Aspirin use for primary and secondary prophylaxis of cardiovascular disease

Background: The benefits of aspirin use for the secondary and primary prevention of cardiovascular disease (CVD) have been demonstrated in several clinical trials. Objective: The purpose of this study was to estimate the prevalence of aspirin use for primary and secondary prophylaxis of CVD and to identify predictors associated with its use. Methods: A retrospective, cross-sectional study was conducted using data from the Behavioral Risk Factor Surveillance System from 1997 to 1999 to identify individuals using aspirin for the primary and secondary prevention of CVD. Logistic regression procedures were used to determine the contribution of various predictors of aspirin use. Results: The prevalence of aspirin use for both primary and secondary prevention of CVD increased from 1997 to 1999. In 1999, the rate of aspirin use for secondary prevention (72.4%) was >3 times the rate of use for primary prevention (19.8%). Use of aspirin for primary and secondary prevention was greater among whites, men, and those aged 65 to 74 years. Better compliance with other preventive care recommendations such as influenza vaccinations, cholesterol screening, and pneumonia vaccination; eating less fat and exercising more; and existing risk factors for CVD such as hypertension and high blood cholesterol were positively associated with aspirin use for primary and secondary prevention of CVD. Conclusions: Aspirin use rates for secondary prevention were higher than the rates for primary prevention because of the strong evidence linking aspirin use with the prevention of recurrence of a cardiovascular event. However, there is still an opportunity to promote the use of an inexpensive and effective drug such as aspirin for the primary prevention of CVD among patients who have risk factors for CVD and no contraindications to aspirin use. Increased adherence to cost-effective preventive measures such as aspirin therapy can contribute significantly to reducing the societal burden of CVD.