Daily Dose: Aspirin for Secondary Prevention of Cardiovascular Disease

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on a study published in JAMA that evaluated aspirin use for secondary prevention of cardiovascular disease (CVD) across low-, middle-, and high-income countries.

The study

Researchers examined pooled, individual participant data from nationally representative health surveys conducted between 2013 to 2020 in 51 low-, lower-middle-, upper-middle-, and high-income countries. The surveys contained information on self-reported history of CVD and aspirin use.

The overall pooled sample included 124 505 nonpregnant adults aged 40-69 years (median age, 52 years; 50.5% women), of whom 10 589 (8.1%) had a self-reported history of CVD. Among them, 40.3% used aspirin for secondary prevention.

The findings

Results showed that aspirin use for secondary prevention of CVD was lowest in lower-income countries and highest in higher-income countries.

The rate of aspirin use for secondary prevention of CVD in low-income countries was 16.6%, whereas it was 24.5% in lower-middle-income countries, 51.1% in upper-middle-income countries, and 65% in high-income countries.

Authors' commentary

"Worldwide, aspirin is underused in secondary prevention, particularly in low-income countries. To meet the goal of reducing premature mortality from [noncommunicable diseases], including CVD, national health policies and health systems must develop, implement, and evaluate strategies to promote evidence-based use of aspirin.”

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