Most women at CVD risk do not take daily aspirin
MedWire News: The majority of women at risk for cardiovascular disease (CVD) do not take daily aspirin even though it is recommended for them, researchers report.
"Educational programs for clinicians and women aimed at promoting appropriate use of aspirin is one measure that should improve CVD outcomes in women," write Cathleen Rivera (Scott and White Healthcare, Temple, Texas, USA) and team in the Journal of Women's Health.
They used a web-based CVD risk assessment tool at 127 US centers to question 217,987 women about their risk for CVD. The survey took approximately 7-10 minutes to complete and as well as demographics, collected information on CVD risk factors: tobacco use, diabetes mellitus, hypertension, hyperlipidemia and forms of CVD (coronary, cerebral, and peripheral arterial disease).
Information on CVD-related procedures (angioplasty, coronary artery bypass graft surgery), medication use including daily aspirin, family history, and whether the respondent was under the care of a physician was also obtained.
Using the 2007 American Heart Association guidelines, women were deemed to be eligible for aspirin use for the primary prevention of CVD if they were aged 65 years or over and did not meet the criteria for secondary prevention.
Women were eligible for secondary prevention if they had a history of acute myocardial infarction (MI), stroke, abdominal aortic aneurysm, coronary artery stenting, bypass surgery, balloon angioplasty, or carotid endarterectomy.
Overall, 29,701 women were considered eligible for daily aspirin therapy: 13,593 for primary prevention and 16,108 for secondary prevention.
However, only 41% of women who met the criteria for primary prevention and 48% of those who met the criteria for secondary prevention reported taking aspirin on a daily basis.
Multivariate analysis revealed that having a primary care physician and/or a cardiologist, as well as hypertension (systolic blood pressure [SBP]≥140 mmHg or diastolic BP [DBP]≥90 mmHg) or the use of antihypertensive medications, was significantly associated with daily aspirin use for primary prevention.
Predictors for taking daily aspirin for secondary prevention were Caucasian ethnicity, never smoking, having a primary care physician and/or a cardiologist, taking antihypertensives, and having a family history of CVD.
Although aspirin use for secondary prevention did not change between 2004 and 2009, there was a significant increase in aspirin use for primary prevention, note the authors.
Considering that CVD is poised to surpass infectious diseases as the world's leading cause of mortality and disability and that direct and indirect costs are estimated at over $400 billion, "the impact of preventive measures on our future healthcare costs is vast, yet the cost of one aspirin is minute," conclude the authors.
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By Piriya Mahendra