Harvard Health Letter

By the way, doctor: Must I take aspirin?

Q. I am a 56-year-old woman with a 20-year history of ulcerative colitis. I also happen to be diabetic. My new doctor has been pushing aspirin therapy. His philosophy is that no one ever died from a flare-up of ulcerative colitis but plenty of women have died from heart attacks and strokes. My gastroenterologist, who has treated me for more than 20 years, feels that I should consider aspirin if and when there are signs that I would benefit from it and not to risk having problems with my colitis. I am in a real quandary.

A. Diabetes is a major risk factor for having a heart attack, so your new doctor is right to be concerned. And small regular doses of aspirin are definitely one of the best ways we have for lowering that risk. Aspirin makes platelets less sticky, and research has shown that it decreases the risk of cardiovascular disease in individuals with a history of a heart attack or stroke and in men and high-risk women without previous cardiovascular disease.

The American Diabetes Association recommends that people with diabetes who have had cardiovascular disease should take aspirin regularly (75–162 mg a day) and even those with no history of cardiovascular disease should do so if they're over 40 or have additional risk factors (among them, a family history of cardiovascular disease, high blood pressure, and high cholesterol levels).

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