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Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Countries

Aspirin is underused for secondary prevention of cardiovascular disease (CVD), particularly in low-income countries, according to a study of 51 countries with varying per-capita income levels. “National health policies and health systems must develop, implement, and evaluate strategies to promote aspirin therapy,” the authors conclude.

Conducted between 2013 and 2020 in 51 low-, middle-, and high-income countries, the cross-sectional study of nationally representative health surveys looked for effects of countries’ per capita income levels, world region, and individuals’ socioeconomic demographics through analysis of pooled individual data for nonpregnant adults aged 40 to 69 years.

Based on a primary outcome measure of self-reported use of aspirin for secondary prevention of CVD, the study showed the following: “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.”

Source: JAMA