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Senior Citizen Health & Medicine
Women Taking Aspirin Show Reduced Risk of Death from
Any Cause Says Study
Editorial challenges findings based on
‘accumulated evidence’
 March
26, 2007 - Women who take low to moderate doses of
aspirin have a reduced risk of death from any cause, and especially
heart disease–related deaths, according to a report in the March 26
issue of Archives of Internal Medicine, one of the Archives journals of
the Journal of the American Medical Association. But, an editorial in
the same journal says this evidence “cannot overcome accumulated
evidence that aspirin is not particularly effective for the primary
prevention of death from cardiovascular disease in women.”
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Previous studies have provided evidence that
aspirin may reduce the risk of heart disease and some types of cancer,
the two leading causes of death in U.S. women, according to information
in the article. However, it has been unclear whether aspirin reduces the
risk of death overall for women, the author’s say.
Andrew T. Chan, M.D., M.P.H., Massachusetts General
Hospital and Harvard Medical School, Boston, and colleagues examined the
association between aspirin use and death in 79,439 women enrolled in
the Nurses’ Health Study, a large group of female nurses who have been
followed since 1976.
Beginning in 1980 and again every two years through
2004, the women were asked if they used aspirin regularly and if so, how
many tablets they typically took per week. At the beginning of the
study, the women had no history of cardiovascular disease or cancer.
A total of 45,305 women did not use aspirin; 29,132
took low to moderate doses (one to 14 standard 325-milligram tablets of
aspirin per week); and 5,002 took more than 14 tablets per week.
By June 1, 2004, 9,477 of the women had died, 1,991
of heart disease and 4,469 of cancer.
Women who reported using aspirin currently had a 25
percent lower risk of death from any cause than women who never used
aspirin regularly.
The association was stronger for death from
cardiovascular disease (women who used aspirin had a 38 percent lower
risk) than for death from cancer (women who used aspirin had a 12
percent lower risk).
“Use of aspirin for one to five years was
associated with significant reductions in cardiovascular mortality,” the
authors write.
“In contrast, a significant reduction in risk of
cancer deaths was not observed until after 10 years of aspirin use. The
benefit associated with aspirin was confined to low and moderate doses
and was significantly greater in older participants and those with more
cardiac risk factors.”
There are several mechanisms by which aspirin could
reduce the risk of death, the authors note.
“Aspirin therapy may influence cardiovascular
disease and cancer through its effect on common pathogenic pathways such
as inflammation, insulin resistance, oxidative stress (damage to the
cells caused by oxygen exposure) and cyclooxygenase (COX) enzyme
activity,” also linked to inflammation, they write.
Because the study looked at women who made the
decision themselves whether or not to take aspirin, as opposed to a
clinical trial where women are randomly assigned to aspirin or a
placebo, the results do not suggest that all women should take aspirin.
“Nevertheless, these data support a need for
continued investigation of the use of aspirin for chronic disease
prevention,” the authors conclude.
Editor's Note: This study was supported by grants
from the National Institutes of Health. Dr. Chan is the recipient of a
career development award from the National Cancer Institute, an American
Gastroenterological Association/Foundation for Digestive Health and
Nutrition Research Scholar Award, and a GlaxoSmithKline Institute for
Digestive Health Research Award.
Editorial: Is aspirin that good, or is there
another explanation
These findings differ from the results of other
studies regarding the benefits of aspirin use in healthy women, leaving
confusion about aspirin’s role, writes John A. Baron, M.D., Dartmouth
Medical School, Lebanon, N.H., in an accompanying editorial.
Dr. Baron points out that in the Women’s Health
Study, researchers followed almost 40,000 women for 11 years and did not
find any reduced risk of cardiovascular or other death associated with
aspirin therapy, in contrast to the dramatic risk reduction seen in the
Nurses’ Health Study.
“Is aspirin really that good or is there some other
explanation for the findings that differ so much from those of the WHS
and other primary prevention trials?” he writes.
“The difference between the NHS and the aggregated
data from the WHS and other trials is too large to be explained by
potential weaknesses in the randomized studies,” Dr. Baron writes.
“At the same time, one has to consider that the
observational NHS may not have been able to deal with the differences
between aspirin users and non-users.”
“Therefore, these new findings by Chan et al cannot
overcome the accumulated evidence that aspirin is not particularly
effective for the primary prevention of death from cardiovascular
disease in women,” he concludes.
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