New evidence suggests that diabetic people who take aspirin or vitamins long-term are not protecting themselves against heart disease, heart attack, or stroke.
It also has no effect on the overall risk of death, say Professor Jill Belch and colleagues at Dundee University, UK.
They sought to discover whether aspirin and antioxidants, such as vitamins, combined or alone, are better than placebo at cutting the risk of cardiovascular events in diabetic patients.
A total of 1,276 adults aged 40 or older with type 1 or type 2 diabetes were recruited and given either 100mg aspirin plus an antioxidant capsule, aspirin plus placebo, placebo plus antioxidant, or two placebo tablets, every day for up to eight years.
The study looked at two measures of disease. The first was death from coronary heart disease or stroke. The second combined the first outcome, plus non-fatal heart attack or stroke, or limb amputation for ischaemia (loss of blood supply).
The researchers report roughly 18 per cent of patients who took aspirin fell ill as did 18 per cent of those not taking aspirin – suggesting that aspirin did not have a protective effect. A very similar result was found for antioxidants versus no antioxidants.
On the website of the British Medical Journal, they write: “This trial does not provide evidence to support the use of aspirin or antioxidants in primary prevention of cardiovascular events and mortality in the population with diabetes studied.
“Aspirin should, however, still be given for secondary prevention [to avoid recurrence] of cardiovascular disease in people with diabetes mellitus, when the evidence base is convincing, and the results of this study must not detract from this important standard of care.”
Belch, J. et al. The prevention of progression of arterial disease and diabetes (POPADAD): a factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease. The British Medical Journal, 2008;337:a1840.
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