CAN I TAKE DAILY ASPIRIN AS A T2 TO PREVENT STROKE RISK, PLE

For primary prevention, the balance of benefits vs harm mandate that patients need to be aged over
50 years and have a CVD risk level ≥ 20% over 10 years to shift the balance in favour of benefit.
Thus, for primary prevention, low- dose aspirin should only be offered to hypertensive patients aged
over 50 years whose blood pressure has been controlled to the audit standard (<150/90 mmHg) and
who have a baseline CVD risk ≥20% over 10 years and no contraindication to aspirin use. These
recommendations were strongly influenced by the assessment of the benefit and harm of low-dose
aspirin in well treated hypertensive subjects at different levels of baseline CVD risk (5). In these
analyses the benefit vs harm was neutral at a 10 year CVD risk of about 10%, but favoured benefit at
higher levels of risk.

The recently published updated meta-analysis using individual participant data from the original trials
of the use of aspirin in primary prevention (1), reported an overall proportional risk reduction in
serious vascular events of 12% (0.51% aspirin vs 0.57% control per year, p=0.0001) due mainly to a
reduction of about one fifth in non-fatal myocardial infarction (0.18% vs0.23% per year, p<0.0001).
However, this benefit was offset by an increase in major gastrointestinal and extracranial bleeds
(0.10% vs 0.07% per year, p<0.0001). Thus the absolute reduction in the risk of vascular events is
only about twice as large as the absolute increase in bleeding. As the authors of the meta-analysis
point out, most of the patients recruited into these primary prevention trials were not taking statins,
which would have reduced their absolute risk of vascular events without any increase in harm. Even
in those patients at higher risk the number of vascular events was too few to allow any reliable
conclusions to be drawn.

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Q007 said:

My wife has CVD and 3 heart attacks chalked up, she takes aspirin daily and doctor says its the most important drug of all. My GP told me NOT to take aspirin because of the risk of setting off a bleed. We discussed that aspirin is proven to significantly reduce risk of heart attacks and strokes for those with cardio-vascular disease, and I was surprised to here that diabetics are in the same risk group, in fact shocked. Apparently all NSAID drugs have similar risks of setting off a bleed, he went on to say.

I understand there is risk with taking most drugs, I got that. But, what are the risks vs benefits for a T2 diabetic, is anyone taking it? What are the RVB? What do you think? Kind regards, Q..


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julifriend said:

Anyone with asthma should be very careful about taking aspirin if they don't normally take it for headaches etc.. It's one of the few things that has caused me to have a very bad asthma attack and under no circumstances would I ever take aspirin.

I take aspirin because it was prescribed me thirteen years ago, following a heart attack and surgery. Otherwise I wouldn't take it just as a precautionary measure. Research seems to be throwing up evidence that it isn't the wonder drug it was thought to be. Would I come off it now? Hmmmm....I'm still out on that one, lol

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CathyP said:

but I do occasionally have "unknown" bruises

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