Diabetes Standards of Care & Clinical Practice Resources
Aspirin and Other Antiplatelet Therapy
Antiplatelet therapy, including aspirin and clopidogrel, may be used to reduce the risk of cardiovascular disease (CVD) events in appropriate patients with diabetes.
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Aspirin or Other Antiplatelet Therapy Sections
Quickly jump to a section on this page by clicking on one of the links below.
- Section 1 – Clinical Practice Recommendations: Aspirin or Other Antiplatelet Therapy
- Section 2 – Clinician and Educator Resources: Aspirin or Other Antiplatelet Therapy
- Section 3 – Patient Education Resources: Aspirin or Other Antiplatelet Therapy
Clinical Practice Recommendations
Secondary Prevention
- Patients with a history of Atherosclerotic Cardiovascular Disease (ASCVD)* should receive aspirin 75-162mg who are not at increased risk of bleeding.
- If allergic to aspirin, consider clopidogrel 75mg daily.
Primary Prevention
- Consider aspirin 75-162mg in patients with increased risk of ASCVD, (e.g., age ≥ 50 years and one or more risk factors**), who are not at increased risk of bleeding.
- Aspirin is not recommended in patients at lower risk of ASCVD, (e.g., age < 50 years with no other major ASCVD risk factors**).
* ASCVD is atherosclerosis affecting the vasculature of any of the following: the heart, periphery (e.g., legs, carotids), and the brain (e.g., stroke, transient ischemic attack).
** Risk factors include: family history of premature ASCVD, hypertension, dyslipidemia, smoking, or albuminuria.
Clinician and Educator Resources
Diabetes Treatment Algorithm: Lipid and Aspirin Therapy in Type 2 Diabetes
IHS Division of Diabetes Treatment and Prevention
American Diabetes Association Standards of Medical Care in Diabetes – 2020
Diabetes Care 2020;43(Supplement 1):S111-S134. doi:10.2337/dc20-S010
Atherosclerotic Cardiovascular Disease Risk Estimator Plus
American College of Cardiology/American Heart Association
Center for American Indian Health Research – College of Public Health
University of Oklahoma Health Sciences Center
Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication
U.S. Preventive Services Task Force
Patient Education Resources
American Heart Association
ABCS of Heart Health to Reduce the Risk of Heart Attack or Stroke [PDF]
HHS Million Hearts Initiative
Diabetes, Heart Disease, and Stroke
National Institute of Diabetes and Digestive and Kidney Diseases