Adults with Type 2 diabetes and an elevated risk for cardiovascular disease who took low-dose aspirin were less likely to experience a major cardiovascular event, including heart attack, stroke or death, than those who did not take aspirin, according to preliminary research presented at the American Heart Association’s Scientific Sessions 2025.
The study, which analyzed 10 years of electronic health records from more than 11,500 adults with Type 2 diabetes and moderate-to-high cardiovascular risk, found that any low-dose aspirin use was linked to a lower incidence of heart attack and stroke. Among those who took aspirin, 42.4% had a heart attack compared to 61.2% in the non-aspirin group, while stroke rates were 14.5% versus 24.8%, and death from any cause was 33% versus 50.7%.
“We were somewhat surprised by the magnitude of the findings,” said study author Aleesha Kainat, M.D., clinical assistant professor at the University of Pittsburgh Medical Center. The greatest benefit was observed in those who took aspirin most consistently. Notably, the reduction in cardiovascular events was more substantial in individuals with better blood sugar control, as indicated by lower HbA1c levels.
The study excluded people with high bleeding risk, and the researchers did not track bleeding events. “Aspirin’s bleeding risk is crucial in real-life decision making,” Kainat noted. The findings are observational and cannot prove causation, but they raise important questions for further research.
Dr. Amit Khera, volunteer chair of the American Heart Association’s Advocacy Coordinating Committee, emphasized that while the Association does not currently recommend low-dose aspirin for primary prevention in Type 2 diabetes without established cardiovascular disease, “this study raises some good questions for further research and validation.” He stressed working with healthcare teams to weigh benefits and risks.
The study’s limitations include its observational design and reliance on medication lists, which may not reflect actual use. Future research should explore balancing cardiovascular benefits with bleeding risks, especially alongside newer therapies like GLP-1 medications and lipid-lowering agents.
