligrams a day, "which today no one would consider," to 100 milligrams every other day, he says.
"I think a reasonable dose is 81 milligrams a day, the amount in one baby aspirin," explains Dr. Brown.
Always consult your physician for more information.
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It is a myth that heart disease is a man's disease. In fact, one in 12 women aged 45 to 64 has heart disease. One in four women over the age of 65 has heart disease.
Currently, 6 million women have heart disease, states the National Heart, Lung, and Blood Institute (NHLBI).
Coronary heart disease is the single largest cause of death for females in the US.
Almost 15 percent of girls ages six to 19 are overweight, which is a risk factor for heart disease.
About 25 percent of girls in grades nine through 12 report using tobacco, which is a risk factor for heart disease.
At menopause, a woman's heart disease risk starts to increase significantly.
Each year, about 88,000 women ages 45 to 64 have a heart attack.
Beginning at age 50, more women than men have an elevated cholesterol.
About 21 million women age 65 and older have high blood pressure.
Each year, about 372,000 women age 65 and older have a heart attack. The average age for women to have a first heart attack is about 70, and women are more likely than men to die within a few weeks of a heart attack.
About 35 percent of women who have had a heart attack will have another within six years.
Who is most at risk - inherited (genetic) factors?
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women with inherited hypertension - high blood pressure
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women with inherited low levels of HDL (high-density lipoprotein) or high levels of LDL (low-density lipoprotein) blood cholesterol
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women with a family history of heart disease (especially with onset before age 55)
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aging women
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women with type 1 diabetes
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women, after the onset of menopause - generally, men are at risk at an earlier age than women, but after the onset of menopause, women are equally at risk.
Who is most at risk - acquired risk factors?
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women with acquired hypertension - high blood pressure
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women with acquired low levels of HDL (high-density lipoprotein) or high levels of LDL (low-density lipoprotein) blood cholesterol
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cigarette smokers
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women who are under a lot of stress
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women who lead a sedentary lifestyle
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women overweight by 30 percent or more
A heart attack can happen to anyone - it is only when we take the time to learn which of the risk factors apply to us, specifically, can we then take steps to eliminate or reduce them.
Always consult your physician for more information.
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