Benefits of aspirin therapy are big for diabetics
Death rate is cut substantially with small dose
Aspirin therapy can cut the death rate among Type 2 diabetics with coronary artery disease (CAD) by a third, according to an Israeli study published in the American Journal of Medicine and independent statements from the American Diabetes Association in Alexandria, VA.
A dose as small as 81 mg per day — the amount contained in one baby aspirin or one-fourth of an adult aspirin — can have profound life-saving effects, says Gerald Bernstein, MD, president of the American Diabetes Association.
"When I was an intern in 1959, the chief of endocrinology said one aspirin per week prevented clotting," Bernstein says. "Anybody with Type 2 diabetes should take the 81 mg dosage unless there are contraindications."
The Israeli study, which used between 100 and 325 mg of aspirin daily, states, "The absolute benefit of aspirin was greater in diabetic patients than in those without diabetes."
Participants who took aspirin had a 10.9% mortality risk from cardiac diseases compared to a 15.9% risk for nonusers. In addition, diabetics who took aspirin had an all-cause mortality rate of 18.2% compared to 26.2% for diabetics who did not take aspirin. By comparison, nondiabetic patients who used aspirin experienced a 4.8% mortality risk from cardiac diseases, and a 6.9% risk for those who did not take aspirin.
It’s not really a surprise that aspirin helps diabetics; it’s just that this is the first time anyone has specifically studied the effects in the diabetic population, says David Vorchheimer, MD, director of the cardiac care unit at the Mount Sinai Medical Center in New York.
He highly recommends a daily dose of 162 mg (one-half an adult-sized aspirin ) as primary prevention in the presence of risk factors such as diabetes, high blood pressure, family history of CAD, and tobacco use (which should be stopped).
These "modest doses," Vorchheimer says, can have "profound" preventive effects. For diabetics who have already had a heart attack, Vorchheimer recommends 325 mg or one adult-sized aspirin per day.
Bernstein warns that aspirin therapy should be discontinued if a patient experiences bleeding, excessive bruising, or heartburn. He also says aspirin therapy should be stopped before elective surgery.
[Gerald Bernstein can be reached at (703) 549-1500. Contact David Vorchheimer at (212) 241-8496.]
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