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 From M. Regina Castro, M.D.

Diabetes increases your risk of heart attack and clot-related stroke (cardiovascular events). Peripheral 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 is recommended as part of a diabetes management plan. But you'll likely need to check with your doctor to determine if he or she would recommend that you take aspirin, based on your individual cardiovascular and bleeding risk.

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.

Aspirin therapy also appears to reduce these risks if you're experiencing symptoms of peripheral artery disease — such as leg cramping, numbness or weakness.

What's less clear is whether aspirin lowers the risk of a cardiovascular event if you haven't experienced one before and you don't have 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 risks and side effects, such as bleeding ulcers and stroke caused by a leaking or burst blood vessel.

If you have diabetes, peripheral artery disease or both, ask your doctor about daily aspirin therapy, including which strength of aspirin would be best for you.


M. Regina Castro, M.D.

Oct. 16, 2019