Science

Review shows Aspirin helps men, women differently

A study of almost 100,000 people suggests a daily dose of Aspirin helps reduce the risk of stroke in women and heart attack in men. Talk to your doctor about heart disease risk before considering low-dose ASA, cardiologists advise.

Women can benefit from taking a daily dose of Aspirin like men, but the drug's protective effects vary, a new review suggests.

For more than a decade, men and women have been told Aspirin, or ASA, prevents heart attacks.

But a review of six clinical trials, which followed 95,456 people without coronary artery disease who took low-dose ASA or a placebo, shows that men taking the drug tend to have fewer heart attacks, while women have fewer strokes.

The study is in the Jan. 18 issue of the Journal of the American Medical Association.

"This is new information, fresh information," said cardiologist Dr. Paul Armstrong of University of Alberta Hospital in Edmonton. "It does provide, I think, new insight into the possibility of Aspirin's benefit at least in stroke if not in heart attack."

The results suggest that, by taking ASA over six years, a stroke will be prevented in three in 1,000 women, and a heart attack prevented in four in 1,000 men.

No one knows why the drug acts differently in men and women, although basic physical differences are suspected.

"We know that women's blood vessels are smaller," Armstrong said. "We know that they have a tendency to have more inflammation."

Side-effect warning

Study author Dr. Jeffrey Berger, a cardiologist at Duke University in Durham, N.C., and his colleagues also found that those taking ASA are at higher risk of serious gastrointestinal bleeding.

ASA should never replace other preventive strategies, such as proper diet and exercise, Berger said. The bottom line is, talk to your doctor.

"Somebody who is at a higher level of risk – because they may be a smoker, they may be hypertensive or have a strong family history – is likely to derive a greater benefit from taking Aspirin than somebody who's at extremely low risk," said Dr. Andre Wielgosz of the Heart and Stroke Foundation in Ottawa.

The benefits from ASA are as strong with low-dose or children's formulations as with higher doses that carry a bigger risk of serious side-effects in both sexes.