Aspirin reduces the risk of
cardiovascular events in men, women
Newswise — An analysis of
previous studies indicates that use of aspirin significantly
reduces the risk of cardiovascular events in women and in
men, due to reducing the risk of stroke in women and
reducing the risk of heart attack in men, according to a
study in the January 18 issue of JAMA.
Although the benefits of
aspirin therapy for reducing the risk of heart attack
(myocardial infarction – MI), stroke, and vascular death
among men and women with preexisting cardiovascular disease
are well established, the role of aspirin in primary
prevention is less clear, according to background
information in the article. And it has not been clear if
there is a differential beneficial effect between men and
women.
Jeffrey S. Berger, M.D.,
M.S., of Duke University, Durham, N.C., and colleagues
performed a sex-specific meta-analysis of aspirin therapy
for the primary prevention of cardiovascular events to
better understand the association of sex with the response
to aspirin. The researchers performed a search of databases
to identify randomized controlled trials of aspirin therapy
in participants without cardiovascular disease that reported
data on heart attack, stroke, and cardiovascular death.
Six
trials with a total of 95,456 individuals were identified; 3
trials included only men, 1 included only women, and 2
included both sexes. The authors examined a combined
endpoint of any major cardiovascular event (cardiovascular
death, nonfatal heart attack, or nonfatal stroke), and each
of these individual components separately.
The researchers found that
among the 51,342 women, there were 625 strokes, 469 heart
attacks, and 364 cardiovascular deaths. Aspirin therapy was
associated with a significant 12 percent reduction in
cardiovascular events and a 17 percent reduction in stroke,
which was a reflection of a 24 percent reduced rate of
ischemic stroke. There was no significant effect on heart
attacks or cardiovascular death.
Among the 44,114 men,
there were 597 strokes, 1,023 heart attacks, and 776
cardiovascular deaths. Aspirin therapy was associated with a
significant 14 percent reduction in cardiovascular events
and a 32 percent reduction in heart attacks. There was no
significant effect on stroke or cardiovascular death.
Aspirin treatment resulted in an approximately 70 percent
increase in the risk of major bleeding events among women
and men.
The authors add that
aspirin therapy for an average of 6.4 years results in an
average absolute benefit of approximately 3 cardiovascular
events prevented per 1,000 women and 4 cardiovascular events
prevented per 1,000 men.
“… the favorable effect of
aspirin on the combined risk of cardiovascular events for
women and men is apparent from these randomized studies.
Aspirin use is also associated with a significant risk of
major bleeding irrespective of sex. Both the beneficial and
harmful effects of aspirin should be considered by the
physician and patient before initiating aspirin for the
primary prevention of cardiovascular disease in both sexes,”
the authors conclude.