ASCEND (A Study of Cardiovascular Events iN Diabetes) was a randomised trial which aimed to find out whether aspirin and/or omega-3 fatty acids (fish oils) reduced the risk of heart attacks and strokes in people with diabetes who did not have any existing problems with their heart or blood circulation, when they started the study.
15,480 people with diabetes (either type 1 or type 2) with no known vascular disease or recent cancer at the start of the trial, were randomly allocated to take 100mg aspirin daily or placebo (dummy) and 1 gram capsules containing naturally occurring omega-3 fatty acids ("fish-oils") or placebo capsules containing olive oil.
The main trial has ended and the results were announced in August 2018. ASCEND is continuing to collect information on health outcomes by obtaining routinely collected data via central data registries and NHS sources. Thank you to all ASCEND participants for your ongoing support.
results of main trial
Aspirin
Aspirin prevented serious vascular events including heart attacks, strokes and mini strokes in people with diabetes who did not already have cardiovascular disease, but it also increased the risk of major bleeds, mainly from the gastrointestinal tract, so overall there was no clear benefit. Because aspirin increases the chances of serious bleeding, it is not recommended for people with diabetes who are otherwise well. Previous studies had suggested that low-dose aspirin might protect against cancer, especially bowel cancer, but there was no reduction in any cancers. We are continuing to follow the participants to see whether any benefits appear later.
Effects of Aspirin for Primary Prevention in People with Diabetes Mellitus
Omega-3 fatty acids (FISH OILS)
Fish oil supplements do not prevent heart attacks or strokes in people with diabetes. This is in line with previous randomised trials in other types of patient at increased risk of cardiovascular events which also showed no benefit of fish oil supplements. There is no justification for recommending fish oil supplements to protect against cardiovascular events.
Effects of n−3 Fatty Acid Supplements in Diabetes Mellitus
Cognitive function
Effects of aspirin on dementia and cognitive impairment in the ASCEND trial [PDF] presented at the American Heart Association (AHA) Scientific Sessions, 15 November 2021.
ascend eye
Our team
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Jane Armitage
Emeritus Professor of Clinical Trials and Epidemiology, and Honorary Consultant in Public Health Medicine
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Louise Bowman
Professor of Medicine and Clinical Trials, and Honorary Consultant Physician (Lipidology)
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Richard Haynes
Professor of Renal Medicine and Clinical Trials
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Marion Mafham
Associate Professor, Heart Studies Group
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Emily Sammons
Clinical Research Fellow
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Michelle Goonasekera
Clinical Research Fellow
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Muram El-Nayir
Clinical Research Fellow
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Georgina Buck
Medical Statistician, CTSU
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Charlie Harper
Trial Data Scientist
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Will Stevens
Senior Programmer/Analyst
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Karl Wallendszus
Senior Analyst/Programmer
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Michelle Nunn
Senior Study Administrator
