Cushman Co-Authors Aspirin and Diabetes Statement
Release Date: 07-09-2010
A joint statement developed by experts from the American College of Cardiology Foundation, the American Diabetes Association (ADA) and the American Heart Association (AHA), including Mary Cushman, M.D., M.Sc., University of Vermont professor of medicine, recommends low-dose aspirin therapy to prevent heart attack in diabetes patients at a high risk for developing heart disease. The statement was recently published in the online and print versions of the journals of each organization — the Journal of the American College of Cardiology, Diabetes Care, and Circulation: Journal of the American Heart Association.
People with diabetes have a 2- to 4-fold increased risk of cardiovascular events compared to individuals without diabetes of similar age and gender, according to the statement authors. In order to better clarify the potential benefit of aspirin therapy for individuals with diabetes, the panel of experts reviewed literature from nine trials focused on the preventive effect of aspirin on cardiovascular events.
Based on the results of their review, the panel recommended that aspirin therapy be prescribed for "most men over age 50 and women over 60 with diabetes who have one or more additional heart disease risk factors," as stated in the joint organizations' news release. This was a change from the 2007 ADA and AHA joint recommendation to commence aspirin therapy for both men and women over age 40 with at least one other major risk factor. The panel suggested that providers consider other factors — such as cholesterol-lowering medication, blood pressure control and smoking status — when considering prescribing aspirin therapy to patients.
The statement authors caution that additional research is needed to clarify aspirin's specific effects in individuals with diabetes, including differences between male and female patients. Two large ongoing European trials including over 15,000 people will help to better define subgroups of patients who will benefit the most from aspirin treatment to prevent heart disease.
"Since this medication can cause bleeding complications, it is important to use it only when there is expected benefit," says Cushman, who recently completed a two-year term as chair of the AHA's Council on Cardiovascular Disease Epidemiology and Prevention.
To read the Scientific Statement, go to Circulation: Journal of the American Heart Association.