23 Jul Almost A Third of Adults With Heart Disease or Stroke Don’t Take Aspirin Regularly
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Fang: Although the effectiveness of aspirin for secondary prevention (e.g. people who already have coronary heart disease or have had an ischemic stroke) of cardiovascular disease has been determined, its prevalence as a preventive measure has varied widely across settings, data collection methods and U.S. states. As a result, we wanted to more closely examine aspirin use among U.S. adults with a history of coronary heart disease or stroke.
To determine these findings, we analyzed data from the 2013 Behavioral Risk Factor Surveillance System. Nearly 18,000 people from 20 states and the District of Columbia with a self-reported history of coronary heart disease or stroke were included in the annual telephone survey.
Overall, we found about 70 percent of U.S. adults with heart disease or stroke reported regularly taking aspirin – meaning every day or every other day. Out of that group, nearly 94 percent said they take aspirin for heart attack prevention, about 80 percent linked it to stroke prevention efforts, and approximately 76 percent said they use it for both heart attack and stroke prevention. However, four percent of respondents with pre-existing cardiovascular problems said they take aspirin for pain relief without awareness of its benefits for cardiovascular disease.
Aspirin use also differed by state and sociodemographic characteristics including gender, race/ethnicity and age. In general, men, non-Hispanic whites, individuals aged 65 and older, and people with at least two of four risk factors (hypertension, smoking, diabetes and high cholesterol) are more likely to use aspirin than other groups. By state, aspirin use ranged from 44 percent in Missouri to more than 71 percent in Mississippi.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Fang: This study is meaningful because it helps to identify disparities in aspirin use for secondary prevention. Public health practitioners and clinicians can use the data to target resources and interventions in specific states or around eligible groups who report lower aspirin use, such as women and minorities. As a result, doctors and patients can work together on customized strategies aimed at preventing recurrent heart attacks and strokes.
Nearly 800,000 Americans die each year from heart disease, stroke and other cardiovascular diseases, accounting for one in every three deaths. Aspirin use is widely promoted as an effective way to treat or prevent recurrent cardiovascular events in the U.S., and is a key strategy in programs including Healthy People 2020 and Million Hearts®, a national initiative aimed at preventing one million heart attacks and strokes by 2017.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Fang: Further work is needed to assess possible variation in aspirin use at subnational levels and among different risk groups. It’s also important to identify how often patients and their healthcare providers are discussing whether aspirin use is right for them.
Dr. Jing Fang Ph.D. (2015). Almost A Third of Adults With Heart Disease or Stroke Don’t Take Aspirin Regularly