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Aspirin Lessens Women's Strokes

Posted on: Tuesday, 8 March 2005, 06:00 CST

ORLANDO -- Aspirin has proved for the first time that it can save healthy middle-aged women's lives by preventing strokes -- but not heart attacks, a major study reported Monday. In women 65 and older, however, it does both.

The Women's Health Study, which involves nearly 40,000 healthy nurses, is the first major long-term study to test the preventive benefits of aspirin in women. The results are at odds with what studies have found in men, who can dramatically cut their risk of dying of heart attacks, but not stroke, by taking aspirin.

''I don't think we should be that surprised,'' study co-author Paul Ridker of Brigham and Women's Hospital in Boston said at an American College of Cardiology meeting here. ''Women do suffer proportionately more strokes than men.''

The study also showed that vitamin E provided no protective benefit at all, but it didn't confirm findings from a major study last fall that suggested vitamin E could be harmful.

Previous studies in both men and women have shown that heart patients who regularly take low-dose aspirin, usually less than 100 milligrams, are less likely to die of heart disease or have a second heart attack.

Anyone who takes an aspirin during a heart attack is more likely to survive and less likely to have a second attack later on. But, until now, no one had studied whether low-dose aspirin can prevent heart attacks in healthy women.

After a decade, women who used aspirin had a 17% lower risk of stroke, driven by a 24% reduction in the most common form of stroke caused by blood clots, the study found. Women 65 and older were 30% less likely to have a stroke caused by a blood clot and 34% less likely to have a heart attack. Non-smokers and former smokers benefited the most.

Current guidelines, based on research in men, advise doctors not to recommend aspirin for women who have less than a 10% risk of heart disease over the next decade. The new findings likely will send doctors back to the drawing board to figure out when it's appropriate to tell middle-aged women to take low-dose, or baby, aspirin. The dosage is still enough to cause serious gastrointestinal bleeding in 2% of patients.

''Our guidelines were based on limited data. Now we have robust data,'' says Sidney Smith of the University of North Carolina-Chapel Hill and a co-chairman of the American Heart Association committee that writes treatment guidelines for cardiologists. ''Older women might benefit.''

The association released a statement Monday urging women whose physicians have prescribed baby aspirin, especially those with heart-disease risk factors, to continue. ''We want to be sure these women realize that this study does not apply to them,'' heart association President Alice Jacobs says.

Women in the study were assigned at random to take a placebo or 100 milligrams of aspirin, slightly more than a baby aspirin of 81 mg but less than an adult dose of 325 milligrams, which can double the risk of gastrointestinal bleeding. Findings also were released online by The New England Journal of Medicine.

Source: USA TODAY

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