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Aspirin's Benefits Differ for Women

Strokes Averted, Not Heart Attacks

By Rob Stein
Washington Post Staff Writer
Tuesday, March 8, 2005; Page A01

Aspirin does not protect women against heart attacks in the same way it does men, but the venerable painkiller does cut women's chances of suffering a stroke, researchers reported yesterday.

A long-awaited 10-year study of nearly 40,000 women, the biggest and best such study to date, provides healthy women with the first authoritative assessment of the benefits of taking regular aspirin, a practice many have already begun based largely on studies of men.

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The study found that aspirin does not reduce the risk of a first heart attack for middle-aged women, as it does for men, but does cut the risk of strokes, which is not the case for men. For women 65 and older, aspirin does lower the chances of having a heart attack, and its stroke-preventing benefits appear to be the greatest.

The findings suggest the benefits of aspirin may not outweigh the risks for healthy women in their forties and fifties, but once they hit their sixties the balance shifts enough to make it worthwhile. Aspirin's major risk is of bleeding, which can cause serious problems including rare but deadly bleeding strokes. Women with high blood pressure and problems with stomach bleeding may be at particular risk.

"The bottom line is that for younger women it's not clear that there would be an overall benefit," said Julie Buring of the Brigham and Women's Hospital in Boston, who led the study. "But for those age 65 and older, that's where we may see it being useful."

The results also add powerful new evidence to the growing body of data showing that men and women differ in fundamental ways on various aspects of health, and that research on men does not necessarily translate directly to women.

"This truly underscores the importance of studying medical therapies among women as well as men," said Buring, whose findings were released early by the New England Journal of Medicine to coincide with a presentation at an American College of Cardiology meeting in Orlando. "We can't assume studies involving men apply to women."

It remains unclear why women respond differently, although some researchers have speculated that it may be due to hormonal differences or the fact that women tend to develop heart disease later in life.

"Age 50 in men is biologically about age 60 in women in terms of their risk of cardiovascular disease," Buring said.

Aspirin, an ancient medicine known for a century mainly as a way to alleviate headaches and fevers, became a key player in the fight against cardiovascular disease -- the nation's leading killer -- after doctors discovered its powers to prevent and help dissolve blood clots and reduce inflammation.

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