Tuesday, March 27, 2007

Aspirin for Women: Yes or No

Fewer Deaths in Women on Aspirin WebMD 3/26/07 "new findings come from the Nurses' Health Study, a 30-year-long study of nearly 80,000 women. The study suggests that women who regularly take low-dose aspirin (81 milligrams of baby aspirin) or moderate-dose aspirin (325 milligrams of adult aspirin) are less likely to die than those who don't take aspirin...The study shows that women who took low- or moderate-dose aspirin were:

25% less likely to die of any cause
38% less likely to die of heart disease or stroke
28% less likely to die of colon cancer

Women who regularly took high-dose aspirin -- more than 14 adult-strength tablets a week -- did not get a health benefit. Instead, they were 43% more likely to die from hemorrhagic stroke compared with those who never took aspirin. Hemorrhagic stroke is stroke due to bleeding in the brain...Women got a heart benefit from aspirin after about five years of use. The cancer benefit didn't appear before 10 years of regular aspirin use...The evidence remains strong that daily low-dose aspirin cuts a man's risk of heart disease and stroke -- although the drug does increase a man's risk of ulcers and gastrointestinal bleeding..."This is the infamous Nurse's Health Study that led us down the wrong path for many things like hormone replacement therapy and antioxidants because it is observational and can't control for bias. The Women's Health Study was long-term and randomized, so recommendations should be based on that."...Chan, too, agrees that women should not start taking aspirin willy-nilly. But he says the study data raise important questions."

Debate not over. I don't think the Women's Health Study is as virtuous as some proponents think, nor is the Nurse's Health Study as bad as critics think. Both have their problems of methodology. But I suspect in this case that the Women's Health Study is wrong about aspirin and that 81mg a day does have significant health benefits. The connection of inflammation to a whole host of diseases should not be so easily dismissed.

The lesson from this latest research is that there seems to be no reason to use more than baby aspirin at 81mg a day and plenty of reasons not to use more than 325mg a day - as in a complete negation of health benefits and dramatic increase in mortality via stroke.

So 81mg's a day it is.

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