AskNadia: Does Taking One Baby Aspirin for Cardiovascular Benefit Men Only?

Hello Nadia,

I read somewhere that the cardiovascular benefits of one baby aspirin a night only applies to men….is this true?

My GP has me taking one baby aspirin at bed time due to my family history of cardiovascular disease (father, deceased of CHF at 65; first heart attack at age 50) although I show no signs/symptoms thus far (normal to low BP, clear cardiac calcium heart scan, slightly elevated cholesterol levels but w/ low triglycerides and high HDL, regular exercise, not over-weight, type 1.5 diabetic on nightly Lantus and Januvia, 10 mg, with good blood sugar and HbA1c control).

Just wondering if I really need to be taking the aspirin….

Thanks for your help,

Krista M.

Dear Krista:

Baby aspirin taken daily is what is called a prophylactic medicine; something taken to prevent the possible onset of a disease in this case, heart attacks or other cardiovascular problems. Although doctors have recommended baby aspirin to certain patients since the 1970s, there is still some disagreement over its effectiveness.

The main argument for aspirin is that it thins the blood, preventing quick clotting. In the case of a heart attack or stroke, the circulatory system’s ability to continue delivering blood to major organs is vital.

Still, you do have to consider the negatives of small-dose aspirin. Its best feature, the ability to prevent clotting, is also its greatest drawback. Another negative is that aspirin increases the danger of extensive internal bleeding from an ulcer or gastric disturbance—a potentially deadly effect.

But given the good numbers you list in your question, why would your doctor prescribe small-dose aspirin? One reason is that people with diabetes are 4x more likely to develop cardiovascular problems than people who are not diabetic. Your diabetes by itself is one reason why your doctor prescribed baby aspirin in the first place.

The other, as you mentioned, is a genetic predisposition to cardio problems, which other members of your family have already experienced. If you combine a genetic predisposition for CVD with your current diabetic status, your doctor now has two solid reasons for asking you to take prophylactic aspirin.

Related to that is your question whether daily aspirin intake is something that works for men but not so much for women—especially in light of the your impressive numbers. The answer, based on extensive studies from the early 2000s, is that baby aspirin seems to work better at helping prevent strokes in women as opposed to heart attacks. For men it’s the opposite: Baby aspirin is better at helping prevent heart attacks but has no effect on preventing strokes. So small-dose aspirin works for both sexes, just not in the same way.

Do you really need to take aspirin? I can say that you should not stop taking it without consulting your doctor or endocrinologist. Suddenly stopping a daily aspirin dose can create a “rebound effect” where the risk of a heart attack or stroke increases to a dangerous level. If you want to wean yourself off the medicine, collaborate closely with your MD in weighing the positive against the negative.




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