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      The role of aspirin in women’s health

      review-article
      Author(s): 1 , 2
      Publication date (Electronic):
      Journal: International Journal of Women's Health
      Publisher: Dove Medical Press
      Keywords: CVD, cancer, menopause, preeclampsia

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          Abstract

          Background

          The aim of this review is to discuss the role of aspirin for various conditions in women.

          Methods

          A nonsystematic review of articles published on PubMed ® that examines the role of aspirin in women.

          Results

          Aspirin is associated with a significant reduction of stroke risk in women, which may be linked to age. However, despite this evidence, underutilization of aspirin in eligible women is reported. In women of reproductive age, it may also have a role to play in reducing early-onset preeclampsia and intrauterine growth restriction, and in the prevention of recurrent miscarriage in women with antiphospholipid antibodies; it may also reduce cardiovascular risk in associated systemic conditions such as lupus. Aspirin may reduce colorectal cancer risk in women, but its role in breast cancer warrants further data from controlled trials.

          Conclusions

          The risk–benefit threshold for aspirin use in women has been established for several conditions. Reasons why women are less likely to be prescribed aspirin have not been established, but the overall underuse of aspirin in women needs to be addressed.

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          Most cited references104

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          Guidelines for Management of Ischaemic Stroke and Transient Ischaemic Attack 2008

          The European Stroke Organisation (ESO) Executive Committee and the ESO Writing Committee (2008)
          This article represents the update of the European Stroke Initiative Recommendations for Stroke Management. These guidelines cover both ischaemic stroke and transient ischaemic attacks, which are now considered to be a single entity. The article covers referral and emergency management, Stroke Unit service, diagnostics, primary and secondary prevention, general stroke treatment, specific treatment including acute management, management of complications, and rehabilitation.
          Article 0 comments Cited 540 times – based on 0 reviews     Review now
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            Sex differences in stroke: epidemiology, clinical presentation, medical care, and outcomes.

            Mathew Reeves, Cheryl Bushnell, George Howard … (2008)
            Stroke has a greater effect on women than men because women have more events and are less likely to recover. Age-specific stroke rates are higher in men, but, because of their longer life expectancy and much higher incidence at older ages, women have more stroke events than men. With the exception of subarachnoid haemorrhage, there is little evidence of sex differences in stroke subtype or severity. Although several reports found that women are less likely to receive some in-hospital interventions, most differences disappear after age and comorbidities are accounted for. However, sex disparities persist in the use of thrombolytic treatment (with alteplase) and lipid testing. Functional outcomes and quality of life after stroke are consistently poorer in women, despite adjustment for baseline differences in age, prestroke function, and comorbidities. Here, we comprehensively review the epidemiology, clinical presentation, medical care, and outcomes of stroke in women.
            Article 0 comments Cited 360 times – based on 0 reviews     Review now
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              A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women.

              Paul Ridker, Nancy Cook, I-Min Lee … (2005)
              Randomized trials have shown that low-dose aspirin decreases the risk of a first myocardial infarction in men, with little effect on the risk of ischemic stroke. There are few similar data in women. We randomly assigned 39,876 initially healthy women 45 years of age or older to receive 100 mg of aspirin on alternate days or placebo and then monitored them for 10 years for a first major cardiovascular event (i.e., nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes). During follow-up, 477 major cardiovascular events were confirmed in the aspirin group, as compared with 522 in the placebo group, for a nonsignificant reduction in risk with aspirin of 9 percent (relative risk, 0.91; 95 percent confidence interval, 0.80 to 1.03; P=0.13). With regard to individual end points, there was a 17 percent reduction in the risk of stroke in the aspirin group, as compared with the placebo group (relative risk, 0.83; 95 percent confidence interval, 0.69 to 0.99; P=0.04), owing to a 24 percent reduction in the risk of ischemic stroke (relative risk, 0.76; 95 percent confidence interval, 0.63 to 0.93; P=0.009) and a nonsignificant increase in the risk of hemorrhagic stroke (relative risk, 1.24; 95 percent confidence interval, 0.82 to 1.87; P=0.31). As compared with placebo, aspirin had no significant effect on the risk of fatal or nonfatal myocardial infarction (relative risk, 1.02; 95 percent confidence interval, 0.84 to 1.25; P=0.83) or death from cardiovascular causes (relative risk, 0.95; 95 percent confidence interval, 0.74 to 1.22; P=0.68). Gastrointestinal bleeding requiring transfusion was more frequent in the aspirin group than in the placebo group (relative risk, 1.40; 95 percent confidence interval, 1.07 to 1.83; P=0.02). Subgroup analyses showed that aspirin significantly reduced the risk of major cardiovascular events, ischemic stroke, and myocardial infarction among women 65 years of age or older. In this large, primary-prevention trial among women, aspirin lowered the risk of stroke without affecting the risk of myocardial infarction or death from cardiovascular causes, leading to a nonsignificant finding with respect to the primary end point. Copyright 2005 Massachusetts Medical Society.
              Article 0 comments Cited 336 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Int J Womens Health
                Journal ID (publisher-id): International Journal of Women's Health
                Title: International Journal of Women's Health
                Publisher: Dove Medical Press
                ISSN (Electronic): 1179-1411
                Publication date Collection: 2011
                Publication date (Electronic): 30 June 2011
                Volume: 3
                Pages: 151-166
                Affiliations
                [1 ] Department of Cardiology, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, The Netherlands
                [2 ] VU University Medical Center, Department of Obstetrics and Gynecology, Division of Maternal- Fetal Medicine, Amsterdam, The Netherlands
                Author notes
                Correspondence: Freek WA Verheugt, Onze Lieve Vrouwe Gasthuis, Oosterpark 9, NL-1091-AC Amsterdam, The Netherlands, Tel +31 20 599 3421, Fax +31 20 599 3997, Email f.w.a.verheugt@ 123456olvg.nl
                Article
                Publisher ID: ijwh-3-151
                DOI: 10.2147/IJWH.S18033
                PMC ID: 3140811
                PubMed ID: 21792337
                SO-VID: cf8e5462-805f-49c1-819f-7991a5276727
                Copyright © © 2011 Verheugt and Bolte, publisher and licensee Dove Medical Press Ltd.
                License:

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                Categories
                Subject: Review

                ScienceOpen disciplines: Obstetrics & Gynecology
                Keywords: cvd,cancer,menopause,preeclampsia
                Data availability:
                ScienceOpen disciplines: Obstetrics & Gynecology
                Keywords: cvd, cancer, menopause, preeclampsia

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