Abstract P366: Primary Prevention of Cardiovascular Disease with Low Dose Aspirin Use: Lessons from the Minnesota Heart Health Program
Introduction: Heart attack and stroke represent the primary causes of cardiovascular disease (CVD) morbidity and mortality. Primary prevention of these events might be achieved via population-based CVD interventions, such as the evidence-based use of low-dose aspirin (ASA). According to U.S. Preventive Services Task Force guidelines, low-dose ASA is indicated in men ages 45-79 and women ages 55-79. However, current primary CVD prevention ASA use rates, and the potential impact of both public and health-professional campaigns to increase use, have not been previously well-defined. Traditional media, social media, and clinic-based activities were developed to increase appropriate low-dose ASA use in a community setting. Population-based measures of message exposure and ASA use were examined to evaluate program impact.
Methods: A small city in Minnesota was selected for study. Independent cross-sectional samples of city residents (men ages 45-79; women ages 55-79) were surveyed at baseline and 4 months after program implementation. Interviewers administered a 10-minute telephone survey to eligible residents. Primary prevention candidates were defined as not having a self-reported history of CV events or procedures. ASA use messages were disseminated to the public via a 3-month media campaign, and to health system professionals via educational sessions and supporting reinforcement materials. Exposure to program messages and ASA use behaviors were analyzed among primary-prevention candidates only.
Results: Two-thirds of the baseline (74/103) and 4-month (85/126) survey samples were primary prevention candidates. The demographic and socioeconomic distribution was similar across both samples, with slight oversampling of women in the 4-month survey. At baseline, 27 (37%) of the primary prevention candidates reported at least every other day ASA use, with all of them reporting daily ASA use. At 4 months, ASA use was higher with 46 (54%) reporting at least every other day use [OR=2.1; 95% CI 1.1-3.9] and 44 (52%) reporting daily use [OR=1.9; 95% CI 0.99-3.5]. In the 4-month survey, 39 (46%) of the primary prevention candidates indicated they had seen/heard the program messages in their community or workplace. Of these candidates, 95% found the messages to be believable, 87% had a favorable reaction, and 26% reported talking with their healthcare providers as a result. In addition, 26 (67%) of the candidates taking ASA regularly to prevent heart attack and stroke reported they did so on the advice of their healthcare providers, and 26 (67%) initiated ASA use in response to media advertisements.
Conclusions: Current ASA use for the primary prevention of CVD remains relatively low. A short media and health system campaign may increase ASA use. Increasing message exposure through additional media channels and reinforcing clinic-based ASA discussions are key elements to increase aspirin use.
- © 2013 by American Heart Association, Inc.