Aspirin Anomaly

By Christine Gorman

Doctors have long known that they can't always treat heart disease exactly the same way in women as in men. Now they are learning that they have to take gender differences into account when it comes to prevention as well. A rigorously conducted clinical trial released last week shows that a low dose of aspirin taken regularly, which seems to help middle-aged men avoid heart attacks, does not offer the same cardiovascular benefits for middle-aged women--although it does lessen their risk of stroke.

As with any medical news report, it's important to understand what this study, which will be published in the New England Journal of Medicine, does--and does not--mean. For starters, if you think you are in the midst of a heart attack, chewing a 325-mg aspirin tablet right away may save your life, whether you are a woman or a man. Aspirin also helps many women (and men) who have already suffered a heart attack avoid having a second one. And anyone with diabetes who also suffers from high blood pressure or high cholesterol should talk to a doctor about possibly going on aspirin therapy, whether or not he or she has had a heart attack.

Now for what aspirin can't do. The new study looked at 40,000 healthy women, most of whom were in their 40s and 50s at the beginning of the investigation. Half took 100 mg of aspirin every other day; the rest took a placebo. After following the women for a decade, doctors saw no statistically significant difference between the two groups in the number of heart attacks, with one important exception: women who were at least 65 years old at the start of the study were less likely to suffer a heart attack if they followed the aspirin regimen. Aspirin helped protect all women, regardless of age, from strokes triggered by clots. As expected, women on aspirin suffered more internal bleeding and gastric problems. o