Prevalence of Aspirin Use for Primary Prevention of Cardiovascular Disease in the United States: Results From the 2017 National Health Interview Survey
Authors: Colin W. O'Brien, Stephen P. Juraschek, Christina C. Wee
Journal: Annals of Internal Medicine (2019)

Letters15 October 2019Prevalence of Aspirin Use for Primary Prevention of Cardiovascular Disease in the United States: Results From the 2017 National Health Interview SurveyColin W. O'Brien, MD, Stephen P. Juraschek, MD, PhD, and Christina C. Wee, MD, MPHColin W. O'Brien, MDHarvard Medical School, Boston, Massachusetts (C.W.O.), Stephen P. Juraschek, MD, PhDBeth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (S.P.J., C.C.W.), and Christina C. Wee, MD, MPHBeth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (S.P.J., C.C.W.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-0953 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Physicians and medical professional societies have widely supported use of aspirin for primary prevention of cardiovascular disease (CVD) in persons who are at increased risk (1) (Table 1). Three randomized controlled trials published in 2018—ASCEND (A Study of Cardiovascular Events in Diabetes), ARRIVE (Aspirin to Reduce Risk of Initial Vascular Events), and ASPREE (Aspirin in Reducing Events in the Elderly)—sought to evaluate the benefits and risks of aspirin use for primary prevention of CVD in adults with diabetes, average-risk adults, and older adults, respectively (2–4). Collectively, these studies showed few benefits and consistent bleeding risks. ASCEND studied adults with ...References1. Capodanno D, Angiolillo DJ. Aspirin for primary cardiovascular risk prevention and beyond in diabetes mellitus. Circulation. 2016;134:1579-94. [PMID: 27729421] CrossrefMedlineGoogle Scholar2. Bowman L, Mafham M, Wallendszus K, et al; ASCEND Study Collaborative Group. Effects of aspirin for primary prevention in persons with diabetes mellitus. N Engl J Med. 2018;379:1529-39. [PMID: 30146931] doi:10.1056/NEJMoa1804988 CrossrefMedlineGoogle Scholar3. Gaziano JM, Brotons C, Coppolecchia R, et al; ARRIVE Executive Committee. Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial. Lancet. 2018;392:1036-46. [PMID: 30158069] doi:10.1016/S0140-6736(18)31924-X CrossrefMedlineGoogle Scholar4. McNeil JJ, Woods RL, Nelson MR, et al; ASPREE Investigator Group. Effect of aspirin on disability-free survival in the healthy elderly. N Engl J Med. 2018;379:1499-508. [PMID: 30221596] doi:10.1056/NEJMoa1800722 CrossrefMedlineGoogle Scholar5. Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease. Circulation. 2019:CIR0000000000000678. [PMID: 30879355] doi:10.1161/CIR.0000000000000678 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Harvard Medical School, Boston, Massachusetts (C.W.O.)Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (S.P.J., C.C.W.)Note: The institutional review board at Beth Israel Deaconess Medical Center deemed this study not to be human subjects research.Acknowledgment: The authors thank Aaron Fleishman, MPH, for checking the statistical programs and outputs and the participants of NHIS for their important contributions.Grant Support: Dr. Juraschek is supported by grant K23HL135273 from the National Heart, Lung, and Blood Institute of the National Institutes of Health.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-0953.Reproducible Research Statement: Study protocol and data set: Publicly available at www.cdc.gov/nchs/nhis/index.htm. Statistical code: Available from Dr. Wee (e-mail, [email protected]harvard.edu).This article was published at Annals.org on 23 July 2019. 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