Clinical research studyAspirin use for the primary prevention of coronary heart disease in older adults
Section snippets
Subjects and design
This prospective study examined participants in the Health, Aging, and Body Composition Study (Health ABC), a population-based study of 3075 healthy community-dwelling men and women aged 68 to 80 years. Participants were identified from a random sample of white and all black Medicare-eligible adults living in designated zip codes areas surrounding Pittsburgh, Pa, and Memphis, Tenn; details of the eligibility criteria have been described.13 All participants gave written informed consent; the
Baseline characteristics
Fifty-five percent of the participants were women, and 42% were black (Table 1). In 1997 and 1998, 367 participants (17%) were regular aspirin users.
Coronary heart disease risk
Aspirin use increased with 10-year coronary heart disease risk by Framingham risk score from 13% in persons with a 10-year risk less than 6% (low risk) to 23% in those with a 10-year risk greater than 20% (highest risk) (P for trend < .001).
Other covariates
Aspirin use was less frequent in black participants (13%) compared with white participants (20%). Aspirin use
Discussion
This population-based study of a biracial cohort of older adults suggests that aspirin use for primary prevention has increased in recent years, to one third of the older population. Individuals at higher coronary heart disease risk were more likely to take aspirin. However, aspirin was not sufficiently targeted to high-risk individuals, particularly diabetic persons and blacks. In 2002 and 2003, only 37% of adults with a 10-year coronary heart disease risk greater than 20% used aspirin; 24% of
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2009, American Journal of CardiologyCitation Excerpt :Following the standard procedure for risk estimation with SCORE/ESC, we modeled the risk in subjects <60 years of age as if they were 60 years old to generate estimates of the SCORE algorithm with extrapolation. Because the upper age limit of the PROCAM and SCORE algorithms is 65 years, we used the risk prediction of age 65 years for participants ≥66 years old, similar to a previous study.14 In contrast with FRS/ATP-III and SCORE/ESC, in which patients with diabetes are considered like patients with a previous CHD event, in PROCAM/IAS diabetic patients are incorporated into the risk algorithm and are not directly classified as high risk.
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2008, Preventive MedicineCitation Excerpt :In a survey of general practitioners in Italy, 14% of diabetics without CVD were taking antiplatelet drug (mostly aspirin) (Monesi et al., 2005). Previous studies in the US have also found low rates (ranging from 12 to 38%) of aspirin use in diabetics (Persell and Baker, 2004; Stafford et al., 2005), and one study in older adults found that, after adjusting for confounders, diabetics were not more likely to take aspirin than non-diabetics (OR 0.89, 95% CI 0.56–1.40) (Rodondi et al., 2005). This underuse of aspirin among diabetics is observed despite strong convergence of guidelines.
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2019, Journal of the American Heart Association
This study was supported by Contracts NO1-AG-6-2101, NO1-AG-6-2103, and NO1-AG-6-2106 of National Institute on Aging. The National Institute on Aging funded the Health ABC study, reviewed the article, and approved its publication. Dr. Rodondi was supported by a grant from the Swiss National Foundation (PBLAB-102353).