A spirin overutilization for the primary prevention of cardiovascular disease

被引:20
作者
VanWormer, Jeffrey J. [1 ]
Miller, Aron W. [2 ]
Rezkalla, Shereif H. [3 ]
机构
[1] Marshfield Clin Res Fdn, Ctr Clin Epidemiol & Populat Hlth, 1000 North Oak Ave, Marshfield, WI 54449 USA
[2] Marshfield Clin Res Fdn, Biomed Informat Res Ctr, Marshfield, WI USA
[3] Marshfield Clin Fdn Med Res & Educ, Dept Cardiol, Marshfield, WI USA
来源
CLINICAL EPIDEMIOLOGY | 2014年 / 6卷
基金
美国国家卫生研究院;
关键词
aspirin; primary prevention; cardiovascular disease; adults; United States;
D O I
10.2147/CLEP.S72032
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Aspirin is commonly used for the primary prevention of cardiovascular disease (CVD) in the US. Previous research has observed significant levels of inappropriate aspirin use for primary CVD prevention in some European populations, but the degree to which aspirin is overutilized in the US remains unknown. This study examined the association between regular aspirin use and demographic/clinical factors in a population-based sample of adults without a clinical indication for aspirin for primary prevention. Methods: A cross-sectional analysis was performed using 2010-2012 data from individuals aged 30-79 years in the Marshfield Epidemiologic Study Area (WI, USA). Regular aspirin users included those who took aspirin at least every other day. Results: There were 16,922 individuals who were not clinically indicated for aspirin therapy for primary CVD prevention. Of these, 19% were regular aspirin users. In the final adjusted model, participants who were older, male, lived in northern Wisconsin, had more frequent medical visits, and had greater body mass index had significantly higher odds of regular aspirin use (P<0.001 for all). Race/ethnicity, health insurance, smoking, blood pressure, and lipid levels had negligible influence on aspirin use. A sensitivity analysis found a significant interaction between age and number of medical visits, indicating progressively more aspirin use in older age groups who visited their provider frequently. Conclusion: There was evidence of aspirin overutilization in this US population without CVD. Older age and more frequent provider visits were the strongest predictors of inappropriate aspirin use. Obesity was the only significant clinical factor, suggesting misalignment between perceived aspirin benefits and cardiovascular risks in this subgroup of patients. Prospective studies that examine cardiac and bleeding events associated with regular aspirin use among obese samples (without CVD) are needed to refine clinical guidelines in this area.
引用
收藏
页码:433 / 440
页数:8
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