Missed opportunities: Many high-risk patients still not taking aspirin to prevent CVD
Aspirin is known to be an effective, affordable way to prevent cardiovascular disease (CVD), but many high-risk patients who could benefit from the drug still don’t take it, according to a new analysis published in JAMA.[1]
The research focused on survey data from more than 124,000 adults between the ages of 40 and 69 years old. The median age was 52 years old, and 50.5% of participants were women. Survey responses came from 51 different countries. None of the participants were pregnant at the time of the study.
While seven of the surveys were performed in low-income countries, 23 were performed in low-middle-income countries, 14 were performed in upper-middle-income countries and another seven were performed in high-income countries.
Among participants with a self-reported history of CVD—defined as a myocardial infarction, stroke or angina—40.3% of patients said they regularly took aspirin to reduce their risk of another adverse cardiovascular event. This broke down to 16.6% of participants in low-income countries, which was lower than seen in lower-middle-income countries (24.5%), upper-middle-income countries (51.1%) and high-income countries (65%). The authors calculated that approximately 41% of the variation seen in these numbers was due to per capita income.
“Survivors of heart attacks and stroke often face a high risk of having subsequent events,” first author Sang Gune Yoo, MD, a cardiovascular disease fellow at Washington University School of Medicine, said in a statement. “In fact, many people die from having recurring attacks. Aspirin offers one effective and relatively low-cost option for reducing the likelihood of additional events in individuals with established CVD, and yet most people who could benefit from a daily aspirin don’t take it.”
Yoo also emphasized that cardiologists and other healthcare providers have been working to increase the number of high-risk patients taking aspirin to prevent CVD. Despite the amount of time put into that goal, however, he said “things haven’t really changed” in the last decade.
“This research deals with a disease process that affects many people, regardless of where you live,” he said. “We have to remember that this could benefit a tremendous number of people.”
In the same statement, Yoo also highlighted the improvements seen in some lower-middle-income countries when it comes to care for patients living with HIV and other serious conditions. A similar approach, he said, could potentially be used to boost care for high-risk patients with a history of CVD.
Going forward, the research team hopes its efforts can lead to considerable improvements in the years ahead.
“In order to create interventions, we have to understand what is actually going on, which is what we’re trying to establish in this study,” Yoo said. “Then we can start to think about how to develop strategies to increase evidence-based aspirin use in order to save lives.”
Read the full analysis in JAMA here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.