Diabetes Standards of Care and Resources for Clinicians and Educators

Recommendations for Aspirin and Other Antiplatelet Therapy

Secondary Prevention

• Prescribe aspirin 75-162 mg in patients with or without diabetes who have a history of atherosclerotic cardiovascular disease (ASCVD*), unless contraindicated.
• Consider clopidogrel 75mg daily, if allergic to aspirin.

Primary Prevention

• Consider aspirin 75-162 mg in patients with diabetes and:
  • An increased risk of atherosclerotic cardiovascular disease (ASCVD*) (e.g., age 50-70 years and one or more risk factors**); and
  • Not at increased risk for bleeding

* ASCVD is atherosclerosis affecting the vasculature that results in diseases of any of the following: the heart (e.g., myocardial infarction, angina), the brain (e.g., stroke, transient ischemic attack), and the lower extremities (e.g., peripheral artery disease, limb ischemia).
** Risk factors include: family history of premature ASCVD, hypertension, dyslipidemia, smoking, chronic kidney disease, or albuminuria.

Featured Aspirin and Other Antiplatelet Therapy Resources

Organization	Resource
	Diabetes Treatment Algorithm Lipid and Aspirin Therapy in Type 2 Diabetes SDPI Toolkits Healthy Heart Program Toolkit
	Atherosclerotic Cardiovascular Disease Risk Estimator Plus Exit Disclaimer: You Are Leaving www.ihs.gov
	American Diabetes Association. 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes 2023 Exit Disclaimer: You Are Leaving www.ihs.gov  Diabetes Care 2023;46(Suppl.1):S158-S190. doi:10.2337/dc23-S010
	Strong Heart Risk Calculator Exit Disclaimer: You Are Leaving www.ihs.gov
	Aspirin Use to Prevent Cardiovascular Disease: Preventive Medication Exit Disclaimer: You Are Leaving www.ihs.gov

Aspirin and Other Antiplatelet Therapy Patient Education Resources

Organization	Resource
	HHS Million Hearts Initiative: ABCS of Heart Health to Reduce the Risk of Heart Attack or Stroke Exit Disclaimer: You Are Leaving www.ihs.gov  [PDF]
	Diabetes, Heart Disease, and Stroke Exit Disclaimer: You Are Leaving www.ihs.gov
	Aspirin and Heart Disease Exit Disclaimer: You Are Leaving www.ihs.gov