In a position statement endorsed by the American Diabetes Association, the American Heart Association, and the American College of Cardiology Foundation, a panel of experts has recommended that men under age 50 and women under age 60 who have diabetes but no other major risk factors for heart disease should probably not be on low-dose aspirin therapy.
The panel was convened to review and clarify the conflicting information about the effectiveness of aspirin for preventing heart problems in people with diabetes. Roughly 50 million Americans, including some who do not have heart disease or a history of heart attack or stroke, currently take low-dose (325 milligrams daily or less) aspirin to prevent cardiovascular problems.
Based on their analysis of nine studies, the panelists determined that the risks of aspirin side effects, such as stomach bleeding and, to a much smaller extent, bleeding strokes, need to be better balanced against the potential benefits. The newest studies, they found, didn’t show enough of a benefit of low-dose aspirin therapy for some younger people with diabetes.
According to Craig D. Williams, PharmD, an expert on the panel that issued the new recommendations, “With any medication, you have to balance the benefits against possible side effects or risks. But even a baby aspirin has some degree of risk, even though it’s very low, so we have to be able to show clear benefits that outweigh that risk. In the case of young adults with diabetes but no other significant risk factors, it’s not clear that the benefits are adequate to merit use of aspirin.”
The widespread use of medicines to control blood pressure and cholesterol has decreased the additional heart benefits of aspirin, Williams said. He noted that further studies are under way to determine which people with diabetes would most benefit from aspirin therapy.
If you have been on daily, low-dose aspirin therapy and would like to stop, be sure to speak with your doctor first: Suddenly stopping daily aspirin therapy could potentially trigger a blood clot.
To learn more about the new recommendations, read the article “Aspirin Recommendations Changed for Many Younger Diabetic Patients” or see the position statement in Diabetes Care.