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?
Answers from M. Regina Castro, M.D.
Diabetes increases your 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 diabetes increases your risk of cardiovascular events, 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 stroke caused by a leaking or burst blood vessel (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.
M. Regina Castro, M.D.
Feb. 20, 2014
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- Pignone M, et al. Aspirin for primary prevention of cardiovascular events in people with diabetes. Diabetes Care. 2010;33:1395.
- Vandvik PO, et al. Primary and secondary prevention of cardiovascular disease. Chest. 2012;141(suppl):e637S. Primary and secondary prevention of cardiovascular disease. Accessed Oct. 13, 2013.