Tighter aspirin recs for diabetics

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PPIs tied to Tighter aspirin recs for diabetics
fracture, C. ALTHOUGH results suggestbeen
               mixed, overall
                              findings have
                                                  events is reasonable for adults
                                                  with diabetes and no history
difficile rates of cardiovascular events in adults
               aspirin modestly reduces the risk  of vascular disease who are at
                                                  increased risk of CVD (most
THE MOST potent medications             with diabetes.                                              men over age 50 years and
available for the suppression of          In a joint statement (authored by                         most women over age 60 years
gastric acid appear to increase         Michael Pignone, MD, and col-                               who have at least one addi-
the risks of fractures and bacterial    leagues and published online on                             tional major risk factor and
infection in users, according to        May 27), the American College of                            who are not at increased risk
three separate studies.                 Cardiology Foundation, American                             for bleeding).
  One analysis looked at data from      Diabetes Association (ADA), and                           • Aspirin for CVD prevention
3,396 postmenopausal women              American Heart Association (AHA)       Aspirin may          should not be recommended for
(aged 50 to 79 years) participating     updated their recommendations for      reduce the           adults with diabetes at low risk
in the Women’s Health Initiative        primary-prevention aspirin use in      risk of CV           for CVD (men under age 50
(Arch Intern Med. 2010;170:765-         people with diabetes.                  events in            years and women under age 60
771). The women were all using            In 2007, the ADA and AHA             adults with          years with no major additional
a proton pump inhibitor (PPI),          recommended low-dose aspirin           diabetes.            CVD risk factors and a 10-year
some for more than three years.         therapy (75-162 mg/day) for men                             CVD risk under 5%).
  At baseline, none of the women        and women over age 40 years                               • Until more research is available,
had ever incurred a hip fracture.       with at least one of the follow-                            low-dose aspirin use for CVD
After an average follow-up peri-        ing major risk factors: smoking,                            primary prevention might be
od of 7.8 years, PPI use was not        hypertension, dyslipidemia, fam-                            considered for those wit
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