Differential vascular effects of aspirin in people with Type 2 diabetes without cardiovascular disease and matched controls without diabetes

Abstract

Aim We investigated whether the effect of low‐dose aspirin on endothelium‐dependent vasodilation and arterial stiffness in people with Type 2 diabetes is different from a matched control group. We examined acute and chronic effects, and effects over the 24h dosing interval. Methods In an open‐label parallel group intervention study, we included 21 participants with Type 2 diabetes and 21 age‐ and sex‐matched controls. Endothelium‐dependent vasodilation was assessed as the reactive hyperaemia index (lnRHI) measured by peripheral arterial tonometry (EndoPAT®). Arterial stiffness was assessed as pulse wave velocity (PWV) measured by applanation tonometry (SphygmoCor®). Measurements were performed prior to aspirin intake and 1h after aspirin administration (75 mg). Participants were then treated for 6 days, and measurements were repeated at 24 h and 1 h after aspirin intake. Results Baseline lnRHI did not differ between groups. The controls had an immediate increase in lnRHI after the first aspirin tablet. This was not observed in participants with diabetes (difference between groups; P < 0.05). After 1 week, both groups demonstrated increased lnRHI compared with baseline (P < 0.01). In participants with diabetes, lnRHI was significantly lower 24 h after aspirin administration compared with 1 h after administration (P < 0.05). This difference was not observed in controls (P = 0.84, difference between groups; P = 0.12). The effect on PWV did not differ between groups. Conclusion Aspirin had a reduced immediate effect on endothelium‐dependent vasodilation in participants with diabetes. Both groups had improved endothelial function after 1 week of treatment. Further, the effect of aspirin on endothelial function may be declining during a 24 h dosing interval in people with Type 2 diabetes. (Clinical Trial Registry No: 2016‐000515‐32)

Effects of Long-Term Intervention with Losartan, Aspirin and Atorvastatin on Vascular Remodeling in Juvenile Spontaneously Hypertensive Rats

“…We, therefore, chose a dose of 10 mg/kg/day, at which improvement in vascular remodeling provided data to support the benefits of low-dose aspirin. Although aspirin has been comprehensively used in populations, comparatively, its clinical reports about arterial stiffness are not too many [ 19 , 61 , 62 ], and none of them involve mechanism explanation. It is taken for granted anti-platelet effect duo to direct correlation of platelet activation with arterial stiffness [ 63 , 64 , 65 ].…”

Vascular protective effect of aspirin and rivaroxaban upon endothelial denudation of the mouse carotid artery

“…Aspirin treatment antagonized vascular stiffening and rivaroxaban treatment led to a trend towards reduced stiffening. For humans, conflicting reports exist on the www.nature.com/scientificreports/ effects of aspirin or rivaroxaban intake on arterial stiffness [20][21][22][23][24][32][33][34] , whereas in mice this appears not to have been studied at all. In humans, aspirin treatment can prevent arterial stiffening caused by an acute systemic inflammation 23 or by smoking 32,34 .…”

“…In humans, aspirin treatment can prevent arterial stiffening caused by an acute systemic inflammation 23 or by smoking 32 , 34 . Interestingly, variable results are obtained for small scale clinical studies with respect to an effect of aspirin on vascular stiffening: a reducing effect of aspirin treatment was reported in a group of 15 patients with hypertension versus 15 controls 22 , but no effect in 21 diabetic patients versus age and sex matched controls 33 . Furthermore, no difference in arterial stiffness was found between subjects with CAD that are aspirin sensitive versus aspirin resistant 21 .…”