Should I be on Aspirin?
Aspirin Therapy In Diabetes
Aspirin therapy for Diabetics with previous vascular events (secondary prevention) significantly reduces the risk of subsequent myocardial infarction, stroke, and vascular death; however, in people with diabetes without previous Coronary disease or stroke, there is only a 7% decrease in cardiovascular events (not significant).
Aspirin therapy for people without diabetes with no previous vascular events (primary prevention) reduces the risk of myocardial infarction, stroke, and vascular death by 30%; however, in diabetics, there is only a 10% decrease in cardiovascular events (not significant).
Aspirin appears to be less effective in primary and secondary prevention of cardiovascular events in people with diabetes than nondiabetics. At least two studies suggest a small benefit. Two large studies are currently evaluating aspirin’s role in preventing cardiovascular events in people with diabetes.
Despite the lack of significant benefit in diabetics, the American Diabetes Association recommends low dose aspirin, i.e., 81 mg, for secondary prevention in people with diabetes with a history of MI, vascular procedure, stroke, TIA, peripheral vascular disease, claudication symptom, or angina.
Low dose aspirin is recommended for primary prevention in people with diabetes with increased cardiovascular risk, i.e., the 10-year risk greater than 10%. Calculate your risk. This includes most men over the age of 50 and most women over the age of 60 who have at least one additional cardiovascular risk factor, e.g., cigarette smoking, hypertension, obesity, microalbuminuria, dyslipidemia, or family history of CAD.
In people with diabetes under the age of 30, there is no benefit in taking aspirin.
However, aspirin is not safe for everyone. Avoid if allergic to Aspirin or Nonsteroidal analgesics, avoid if you have a history of Peptic ulcer disease. The United States Physician’s Health Study showed a slight increase in hemorrhagic stroke and GI bleeding. Your doctor can tell you whether taking aspirin is right for you.
In aspirin allergy, Plavix 75-mg daily can be used in people with diabetes with cardiovascular disease.
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