Prevention of stroke in women: low-dose Acetylsalicylic acid


A study performed at Harvard Medical School found that low-dose Acetylsalicylic acid ( Aspirin ) may reduce the risk of ischemic stroke in women.

Previous trials had showed that low-dose Aspirin reduces the risk of a first myocardial infarction in men, with little effect on the risk of ischemic stroke.
The use of Aspirin in primary prevention in women is based on limited data .

In total 39,876 healthy women, 45 years or older, were randomized to receive 100mg Aspirin or placebo on alternate days.

The follow-up was 10 years.

During this period subjects were monitored for a first major cardiovascular event.

A total of 477 major cardiovascular events were found in the Aspirin group, as compared with 522 in the placebo group, with a non-significant reduction in risk with Aspirin of 9 percent.

The risk of stroke decreased of 17 percent in the Aspirin group, as compared with a 24 percent reduction in the risk of ischemic stroke and non-significant increase in the risk of hemorrhagic stroke.

As compared with placebo, Aspirin had no significant effect on the risk of fatal or nonfatal myocardial infarction or death from cardiovascular causes.

Gastrointestinal bleeding and peptic ulcer were significantly more common among women in the Aspirin group than among women in the placebo group.
There were 127 episodes of gastrointestinal bleeding requiring transfusion in the Aspirin group, as compared with 91 in the placebo group.

A subgroup analysis found that the most consistent benefit of Aspirin was observed among women 65 years of age or older.

The results of this study showed that the recommendations in primary prevention of coronary heart disease ( CHD ) may be complex for women.
Aspirin seems to reduce the risk of stroke without affecting the risk of myocardial infarction or death from cardiovascular causes.

In 2002, the Preventive Services Task Force and the American Heart Association recommended Aspirin for adults whose 10-year risks of a first CHD event were at least 6 percent and 10 percent, respectively.

Source: The New England Journal of Medicine, 2005

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