A meta-analysis of more than 95,000 patients has shown that Acetylsalicylic Acid ( Aspirin ) can significantly reduce the risk of cardiovascular events, a combined endpoint including stroke, myocardial infarction and death due to cardiovascular disease -- in both men and women.

However, the researchers at Duke University Medical Center found, the major reasons for the risk reduction differed between the sexes. For men, Aspirin lowered the risk of a myocardial infarction, 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 this 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.

The study is published in the Journal of the American Medical Association ( JAMA ).

Jeffrey Berger, first author of the paper, 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 myocardial infarction for men," Berger said. " While our analysis showed that Aspirin may have different effects in men and women, the relatively small number of infarction myocardial 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 myocardial infarctions. Among the 44,114 men, there were 597 strokes and 1,023 myocardial infarctions.

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.

Source: Duke University Medical Center, 2006


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