Hosted by Ray Shields, MD

Aspirin has been used as a primary and secondary prevention strategy to prevent cardiovascular events. 

Primary Prevention:

Aspirin therapy (or other antiplatelet therapy) is strongly recommended as a primary prevention strategy for high risk men and women aged 40 and above with diabetes at increased risk for cardiovascular disease.  This includes individuals with a family history of CVD, cigarette smoking, hypertension, obesity, albuminuria, or dyslipidemia.  

Secondary Prevention:

Aspirin therapy at 75 – 325 mg/day is recommended for adults with diabetes and evidence of large vessel disease, such as a history of myocardial infarction (MI), stroke, peripheral vascular disease, claudication or angina.

No specific data support an exact dose of aspirin; however, using lower doses decreases the risk of side effects.  Combination therapy with medication such as clopidrogel (Plavix) may be considered in patients with severe and progressive CVD.  

Other considerations:

Providers should consider initiating long-term aspirin therapy in people aged 30 to 40 who have additional cardiovascular risks.   Aspirin therapy is not recommended for patients under the age of 21 due to the increased risk of Reye’s syndrome.  

Consider using clopidrogel (Plavix) as an alternative to aspirin therapy if the patient has significant GI intolerance or true aspirin allergy.  Studies show similar, if not better, efficacy when compared to aspirin.