Aspirin Reduces Cerebrovascular Events in Type 2 Diabetic Patients With Poorly Controlled Blood Pressure – Subanalysis From the JPAD Trial –

Hirofumi Soejima; Hisao Ogawa; Takeshi Morimoto; Masafumi Nakayama; Sadanori Okada; Shiro Uemura; Masao Kanauchi; Naofumi Doi; Mio Sakuma; Hideaki Jinnouchi; Seigo Sugiyama; Masako Waki; Yoshihiko Saito; for the JPAD Trial Investigators

doi:10.1253/circj.CJ-11-1033

Stroke

Aspirin Reduces Cerebrovascular Events in Type 2 Diabetic Patients With Poorly Controlled Blood Pressure

– Subanalysis From the JPAD Trial –

Hirofumi Soejima, Hisao Ogawa, Takeshi Morimoto, Masafumi Nakayama, Sadanori Okada, Shiro Uemura, Masao Kanauchi, Naofumi Doi, Mio Sakuma, Hideaki Jinnouchi, Seigo Sugiyama, Masako Waki, Yoshihiko Saito, for the JPAD Trial Investigators

Author information

Hirofumi Soejima
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
Health Care Center, Kumamoto University
Hisao Ogawa
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
Takeshi Morimoto
Center for Medical Education, Kyoto University Graduate School of Medicine
Masafumi Nakayama
Nakayama Cardiovascular Clinic
Sadanori Okada
First Department of Internal Medicine, Nara Medical University
Shiro Uemura
First Department of Internal Medicine, Nara Medical University
Masao Kanauchi
Department of Health and Nutrition, Faculty of Health Science, Kio University
Naofumi Doi
First Department of Internal Medicine, Nara Medical University
Mio Sakuma
Center for Medical Education, Kyoto University Graduate School of Medicine
Hideaki Jinnouchi
Jinnouchi Clinic, Diabetes Care Center
Seigo Sugiyama
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
Masako Waki
Division of Endocrinology and Metabolism, Department of Internal Medicine, Shizuoka City Shizuoka Hospital
Yoshihiko Saito
First Department of Internal Medicine, Nara Medical University
Department of Regulatory Medicine of Blood Pressure, Nara Medical University
for the JPAD Trial Investigators

Keywords: Blood pressure, Cardiovascular diseases, Diabetes mellitus, Hypertension, Stroke

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Supplementary material

2012 Volume 76 Issue 6 Pages 1526-1532

DOI https://doi.org/10.1253/circj.CJ-11-1033

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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. Methods and Results: We divided the JPAD participants according to their systolic (SBP) and diastolic (DBP) BPs at enrollment (SBP ≥140mmHg and/or DBP ≥90mmHg: unattained group, SBP <140mmHg and DBP <90mmHg: 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. (Circ J 2012; 76: 1526-1532)

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