The most consistent benefit for aspirin was in women 65 years of age at study entry, among whom the risk of major cardiovascular events was reduced a 30% reduction in the risk of ischemic stroke (RR, 0.70; 95% CI, 0.49 1.00; P=0.05); however, there was only a trend in the reduction of the overall risk of all types of stroke (RR, 0.78; 95% CI, 0.57 1.08; P=0.13), likely related to an increase in the risk of brain hemorrhages. Subgroup analyses showed a reduc- tion in stroke for those women with a history of hypertension further post hoc subgroup WHS analysis found that the over- all effect of aspirin was not modified in women with migraine (with or without aura), but aspirin use was associated with an increased risk of MI in those with migraine with aura (RR, 3.72; 95% CI, 1.39 9.95), an unexpected finding that may have been attributable to chance.615 TheAHA evidence-based guide- lines for CVD prevention in women also endorse the use of aspirin in high-risk women, unless contraindicated, in women 65 years of age if BP is controlled and benefit for ischemic stroke and MI prevention outweighs the risk of gastrointesti- nal bleeding and hemorrhagic stroke, as well as in women <65 years of age when benefit for ischemic stroke prevention is likely to outweigh complications.890 There are several other subpopulations for whom aspirin might be helpful in reducing risk of stroke. Patients with a reduced ankle-brachial index are at higher risk of vascular events. One trial evaluated the benefit of aspirin in a screened general population cohort with a low ankle-brachial index.891 There was no benefit of aspirin in reducing the rate of fatal or nonfatal coronary events, stroke, or revascularization pro- cedures (HR, 1.03; 95% CI, 0.84 1.27). 