title: Aspirin reduces cerebrovascular events in type 2 diabetic patients with poorly controlled blood pressure. Subanalysis from the JPAD trial.
abstract: BACKGROUND
  There are few data that demonstrate a significant effect of aspirin therapy for diabetic patients. To clarify the effect of the primary prevention of aspirin therapy in diabetic patients, the relationship between blood pressure (BP) and the incidence of atherosclerotic events was investigated in participants in the Japanese primary prevention of atherosclerosis with aspirin for diabetes (JPAD) trial.
  
  
  RESULTS
  We divided the JPAD participants according to their systolic (SBP) and diastolic (DBP) BPs at enrollment (SBP ≥140 mmHg and/or DBP ≥90 mmHg: unattained group, SBP <140 mmHg and DBP <90 mmHg: attained group). The incidence of the primary atherosclerotic events, especially cerebrovascular events, was higher in the unattained group than in the attained group. The incidence of cerebrovascular events was higher in the unattained group than in the attained group in patients without aspirin therapy; however, the incidence of cerebrovascular events in the unattained group was as low as the incidence in the attained group in patients undergoing aspirin therapy. Cox proportional hazards analysis revealed that BP level was an independent predictor for cerebrovascular events in diabetic patients.
  
  
  CONCLUSIONS
  Aspirin therapy may reduce cerebrovascular events in diabetic patients with higher BP. Aspirin therapy could be an additional strategy as primary prevention for diabetic patients with higher BP.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. yuuki@gpo.kumamoto-u.ac.jp
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Soejima
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morimoto
authors.forename: Masafumi
authors.initials: M
authors.lastname: Nakayama
authors.forename: Sadanori
authors.initials: S
authors.lastname: Okada
authors.forename: Shiro
authors.initials: S
authors.lastname: Uemura
authors.forename: Masao
authors.initials: M
authors.lastname: Kanauchi
authors.forename: Naofumi
authors.initials: N
authors.lastname: Doi
authors.forename: Mio
authors.initials: M
authors.lastname: Sakuma
authors.forename: Hideaki
authors.initials: H
authors.lastname: Jinnouchi
authors.forename: Seigo
authors.initials: S
authors.lastname: Sugiyama
authors.forename: Masako
authors.initials: M
authors.lastname: Waki
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Saito
mesh_terms: D000368:Aged; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000517:prevention & control*; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention / Q000379:methods*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D001241:Aspirin