There is good data to support recommending a daily aspirin for people with" known cardiovascular disease ".
There is a large group of people " without known cardiovascular disease" asking a question.
" should I be taking an aspirin to lower my risk of a heart attack or stroke ? "
This seems like a simple question that I have mumbled my answers through for years. The first problem I have is with the term "known cardiovascular Disease " Most of us have some silent fat build up in our arteries . I also know that we have no safe way of detecting who does and who does not have silent cardiovascular disease. We do know that correcting know risk factors for heart disease lowers our risk of having a heart attack or stroke. I also know that the risk factors do not tell me the status of a persons arteries at the moment the question is ask. This combinations of uncertainty turns a simple question into a complex issue for most doctors.
Dr Ebbert , A professor of medicine at the Mayo Clinic in Rochester, Minn., wrote a short article in the Feb. 1, 2012 Internal Medicine News. He reviewed a large meta- analysis published in the Archives of Internal medicine 2012 Jan. 9 . The data suggest aspirin will prevent one non-fatal heart attack for each 162 patients and one nontrivial bleed for each 73 patients treated without known cardiovascular disease.
Basically ,by treating patients with aspirin who are at low risk for cardiovascular disease may make them bleed.
I have attached the ADA recommendations and one of my blogs from Dec 1, 2011 for more information on this topic. The decision to take or not take aspirin becomes a personal decision made with advise from your physician.
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American Diabetes Association Recommendations
Consider aspirin therapy (75-162 mg/day) as a primary prevention strategy in those with type 1 or type 2 diabetes at increased cardiovascular risk (10-yr risk > 10%). This includes most men > 50 years of age or women > 60 years of age who have at least one additional major risk factor (family history of CVD, hypertension, smoking, dyslipidemia, or albuminuria). (C
• Aspirin should not be recommended for CVD prevention for adults with diabetes at low CVD risk (10-year CVD risk <5%, such as in men <50 years and women <60 years with no major additional CVD risk factors), since the potential adverse effects from bleeding likely offset the potential benefits. (C)
In patients in these age groups with multiple other risk factors (e.g. 10-yr risk 5-10%), clinical judgment is required (E).
Use aspirin therapy (75–162 mg/day) as a secondary prevention strategy in those with diabetes with a history of CVD. (A)
For patients with CVD and documented aspirin allergy, clopidogrel (75 mg/day) should be used. (B)
Combination therapy with ASA (75-162 mg/day) and clopidogrel (75 mg/day) is reasonable for up to a year after an acute coronary syndrome. (B)
Dec. I, 2011
The question of when and if we should take an aspirin a day has not been completely answered. The article below may help with your understanding of the problem. I suggest that you read the highlighted areas first and then read the whole article if you want more detail.