Diabetes and Aspirin May Not Always Mix

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Diabetes patients with no history of cardiovascular disease may not benefit from daily aspirin

April 26, 2013 / Author:  / Reviewed by: Joseph V. Madia, MD

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(dailyRx News) While aspirin is often recommended to lower the risk of heart attack in those with diabetes, new research suggests that it may not always help, and it could do more harm than good.

The American Diabetes Association (ADA) says that a low daily dose of aspirin can benefit people at high risk of a heart attack, such as those with diabetes.

As an anti-clotting agent, aspirin can prevent blockages in blood vessels that lead to heart attack or stroke.

Investigators recently observed, however, that diabetes patients without cardiovascular disease may not get any positive effect from the medication.

"Learn the side effects of aspirin."

Nils Ekström, MD, with the Department of Medicine at Sahlgrenska Academy, University of Gothenburg in Göteborg, Sweden, and his colleagues analyzed data on more than 18,600 patients with type 2 diabetes and no previous cardiovascular disease.

One group of 4,608 patients received continuous low-dose aspirin treatment, while 14,038 patients had no aspirin treatment.

All patients were followed from a baseline examination until a first incident event, such as a heart attack, or death. The average follow-up was 3.9 years. Patients were between the ages of 30 and 80, and participated between 2005 and 2009.

Dr. Ekström and his colleagues noticed no link between aspirin use and beneficial effects on risks of cardiovascular disease or death.

When looking at data on women only, the scientists did note that women who regularly took aspirin had a slight increase in both fatal and non-fatal heart disease risk, compared to women who did not take aspirin. This heightened risk was not observed among the men.

“More research is needed to explore and better understand the differences in aspirin's effects in women and men,” wrote the authors.

The report indicated that risk of major cerebral or ventricular bleeding did not differ between the aspirin and non-aspirin groups. Aspirin was associated with a significantly increased risk of gastric ulcer in the whole sample and in women.

Low-dose aspirin is thought to help prevent clots from forming by keeping red blood cells from clumping together, according to the ADA.

Jason Poquette, BPharm, RPh, a pharmacist with Decisions Resources Group in Boston, told dailyRx News, "A low-dose aspirin taken once daily is recommended to lower the risk of heart attack and stroke in certain patient populations. Not every person needs to take daily aspirin, and some definitely should not. I recommend patients follow the advice of their physician or cardiologist if a daily aspirin dosage is recommended. Patients should not take aspirin if they are allergic to aspirin, at risk of GI bleeds or shortly to undergo surgery or dental work, unless instructed to do so by their physician."

The ADA warns that aspirin can irritate the lining of the stomach, resulting in pain, nausea, vomiting or bleeding in some people. It recommends that you should avoid taking aspirin if you have any of the following conditions:

  • Allergy to aspirin
  • Tendency to bleed
  • Recent bleeding from your digestive tract
  • Active liver disease
  • Under 21 years of age

The study was published in April in BMJ Open, an open access online-only general medical journal dedicated to publishing research from all disciplines and therapeutic areas.