US Pharm. 2006;2:50.       

Aspirin's Positive Effects Differ in Men and Women
Aspirin may reduce the risk of ischemic stroke in women and may also lower the risk of MI in men, according to results of a meta-analysis that recent­ ly appeared in JAMA (2006;295:306-313).

Existing research on the effect of aspirin in the prevention of cardiovascular disease primarily relates to men. Thus, authors aimed to establish whether the benefits and risks of aspirin therapy in preventing cardiovascular events (e.g., MI, stroke, and cardiovascular mortality) varied by gender. Data were analyzed from six randomized controlled trials involving 95,456 people (51,342 women and 44,114 men) without cardiovascular disease.

Among women, 1,285 cardiovascular events occurred: 625 strokes, 469 MIs, and 364 cardiovascular deaths. Alternatively, of 2,047 cardiovascular events in men, there were 597 strokes, 1,023 MIs, and 776 cardiovascular deaths. Significantly, aspirin was associated with a 17% decline in ischemic stroke in women and a 32% reduction in MI in men. However, aspirin increased the risk of bleeding in both men and women and did not provide significant protection against cardiovascular mortality in either sex.

Losing Weight Reduces Incontinence
Women with prediabetes who lost 7% of their body weight had a lower prevalence of urinary incontinence, compared to those taking an oral diabetes drug or placebo. These data were published in the February issue of Diabetes Care (2006;29: 385-390).

Researchers examined data from the Diabetes Prevention Program, a trial conducted in 27 U.S. centers. Women (1,957 participants) were assigned to three groups: 660 were randomized to intensive lifestyle therapy (diet and physical activity aimed at a 7% weight loss), 636 received metformin, and 661 received placebo. Both the metformin and placebo groups received standard medical advice about diet and weight loss. Incontinence symptoms were documented based on frequency and type using a validated questionnaire.

Implementing intensive lifestyle changes, women who lost weight had a lower rate of weekly incontinence symptoms (stress or urge) than both the metformin and placebo groups (38% vs. 48% and 46%, respectively). The most significant difference was seen in women with stress incontinence (31%, intensive lifestyle group; 39.7%, metformin group; and 36.7%, placebo; P = .006). Thus, authors concluded that weight loss and lifestyle interven­ tion may decrease the risk of urinary incontinence, and this lower prevalence may motivate women with prediabetes to choose a lifestyle change to prevent the condition.

Heart Disease Is Misdiagnosed in Women
Women with coronary microvascular syndrome may be incorrectly diagnosed when tested with coronary angiography. This research was published in a supplement to the Journal of the American College of Cardiology (2006;47[3]).

The Women's Ischemia Syndrome Evaluation (WISE) study, sponsored by the National Institutes of Health, evaluated coronary heart disease in women. Since plaque collects in small arteries in women with coronary microvascular syndrome, the lack of significant blockage in routine angiographies can lead to misdiagnosis. Thus, women may be considered at low risk for heart disease but continue to have symptoms, a decline in quality of life, and repeated hospitalizations and tests. The WISE study indicates that more research is needed on the detection and treatment of women with ischemic heart disease.

--Jessica Jannicelli

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