Posted on 01/18/2006 9:48:28 AM PST by neverdem
DURHAM, N.C. – Aspirin can significantly reduce the risk of cardiovascular events -- a combined endpoint including stroke, heart attack and death due to cardiovascular disease -- in both men and women, according to a new meta-analysis of more than 95,000 patients by a Duke University Medical Center cardiologist.
However, the researchers found, the major reasons for the risk reduction differed between the sexes. For men, aspirin lowered the risk of a heart attack, while in women, aspirin reduced the risk of a stroke.
The use of aspirin, however, also carries an increased risk of bleeding among both sexes, the study found. The results of the new analysis lead the researchers to recommend that all patients and physicians should discuss the benefits and drawbacks of regularly taking aspirin as a preventative measure against cardiovascular events.
"Aspirin is a drug that has been used for many years – it is well-understood, effective, inexpensive and widely available," said Duke cardiology fellow Jeffrey Berger, M.D, first author of a paper published Jan. 18, 2006, in the Journal of the American Medical Association. He performed much of the research while at Beth Israel Medical Center, New York, under senior author cardiologist David Brown, M.D.
"This is good news because many of the past studies of the effect of aspirin in preventing cardiovascular events looked only at men, so physicians were reluctant to prescribe aspirin for women because there was little data," Berger continued. "But now, the combined data of recent trials involving women demonstrates that women can benefit just as much from aspirin therapy as men."
Berger emphasized that more healthy men and women who can tolerate aspirin should be taking the medication for the prevention of cardiovascular disease. It is estimated that fewer than five percent of the population suffers from the known gastrointestinal side effects of aspirin or are allergic to it, meaning that many more serious cardiovascular events could be prevented if aspirin was more widely used, Berger said
In his analysis, Berger combined the data from six different randomized clinical trials, which yielded a total of 95,456 patients, none of whom had coronary artery disease. Of that total, 51,342 were women. The trials all involved the comparison of low-dose aspirin versus placebo for the primary prevention of cardiovascular disease.
The analysis revealed that aspirin conferred a 12 percent reduction in risk in cardiovascular events for women, and a 14 percent reduction for men.
"Our findings are particularly noteworthy in that aspirin's main beneficial effects appeared to be the reduction in the risk of stroke for women and reduction in the risk of heart attacks for men," Berger said. "While our analysis showed that aspirin may have different effects in men and women, the relatively small number of heart attacks among women and strokes among men suggest that more research is needed to better understand any differences in cardiovascular responses to aspirin."
Specifically, among the 51,342 women in the analysis, there were 625 strokes and 469 heart attacks. Among the 44,114 men, there were 597 strokes and 1,023 heart attacks.
However, the routine use of aspirin does not come without potential risks, especially in terms of major bleeding episodes. The analysis found that routine aspirin use for an average of 6.4 years would lead to 2.5 major bleeding events per 1,000 women and 3 major bleeding events per 1,000 men.
"For this reason, while we believe that many more people could benefit from taking aspirin, it is important for patients and their physicians to discuss the issue and weigh the benefits and potential drawbacks to this therapy," Berger said. "Also, aspirin should never replace other ways of reducing cardiovascular risks, such eating a proper diet and exercising."
Of the six randomized clinical trials involved in the analysis, three enrolled solely men, one included only women, and two enrolled both sexes. The trials were: Physicians Health Study, British Doctor's Trial, Thrombosis Prevention Trial, Hypertension Optimal Treatment Trial, Primary Prevention Project and the Women's Health Study.
Berger presented part a portion of this analysis Nov. 14, 2005, during the annual scientific sessions of the American Heart Association.
Great! I'm unlikely to have a heart attack,but am at increased risk of having a stroke.I guess that's OK,though,because I already have a tendency to dribble and drool.
BTTT
BTTT
Transplant doctor reveals tissue rejection
FReepmail me if you want on or off my health and science ping list.
Considering everything it does, if aspirin were invented today, it would likely cost $10 a pill.
The "off the shelf" product is 81 milligrams for prophylactic purposes. My son takes one daily along with coumedin or warfarin to keep his blood appropriately thinned for his artificial mitral and aortic valves. He goes for a PT blood test about every 3 weeks to ensure the dosage is working as intended.
The usual recommendation is 81 milligrams per day. If your thinking of starting it, check with your doc, and spring for coated aspirin.
Or take two Alka-Seltzer.
And be available by prescription only.
Only five percent? That's always been one of biggest drawbacks to aspirin, especially stomach upset. I would think the percentages would be higher but even if it is helping to prevent heart attacks still makes it worth taking.
The doc put me on Warfarin a few years ago when I developed heart palpitations because he was worried about the blood pooling, creating clots and causing a stroke. Had EKGs and a Holter monitor session. When an ultrasound revealed no underlying heart condition, the cardiologist said he didn't think I needed to be on the Warfarin, but that was my GP's call since he was the one who prescribed it. I had to bully the guy to get off the stuff, and told him I'd take an 81mg aspirin every day. Been doing that for three years now with no other problems.
"... if aspirin were available today, it would likely cost $10 a pill."
Most likely, the FDA would reject it because of "unacceptable" side effects (gastrointestinal bleeding among fewer than 5% of the clinical-trial treatment group!
I think one baby aspirin is 81 mg, and would do the trick. Plus they're orange flavored ::grin::
LQ
I am on .82. Its baby aspirin and I will have to take it for the rest of my life.
Gull dam what a shock that heart attack was.
I have no risk factors and take one every other day, along with fish oil and a centrum.
Just on principle.
They make a 1/4 grain aspirin that is coated to protect your stomach. Bayer makes one and St. Joseph too. I take mine with food for extra protection.
People were breaking standard 325 mg and buying baby aspirin before the manufacturers decided to cater to this growing segment of the market.
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