Research Article
Aspirin Use Among Adults in the U.S.: Results of a National Survey

https://doi.org/10.1016/j.amepre.2014.11.005Get rights and content

Introduction

The use of aspirin in patients without cardiovascular disease remains controversial. Patients’ understanding of the risks and benefits of aspirin likely contribute to the decision of whether or not to use aspirin regularly. The purpose of this study is to assess patients’ knowledge of aspirin and identify factors contributing to regular use.

Methods

A survey of U.S. adults aged 45–75 years was performed to ascertain aspirin use and factors that may be associated with use. Multivariate logistic regression was used to identify predictors of current use of aspirin among those with a primary prevention indication. The survey was completed in 2012 with data analysis performed in 2013.

Results

Among 2,509 respondents, 52% reported current aspirin use. Among 2,039 respondents without a history of cardiovascular disease, current use of aspirin was 47%. Regular use of aspirin for primary prevention was associated with the presence of major cardiovascular disease risk factors (OR=3.0, 95% CI=2.4, 3.7), high self-assessed knowledge of aspirin (OR=9.1, 95% CI=5.2, 15.7), and having discussed aspirin therapy with a provider (OR=25.9, 95% CI=19.7, 34.1). Several markers of healthy lifestyle choices were also associated with regular use. After multivariate analysis, the strongest independent predictor of regular aspirin use was having discussed aspirin therapy with a provider (OR=23.79, 95% CI=17.8, 31.5).

Conclusions

Approximately half of the nationwide survey of U.S. adults reported regular aspirin use. Among those with a primary prevention indication, having discussed aspirin with a provider was the strongest predictor of regular use.

Introduction

Aspirin reduces recurrent cardiovascular disease (CVD) events in individuals with CVD, as well as first events in those with high CVD risk.1 Recommendations regarding aspirin use for primary prevention differ among organizations. Although aspirin is recommended for moderately high-risk individuals by the U.S. Preventive Services Task Force,2 it is not recommended for primary prevention for any risk level by the European Society of Cardiology.3 Recently, the U.S. Food and Drug Administration also recommended4 against routine use of aspirin for primary prevention but stated it may still be appropriate when prescribed by a healthcare provider to higher-risk patients.

New data suggesting that aspirin prevents certain forms of cancer may add to the potential benefits of regular use.5 These new findings, along with conflicting recommendations for primary prevention of CVD, have led to renewed efforts to clarify aspirin’s role in individuals without CVD.6, 7

Despite ongoing debate regarding the optimal role of aspirin in prevention, its use among U.S. adults is increasing. A recent report found a 57% increase in regular use between 2005 and 2010.8 Respondents’ perceptions about aspirin, their CVD health, and their interactions with care providers likely impact the decision to use aspirin on a daily basis. To better understand the current level of regular aspirin use and predictors of use, U.S. adults were surveyed about their aspirin use and factors that might be associated with that decision.

Section snippets

Survey Development and Administration

A 25-question web-based survey was developed to assess the following domains: use of aspirin by adults in the U.S., beliefs about the risks and benefits of aspirin, self-assessed CVD risk, and discussions about regular aspirin use with healthcare providers. The survey also collected respondent demographic data as well as personal and family medical history. All collected data were de-identified. An exemption from oversight was granted by the Oregon Health & Science University IRB.

The survey was

Results

The survey was initiated by 2,724 respondents and completed by 2,537 (93%). Respondents outside of the specified age range (n=28) were excluded. Data were analyzed for the remaining 2,509 respondents; their characteristics are presented in Table 2. Briefly, 41% of respondents were women and 38% were aged ≥65 years. Major risk factors for CVD were prevalent, with 49% of respondents reporting high cholesterol, 49% reporting hypertension, and 61% reporting either current or previous smoking.

Based

Discussion

This survey provides an update to the authors’ previous 2004 national survey assessing patterns of aspirin use among middle-aged and older Americans.9 Overall, the prevalence of aspirin use was slightly higher than the earlier survey (52% vs 41%) and consistent with recent findings by other investigators.8 Compared to the previous survey, current use of aspirin for secondary prevention increased from 69% to 80%, while current use for primary prevention increased from 36% to 47%.9

For primary

Acknowledgments

The study survey was sponsored by Partnership for Prevention and the Council on Aspirin for Health and Prevention. The Council on Aspirin for Health and Prevention is an initiative of Partnership for Prevention, a nonprofit organization that promotes disease prevention and health policy. Partnership for Prevention receives financial support for the Council through an unrestricted grant from Bayer HealthCare, which has no influence over the programs or activities of the Council. Bayer HealthCare

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