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Using Aspirin to Prevent Heart Disease in People With Diabetes

By Kelly Close

Updated July 30, 2008


What Is Aspirin?

Aspirin (acetylsalicylic acid) is a common, over-the-counter drug that is used to relieve minor aches, pains and fever. It also has a blood-thinning effect shown to benefit people with heart disease, including those with diabetes. For this reason, it may be taken regularly in very low doses to lower the risk of heart attack, angina or stroke.

Who Should Consider Taking Aspirin as a Prevention Strategy?

People with an elevated risk for cardiovascular events or stroke should consider taking aspirin regularly. The American Heart Association recommends aspirin for people with a history of heart attack, angina, strokes caused by blood clots or "little strokes" (also known as transient ischemic attacks). The American Diabetes Association (ADA) recommends aspirin therapy for people who have either type 1 or type 2 diabetes and one or more of the following risk factors:

  • A family history of coronary heart disease
  • Cigarette smoking
  • Hypertension
  • Obesity (defined as a body mass index of more than 27.3 in women or 27.8 in men)
  • Albuminuria (a protein in the urine; sometimes a sign of heart disease)
  • Age of 30 or greater
Another risk factor is a lipid profile indicating any of the following:
  • Total cholesterol greater than 200 mg/dL (milligrams per deciliter)
  • LDL cholesterol greater than or equal to 100 mg/dL
  • HDL cholesterol less than 45 mg/dL in men or 55 mg/dL in women
  • Triglycerides greater than 200 mg/dL

What's the Right Aspirin Dosage?

As a preventive therapy, aspirin should be taken in very low doses. The ADA recommends using enteric-coated aspirin, which is easier on the stomach than uncoated aspirin, in doses of 81 to 325 mg a day. (A standard Bayer aspirin is 325 mg, whereas a baby aspirin is typically 81 mg.) A study published in the journal Diabetes Care suggests that an aspirin dose of 75 mg a day or more is effective as a preventative therapy.

Who Should Not Take Aspirin?

Long-term aspirin therapy should not be considered for those people who have at least one of the following criteria:

  • Aspirin allergy
  • Bleeding tendency (recent gastrointestinal bleeding, recent anticoagulant therapy, etc.)
  • Active liver disease
  • Age younger than 21 (Aspirin may increase the risk of Reye's syndrome, a disease found almost exclusively in children.)

A health care provider or diabetes educator should always be consulted before long-term aspirin therapy is started.



American Diabetes Association, "Aspirin Therapy in Diabetes." Diabetes Care, 1 Jan. 2003 S87-S88. 2 Sep. 2007.

"Aspirin in Heart Attack and Stroke Prevention." Americanheart.org., American Heart Association; 2 Sep. 2007.

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Kelly L. Close is Editor-in-Chief of diaTribe (www.diatribe.us), a free online newsletter for people eager to learn more about better managing diabetes. She is also founder and principal of Close Concerns, Inc., a consulting firm devoted to the business of diabetes. Kelly's passion for the field comes from her extensive professional work as well as from her personal experience as a patient with type 1 diabetes for over 20 years. In addition to her roles at diaTribe and Close Concerns, Kelly also sits on the board of the San Francisco Bay Area JDRF chapter and on the Children With Diabetes Foundation.
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