Diabetics Resistant to Aspirin?

Robert W. Griffith, MD

Many of us have taken a 'baby' aspirin daily (or on alternate days) for years, in the belief that it can stave off coronary artery disease. Recently there have been studies suggesting that for under-65 women this is an unnecessary exercise - it doesn't work so well and has possibly severe side effects (bleeding gastric ulceration, for instance). But for men, and women over 65, the regular use of aspirin, at about 81 to 100 mg daily, has clear benefits. These are related to it's effect on blood platelets, slowing or stopping thrombosis.

Some people are resistant to aspirin; this is demonstrated by platelet aggregation or thromboxane metabolite generation tests. Increasing the dose to 162 mg or 325 mg daily can overcome this resistance.

Between 3% and 14% of non-diabetic people are reported to be resistant to aspirin, while as many as 13% to 37% of diabetic patients are resistant, according to a study described at the recent American College of Cardiology meeting. This is confirmation of an earlier report from Germany, which was criticized as having insufficient data.

So, it looks as if diabetic patients might need to take higher doses of aspirin to get the same benefit of cardioprotection. But, say the investigators, further evidence from larger studies would be needed before routine high-dose aspirin or routine aspirin resistance testing can be recommended, because of the risk of bleeding. As a diabetic taking aspirin, I'll await the results of the 'further studies' with interest!

Source
HealthandAge Blog

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