Underuse of aspirin for primary and secondary prevention of cardiovascular disease events in women.
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BACKGROUND: Evidence-based guidelines for use of aspirin to decrease cardiovascular disease (CVD) events in women are well established. Despite this, aspirin is underused in women. We examined self-reported aspirin use in women for primary and secondary prevention of CVD events, correlates of use, and change in use over time from 2004 to 2009. METHODS: Data from volunteer respondents participating in a web-based CVD risk assessment tool at 127 US healthcare centers were analyzed. Survey questions included information on CVD risk factors, the presence or absence of any form of CVD, diabetes mellitus, and medication usage, including daily aspirin. Logistic regression analyses identified factors associated with aspirin intake. RESULTS: Of the 217,987 women respondents, 29,701 women were recommended to take aspirin based on the guidelines. We found, however, that only 41% of women who meet criteria for primary prevention and 48% of women who meet criteria for secondary prevention report that they take aspirin on a daily basis. The main factors that favored aspirin use were a family history of CVD or high cholesterol. Although aspirin use for secondary prevention did not change between the years 2004 and 2009, there was a significant increase in aspirin use for primary prevention. CONCLUSIONS: These findings confirm that the majority of women for whom aspirin is recommended for primary and secondary prevention of CVD were not following national guidelines. Educational programs for clinicians and women aimed at promoting appropriate use of aspirin is one measure that should improve CVD outcomes in women.
