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
To comment on this article, contact editor@uspharmacist.com.