Population Trends in Aspirin Use for Cardiovascular Disease Prevention 1980–2009: The Minnesota Heart Survey

Abstract

BackgroundDaily low‐dose aspirin is recommended for primary prevention of myocardial infarction and stroke in higher‐risk patients. Population trends in aspirin use for cardiovascular disease (CVD) prevention in an urban population (Minneapolis/St. Paul, 2010 population 2.85 million) from 1980 to 2009 were evaluated.Methods and ResultsSurveys of randomly selected adults aged 25 to 74 years were collected at 5‐year intervals. Self‐reports of regular aspirin use for CVD prevention and history of CVD were obtained. Six cross‐sectional surveys included 12 281 men and 14 258 women. Age‐adjusted aspirin use for primary prevention increased during this period from 1% to 21% among men and 1% to 12% among women. Aspirin use was highest in those aged 65 to 74 years. For secondary prevention, age‐adjusted aspirin use increased from 19% to 74% among men and 11% to 64% among women. While data are based on self‐report, a substudy using a biochemical indicator of aspirin use (serum thromboxane B2) supports the validity of self‐report.ConclusionsAspirin for CVD prevention is commonly used by a large and growing portion of the general population. It is not known if this is based on professional advice or self‐prescribed use. It is also likely that many who would benefit do not use aspirin and others use aspirin inappropriately.

Contemporary Primary Prevention Aspirin Use by Cardiovascular Disease Risk: Impact of US Preventive Services Task Force Recommendations, 2007—2015: A Serial, Cross‐sectional Study

“…The lack of improvement in PP aspirin use contrasts with the large increase in SP aspirin use observed in response to secondary CVD prevention guideline dissemination 30, 34, 35, 36. For example, our work from MHS (Minnesota Heart Survey) reported an increase in SP aspirin use among men aged 25 to 75 years living in Minnesota from 19% in 1980 to 1982 to 74% in 2007 to 2009 30. As is well known, cardiovascular SP efforts have long been embedded into national, regional, and health system quality‐improvement initiatives, which have not emphasized PP.…”

Decreasing human body temperature in the United States since the Industrial Revolution

“…Although many chronic infections had been conquered before the NHANES study, some-periodontitis as one example (20)-continued to decrease over this short period. Moreover, the use of anti-inflammatory drugs including aspirin (21), statins (22) and non-steroidal anti-inflammatory drugs (NSAIDs) 150 (23) increased over this interval, potentially reducing inflammation. NSAIDs have been specifically linked to blunting of body temperature, even in normal volunteers (24).…”

Aspirin Use for Cardiovascular Disease Prevention in an African American Population: Prevalence and Associations with Health Behavior Beliefs

“…In 1987-1989, Atherosclerosis Risk in Communities (ARIC) Study investigators found aspirin use in Black men and women after a heart attack was 49% and 23% respectively [16]. Epidemiologic data from Minnesota shows a steady increase in secondary prevention aspirin use over 25 years [6].…”

“…The benefits of aspirin after a heart attack or stroke are well proven [4,5], and aspirin use for secondary prevention has increased over time in the general public [6]. Several welldesigned clinical trials have demonstrated a reduction in a first myocardial infarction (MI) or stroke in participants taking low dose aspirin, at the expense of increased bleeding events [7][8][9][10][11][12][13].…”