For the past few years, most people with diabetes have been urged to take an aspirin a day to help prevent heart attacks. The American Diabetes Association and American Heart Association have modified that advice, based on evidence from two clinical trials. Here's what the organizations now say, in a scientific statement published in the June 22, 2010, Circulation:
Green light. Low-dose aspirin (75 to 162 milligrams a day) is a good option for most people with diabetes who also have heart disease.
Yellow light. Low-dose aspirin is "reasonable" for adults with diabetes who are at increased risk of heart disease. That covers men over age 50 and women over age 60 who have diabetes and one or more of the following risk factors: smoking, high blood pressure, high cholesterol, a family history of cardiovascular disease, or protein in their urine. Also included are those with a Framingham risk score indicating a 10% or higher chance of having a heart attack in the next 10 years.
Red light. Low-dose aspirin is not recommended for diabetics at low risk of heart disease. For them, the risks of aspirin therapy — particularly stomach irritation and gastrointestinal bleeding — outweigh the benefits.
Whether or not you have diabetes, the decision to take aspirin — or not to take it — is best made in partnership with your doctor. He or she can help you gauge the benefits and the risks of taking aspirin and figure out which one dominates, an essential step in knowing if aspirin is right for you.