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Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries.
- Source :
-
JAMA [JAMA] 2023 Aug 22; Vol. 330 (8), pp. 715-724. - Publication Year :
- 2023
-
Abstract
- Importance: Aspirin is an effective and low-cost option for reducing atherosclerotic cardiovascular disease (CVD) events and improving mortality rates among individuals with established CVD. To guide efforts to mitigate the global CVD burden, there is a need to understand current levels of aspirin use for secondary prevention of CVD.<br />Objective: To report and evaluate aspirin use for secondary prevention of CVD across low-, middle-, and high-income countries.<br />Design, Setting, and Participants: Cross-sectional analysis using pooled, individual participant data from nationally representative health surveys conducted between 2013 and 2020 in 51 low-, middle-, and high-income countries. Included surveys contained data on self-reported history of CVD and aspirin use. The sample of participants included nonpregnant adults aged 40 to 69 years.<br />Exposures: Countries' per capita income levels and world region; individuals' socioeconomic demographics.<br />Main Outcomes and Measures: Self-reported use of aspirin for secondary prevention of CVD.<br />Results: The overall pooled sample included 124 505 individuals. The median age was 52 (IQR, 45-59) years, and 50.5% (95% CI, 49.9%-51.1%) were women. A total of 10 589 individuals had a self-reported history of CVD (8.1% [95% CI, 7.6%-8.6%]). Among individuals with a history of CVD, aspirin use for secondary prevention in the overall pooled sample was 40.3% (95% CI, 37.6%-43.0%). By income group, estimates were 16.6% (95% CI, 12.4%-21.9%) in low-income countries, 24.5% (95% CI, 20.8%-28.6%) in lower-middle-income countries, 51.1% (95% CI, 48.2%-54.0%) in upper-middle-income countries, and 65.0% (95% CI, 59.1%-70.4%) in high-income countries.<br />Conclusion and Relevance: Worldwide, aspirin is underused in secondary prevention, particularly in low-income countries. National health policies and health systems must develop, implement, and evaluate strategies to promote aspirin therapy.
- Subjects :
- Adult
Aged
Female
Humans
Male
Middle Aged
Cross-Sectional Studies
Developed Countries economics
Developed Countries statistics & numerical data
Developing Countries economics
Developing Countries statistics & numerical data
Self Report economics
Self Report statistics & numerical data
Cardiovascular Agents therapeutic use
Aspirin therapeutic use
Cardiovascular Diseases epidemiology
Cardiovascular Diseases mortality
Cardiovascular Diseases prevention & control
Secondary Prevention economics
Secondary Prevention methods
Secondary Prevention statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1538-3598
- Volume :
- 330
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- JAMA
- Publication Type :
- Academic Journal
- Accession number :
- 37606674
- Full Text :
- https://doi.org/10.1001/jama.2023.12905