People With Diabetes Should Use Aspirin to Lower Heart-Attack Risk

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Persell SD , Baker DW: Aspirin use among adults with diabetes: Recent trends and emerging sex disparities. Arch Intern Med 164:2492-2499, 2004.

What is the problem and what is known about it so far?

People with type 2 diabetes are at higher risk for cardiovascular disease (CVD, disease of the heart and blood vessels). Taking aspirin regularly helps lower that risk. Even so, studies show that many adults with diabetes do not use aspirin to help prevent a heart attack. In 1997, the American Diabetes Association recommended aspirin for any high-risk adult over 30 with diabetes.

Who was studied?

Researchers studied adults age 35 years and older with type 2 diabetes.

How was the study done?

Researchers did telephone surveys in 3 different years. In 1997, they surveyed 875 people from 7 states. In 1999, they surveyed 3,205 people from 20 states. In 2001, they surveyed 4,272 people from 20 states. Researchers asked people if they used aspirin every day or every other day. If they answered "no," they were called non-aspirin users.

What did the researchers find?

Aspirin use for all people in the study rose between 1997 and 2001. In 1997, 37.5% used aspirin. In 1999, 38.8% used aspirin. In 2001, 48.7% used aspirin.

People with CVD were twice as likely to use aspirin than people without CVD.

For people who were at higher risk for CVD (but did not have CVD), aspirin use rose a small amount through the years. In 1997, 31.9% used aspirin. In 1999, 31.4% used aspirin. In 2001, 39.8% used aspirin.

In 1997, men used aspirin more than women. This difference grew between 1997 and 2001.

Young and middle-aged adults used aspirin less than older people. People who had had a stroke used aspirin less than people who had had a heart attack.

What were the limitations of the study?

People in the study reported their own aspirin use. So their answers could be incorrect because people sometimes lie or make mistakes. Therefore, researchers might have missed some risk factors for CVD or other details. Researchers did not know which patients could not safely take aspirin.

What are the implications of the study?

Aspirin works, and it is an inexpensive treatment for preventing CVD. Health professionals should talk with their adult patients with diabetes about using aspirin. Women, young adults, and middle-aged adults may need extra encouragement