Introduction
Daily aspirin use for primary cardiovascular disease prevention is common among adults.
Numerous clinical trials observe reduced cardiovascular disease with regular low-dose
aspirin. The U.S. Preventive Services Task Force in 2016 published guidelines for
aspirin use, but controversy exists about the side effects, and overuse or underuse
may be common despite the guidelines. Using the Task Force recommendations, this paper
describes the prevalence of appropriate aspirin use and physician advice in a population
sample.
Methods
A random sample of men and women (aged 50–69 years) living in the Upper Midwest in
2017–2018 were surveyed, collecting demographic data, health history, and aspirin
use. Appropriate primary prevention with aspirin was defined as having ≥10% cardiovascular disease risk (hypertension, hyperlipidemia,
diabetes, smoking) with daily or every other day aspirin use. Those with prevalent
cardiovascular disease were labeled as secondary prevention.
Results
A total of 1,352 adults were surveyed (697 women, 655 men). The criteria for secondary
prevention were fulfilled in 188 participants, and these were eliminated from the
analysis. In the remaining group, aspirin was indicated in 32.9% (383 of 1,164). Among
those, 46.0% (176 of 383) were appropriate users, and 54.0% (207 of 383) were nonusers
despite indications. Overuse, where aspirin is not indicated, was common at 26.9%
(210 of 781). Discussion with a physician, although reported in 29% of subjects, was
associated with some improvement in the appropriate use but also with overuse and
underuse.
Conclusions
Aspirin use for primary cardiovascular disease prevention is common. However, many
adults are medicating without indication (overuse) or are not using aspirin despite
guidelines (underuse).
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Published online: February 03, 2021
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© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
