I came across this article today. Source is my Medscape email newsletter.
Besides thickening the uterine lining for implantation........



Low-Dose Aspirin Linked to Lower Risk for All-Cause Mortality in Women

CME News Author: Laurie Barclay, MD
CME Author: Penny Murata, MD

March 30, 2007 — Use of low-dose aspirin is linked to lower risk for all-cause mortality in women, especially older women and those with cardiac risk factors, according to the results of a study reported in the March 26 issue of the Archives of Internal Medicine.

"The influence of long-term use of aspirin on total mortality in women remains uncertain," write Andrew T. Chan, MD, MPH, from Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues. "Although considerable evidence suggests that aspirin therapy improves survival in men and women with established cardiovascular disease, data for women without cardiovascular disease are limited and conflicting. Recently, a randomized trial of almost 40,000 apparently healthy women did not find a significant benefit of low-dose aspirin therapy on mortality."

In this prospective, nested, case-control study, 79,439 women enrolled in the Nurses' Health Study who had no history of cardiovascular disease or cancer provided data on medication use biennially since 1980. Relative risk (RR) of death according to aspirin use was determined before diagnosis of incident cardiovascular disease or cancer and during the corresponding period for each control subject.

During 24 years, there were 9477 deaths documented from all causes. Compared with women who never used aspirin regularly, women who reported current aspirin use had a multivariate RR of death from all causes of 0.75 (95% confidence interval [CI], 0.71 - 0.81). Risk reduction was more evident for death from cardiovascular disease (RR, 0.62; 95% CI, 0.55 - 0.71) than for death from cancer (RR, 0.88; 95% CI, 0.81 - 0.96).

Aspirin use for 1 to 5 years was associated with a significant reduction in cardiovascular mortality (RR, 0.75; 95% CI, 0.61 - 0.92), whereas a significant reduction in risk for cancer deaths was not observed until after 10 years of aspirin use (P for linear trend = .005). The benefit associated with aspirin was confined to low and moderate doses, and it was greater in older women (P for interaction < .001) and in women with more cardiac risk factors (P for interaction = .02).

"In women, low to moderate doses of aspirin are associated with significantly lower risk of all-cause mortality, particularly in older women and those with cardiac risk factors," the authors write. "A significant benefit is evident within 5 years for cardiovascular disease, whereas a modest benefit for cancer is not apparent until after 10 years of use."

Study limitations include observational design, self-selected aspirin use, possible residual confounding, inability to determine causality, and ability to assess the effect of aspirin only on fatal outcomes.

"Although aspirin therapy seemed to have a benefit against death from cancer, the effect was relatively modest, requiring prolonged use," the authors conclude. "Because our study was observational, these results should be interpreted cautiously and are insufficient evidence to alter current clinical recommendations. Nevertheless, these data support a need for continued investigation of the use of aspirin for chronic disease prevention."

The National Institutes of Health, 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 supported this study. The authors have disclosed no relevant financial relationships.

Arch Intern Med. 2007;167:562-572.

Clinical Context
The benefit of aspirin use in women has not been shown. Results from the placebo-controlled Women's Health Study on aspirin use in healthy women showed no beneficial effect on mortality from cancer, reported by Cook and colleagues in the July 6, 2005, issue of JAMA, and no beneficial effect on mortality from cardiovascular conditions, reported by Ridker and colleagues in March 31, 2005, issue of The New England Journal of Medicine. But as noted in the January 13, 2001, issue of The Lancet by de Gaetano and colleagues, women with at least 1 cardiovascular risk factor or who were at least 65 years of age who received aspirin had a reduced RR for cardiovascular mortality or all-cause mortality.

In 1976, the Nurses' Health Study was initiated and included 121,701 married female registered nurses aged 30 to 55 years in the United States who completed a questionnaire at baseline and biennially on risk factors, cardiovascular events, and cancer. In 1980, diet and medication information was added to the questionnaire. In the July 24-31, 1991, issue of JAMA, Manson and colleagues reported results after 6 years that showed no link between aspirin use and mortality. The current study uses 24 years of data from the Nurses' Health Study to evaluate the link between aspirin use and mortality risk from all causes, cardiovascular disease, and cancer.

Study Highlights
79,439 women from the Nurses' Health Study were included: 9477 women who died up to 24 years after the 1980 questionnaire and 69,962 randomly chosen control subjects.
Exclusion criteria included lack of medication questionnaire and report of cancer (except nonmelanoma skin cancer) or cardiovascular disease (myocardial infarction, stroke, coronary artery bypass grafting, percutaneous coronary intervention, or angina) before or on the 1980 questionnaire.
1991 cardiovascular deaths included 889 from coronary heart disease, 502 from stroke, and 600 from other cardiovascular-related causes.
4469 cancer deaths included 979 from lung cancer, 864 from breast cancer, 433 from colorectal cancer, and 2193 from other cancers.
45,305 women used no aspirin; 11,507 used 1 to two 325-mg tablets of aspirin weekly; 8158 used 3 to 5 tablets; 9467 used 6 to 14 tablets; and 5002 used more than 14 tablets.
Baseline characteristics among nonusers and aspirin users in 1980 were similar: mean age (46 - 48 years), 97% to 99% white, body mass index, exercise, daily saturated fat intake, alcohol intake, hypertension, diabetes mellitus, hypercholesterolemia, smoking history, postmenopausal status and hormone therapy, multivitamin use, parental myocardial infarction younger than 60 years, and number of cardiac risk factors.
Risk for death from all causes was lower in current regular aspirin users vs nonusers (multivariate RR, 0.75; 95% CI, 0.71 - 0.81).
Greatest risk reduction was for death from cardiovascular disease in aspirin users (multivariate RR, 0.62; 95% CI, 0.55 - 0.71).
Risk for death from colorectal cancer was lower in current aspirin users (multivariate RR, 0.72; 95% CI, 0.56 - 0.92).
Increasing duration of aspirin use was linked to decreasing all-cause mortality (P < .001).
Aspirin use for 1 to 5 years was associated with lower risk for cardiovascular mortality (RR, 0.75; 95% CI, 0.61 - 0.92).
Aspirin use for more than 10 years was associated with lower risk for cancer mortality (linear trend P = .005), especially colorectal cancer mortality (11 - 20 years: multivariate RR, 0.50; 95% CI, 0.33 - 0.76; > 20 years: multivariate RR, 0.61; 95% CI, 0.41 - 0.90).
Highest aspirin doses (> 14 tablets per week) were not associated with reduced mortality risk.
Aspirin benefits were greater with increasing age for all-cause mortality (P < .001), cardiovascular mortality (P = .01), and cancer mortality (P = .02).
Aspirin benefits were greater with more cardiac risk factors (P = .02).
Study limitations include observational design and self-selection for aspirin use.
Authors note current clinical recommendations should not be changed based on study results, but future studies on aspirin effect on chronic disease are needed.

Pearls for Practice
Women who take low to moderate doses of aspirin (1 - 5 tablets per week) have lower risk for mortality from all causes.
Women who take low to moderate doses of aspirin have lower risk for mortality from cardiovascular disease within 5 years and lower risk for mortality from cancer after 10 years. However, current clinical practice should not be changed yet based on the results from this observational study.

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Where did I come from?" the baby asked its mother. She answered, half-crying, half-laughing, and clasping the baby to her breast: "You were hidden in my heart as its desire, my darling. You were in the dolls of all my childhood games. In all my hopes and my loves, in my life, in the life of my mother, and in her mother before her, you have lived."
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