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  • With Mayo Clinic endocrinologist

    Maria Collazo-Clavell, M.D.

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Question

Diabetes management: Does aspirin therapy prevent heart problems?

I've heard that aspirin therapy may not help prevent heart problems when you have diabetes and peripheral artery disease. Should I keep taking it?

Answer

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from Maria Collazo-Clavell, M.D.

If you have diabetes, you're at higher risk of heart attack and clot-related stroke (cardiovascular events). Perhipheral artery disease — a condition in which your arteries narrow, reducing blood flow to your arms and legs — also increases your risk of cardiovascular events.

Aspirin interferes with your blood's ability to clot. Because you're at increased risk of cardiovascular events if you have diabetes, daily aspirin therapy typically has been recommended as part of a diabetes management plan. Research has shown that aspirin therapy is effective at reducing the risk of heart attack and clot-related strokes if you've had a previous cardiovascular event. It also appears to reduce these risks if you're experiencing symptoms of peripheral artery disease — such as leg cramping, numbness or weakness.

What's not clear is whether aspirin lowers the risk of a cardiovascular event if you haven't experienced one before and you aren't experiencing symptoms of peripheral artery disease. More study is needed on the potential benefits and risks of aspirin therapy in these people. Aspirin therapy does have potential side effects, such as bleeding and bleeding stroke (hemorrhagic stroke). If you have diabetes, peripheral artery disease or both, ask your doctor about daily aspirin therapy, including which strength of aspirin would be best.

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References
  1. Belch J, et al. The prevention of progression of arterial disease and diabetes (POPADAD) trial: Factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease. British Medical Journal. 2008;337:a1840.
  2. Collazo-Clavell ML (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 10, 2010.
  3. Farkouh ME. Aspirin and/or antioxidants did not prevent CV events in diabetes and peripheral arterial disease. ACP Journal Club. 2009;150:JC6.
  4. Buse JB, et al. Primary prevention of cardiovascular diseases in people with diabetes mellitus. Diabetes Care. 2007;30:162.
  5. Ogawa H, et al. Low-dose aspirin for primary prevention of atherosclerotic events in patients with type 2 diabetes. JAMA. 2008;300:2134.
AN01958 Feb. 5, 2011

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