Abstract P449: Use of Low-dose Aspirin as Secondary Prevention of Recurrent Ischemic Vascular Disease among Adults in the United States-- National Health Interview Survey, 2012
Background: Current guidelines recommend that adults with ischemic vascular disease take low-dose aspirin or other antiplatelet medications as secondary prevention of recurrent cardiovascular events. The objective of this study is to assess the low-dose aspirin use among US adults with ischemic vascular disease.
Methods: Using data from the 2012 National Health Interview Survey, we identified participants aged ≥40 years with ischemic vascular disease (self-reported history of myocardial infarction, stroke, coronary heart disease, or angina). Low-dose aspirin use was ascertained based on four questions: 1) ever advised to take low-dose aspirin; 2) among those who answered “yes”, they were also asked if they followed this advice; 3) for those who didn’t follow the advice, they were asked if they were later advised not to take low-dose aspirin and 4) among those who were not advised to take low-dose aspirin, they were asked if they took it on their own. Multivariable logistic regression models were used to determine the adjusted odds ratio of aspirin use, adjusting for sociodemographic characteristics, health insurance status, and cardiovascular risk factors.
Results: In 2012, among those with ischemic vascular disease (N=3213), 76.2% (95% confidence interval 74.3-77.9) had been told to take low-dose aspirin, and 87.8% (86.0-89.5) followed this advice. Among those who were not advised to take low-dose aspirin, only 11.4% (8.7-14.8) were taking low-dose aspirin on their own. Among those who weren’t following the advice, 53.2% (45.5-60.9) were later told not to take low-dose aspirin. Overall, 69.6% (67.6-71.5) were taking low-dose aspirin. Logistic regression showed those ≥ 65 years were more likely to take low-dose aspirin than those aged 40-64 (adjusted odds ratio =1.50, 95% CI=1.17-1.93). Non-Hispanic blacks and Hispanics were less likely to take LDA compared to non-Hispanic whites (adjusted odds ratio =0.71, CI=0.54-0.94; adjusted odds ratio =0.54, 95% CI=0.38-0.77, respectively). Those with a high school education or with some college were less likely than those with ≥ college education to take low-dose aspirin (adjusted odds ratio =0.64, CI=0.46-0.90; adjusted odds ratio =0.66, CI=0.47-0.92, respectively). Men were more likely to take low-dose aspirin than women (adjusted odds ratio =1.39, CI=1.10-1.75).
Conclusions: Among US adults with ischemic vascular disease, only 76% reported being advised to take low-dose aspirin, and 88% followed this advice. Of the 12% who did not follow this advice, half were later advised to not take low-dose aspirin. Participants reported good compliance with physician’s advice to take low-dose aspirin, yet there is room for improvement in providing advice for low-dose aspirin among those with ischemic vascular disease.
Author Disclosures: J. Fang: None. M. George: None. C. Ayala: None. Y. Hong: None. F. Loustalot: None.
- © 2014 by American Heart Association, Inc.