Aspirin Use Among Adults With Diabetes

Rolka, Deborah B.; Fagot-Campagna, A.; Narayan, K.M. Venkat

doi:10.2337/diacare.24.2.197

Cited by 106 publications

(76 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Prospective Diabetes Study (32) and by the ADA (20), adult individuals with diabetes with evidence of any CVD should receive aspirin, and Ͼ99% of those patients are candidates for aspirin therapy (33). Our data suggests that this guideline was not met in Ͼ50% of the patients.…”

Section: Control Of Cardiovascular Risk Factorsmentioning

confidence: 85%

“…Our data suggests that this guideline was not met in Ͼ50% of the patients. However, as estimated from NHANES III, during 1998 -1994, only 20% of adults with diabetes received aspirin therapy (33). Given that the ADA diabetesspecific guidelines for aspirin therapy were not published until 1997, the higher prevalence of aspirin use among our patients (46%) suggests better translation of the ADA recommendations into clinical practice.…”

Section: Control Of Cardiovascular Risk Factorsmentioning

confidence: 94%

See 1 more Smart Citation

Control of Cardiovascular Risk Factors in Patients With Diabetes and Hypertension at Urban Academic Medical Centers

Jacober²,

et al. 2002

View full text Add to dashboard Cite

OBJECTIVE -There are national mandates to reduce blood pressure (BP) to Ͻ130/85 mmHg, LDL cholesterol to Ͻ100 mg/dl, and HbA 1c to Ͻ7% and to institute aspirin therapy in patients with diabetes. The objective of this study was to determine the proportion of patients in urban institutions with diabetes and hypertension who meet these treatment goals.RESEARCH DESIGN AND METHODS -Using American Diabetes Association (ADA) guidelines, we evaluated the control of cardiovascular disease (CVD) risk factors in 1,372 patients receiving medical care at two major urban medical centers in Brooklyn and Detroit. Information was extracted from charts of outpatient clinics.RESULTS -Of 1,372 active clinic patients with diabetes and hypertension, 1,247 (90.9%) had type 2 diabetes, and 26.7% met the target blood pressure of 130/85 mmHg. A total of 35.5% met the goal LDL cholesterol level of Ͻ100 mg/dl, 26.7% had an HbA 1c Ͻ7%, and 45.6% were on antiplatelet therapy. Only 3.2% of patients met the combined ADA goal for BP, LDL cholesterol, and HbA 1c .CONCLUSIONS -Optimal control of CVD risk factors in adults with diabetes was achieved only in a minority of patients. Results reflect the inherent difficulties in achieving these complex guidelines in our present health care systems. Diabetes Care 25:718 -723, 2002

show abstract

Section: Control Of Cardiovascular Risk Factorsmentioning

confidence: 85%

Section: Control Of Cardiovascular Risk Factorsmentioning

confidence: 94%

Control of Cardiovascular Risk Factors in Patients With Diabetes and Hypertension at Urban Academic Medical Centers

Jacober²,

et al. 2002

View full text Add to dashboard Cite

show abstract

“…This ratio may indicate that preclinical diagnosis of CHD and the consequent early institution of appropriate management might be a relevant factor in the prevention of major cardiac events in the subset of patients with CHD detected at screening (13). These patients were treated with acetylsalicylic acid (14), and in some instances revascularization procedures were performed and appropriate cardiologic therapy and follow-up were instituted (15). It is probable that these interventions have had an influence on the low rate of major cardiac events.…”

Section: -Year Follow-up Of the Misadmentioning

confidence: 99%

Cardiac Events in 735 Type 2 Diabetic Patients Who Underwent Screening for Unknown Asymptomatic Coronary Heart Disease

et al. 2002

View full text Add to dashboard Cite

OBJECTIVE -To report the cardiac events in type 2 diabetic outpatients screened for unknown asymptomatic coronary heart disease (CHD) and followed for 5 years.RESEARCH DESIGN AND METHODS -During 1993, 925 subjects aged 40 -65 years underwent an exercise treadmill test (ETT). If it was abnormal, the subjects then underwent an exercise scintigraphy. Of the 925 subjects, 735 were followed for 5 years and cardiac events were recorded.RESULTS -At the entry of the study, 638 of the 735 followed subjects had normal ETT, 45 had abnormal ETT with normal scintigraphy, and 52 had abnormal ETT and abnormal scintigraphy. The 52 subjects with abnormal scintigraphy and ETT underwent a cardiological and diabetological follow-up; the subjects with just abnormal ETT had a diabetological follow-up only. During the follow-ups, 42 cardiac events occurred: 1 fatal myocardial infarction (MI), 20 nonfatal MIs, and 10 cases of angina in the 638 subjects with normal ETT; 1 fatal MI in the 45 subjects with normal scintigraphy; and 1 fatal MI and 9 cases of angina in the 52 subjects with abnormal scintigraphy. In these 52 subjects all cardiac events were significantly more frequent ( 2 ϭ 21.40, P Ͻ 0.0001) but the ratio of major (cardiac death and MI) to minor (angina) cardiac events was significantly lower (P ϭ 0.002). Scintigraphy abnormality (hazard ratio 5.47; P Ͻ 0.001; 95% CI 2.43-12.29), diabetes duration (1.06; P ϭ 0.021; 1.008 -1.106), and diabetic retinopathy (2.371; P ϭ 0.036; 1.059 -5.307) were independent predictors of cardiac events on multivariate analysis. CONCLUSIONS -The low ratio of major to minor cardiac events in the positive scintigraphy group may suggest, although it does not prove, that the screening program followed by appropriate management was effective for the reduction of risk of major cardiac events.

show abstract

“…In a USA survey, about two thirds of family physicians (65%) surveyed would prescribe aspirin as primary prevention to reduce risk of myocardial infarction, which is in contrast to another USA study among primary care physicians where only 32% would prescribe aspirin for low risk patients 16 . The NHANES III survey showed that only 13% of those with risk factors for CHD were regular aspirin users 21 . Therefore, there are inconsistencies about the use of aspirin for primary prevention.…”

Section: Discussionmentioning

confidence: 99%

“…This was in contrast with the US national survey, which demonstrated that aspirin use in visits by coronary heart disease (CHD) patient in 1995 was 32% and remained unchanged in subsequent years 11,20 . In diabetic patients with CHD, only 37% were regular aspirin users according to the NHANES III survey 21 .…”

Section: Discussionmentioning

confidence: 99%

Knowledge, attitudes and current practice of Jordanian family physicians about prescribing aspirin in primary and secondary prevention of vascular diseases: a self-reported survey

Omari

Khader

Al‐Azzam

et al. 2010

European Journal of Cardiovascular Nursing

View full text Add to dashboard Cite

Background: Long-term aspirin therapy is crucial for patients with increased risk of occlusive vascular diseases. However, inconsistencies in the methods for risk assessment and the perception among health care providers are major contributing factors for challenges in risk assessment. Methods: A questionnaire was distributed to a total of 124 family physicians working at two university teaching centers and Ministry of Health primary health care centers in Jordan. Results: A majority of the physicians reported prescribing aspirin for patients if they have peripheral vascular disease (93%), post-coronary artery bypass graft (92%), stroke (90%), or stable angina (95%). A smaller percentage of physicians reported that they prescribe aspirin if patients have atrial fibrillation (81%) or acute myocardial infarction (85%). The percentage of physicians who prescribe aspirin markedly declined when patients have potential bleeding disorder (52%) or asthma (52%). For patients without cardiovascular diseases but with one or more risk factors, the prophylactic use of aspirin was reported by 85% to 95% of family physicians. Conclusions: The presence of co-morbidity along with vascular diseases tended to hinder physicians from prescribing aspirin even when it is indicated. A majority of family physicians recommends the use of aspirin in primary prevention in spite of its questionable or even negative benefits. Furthermore, self-reported aspirin prescribing rates among physicians in Jordan are higher than those reported by physicians in the U.S. and Europe. Therefore, we believe that proper dissemination of updated evidence-based treatment guidelines is required to ensure appropriate and efficient preventive services for cardiovascular diseases.

show abstract

Aspirin Use Among Adults With Diabetes

Cited by 106 publications

References 28 publications

Control of Cardiovascular Risk Factors in Patients With Diabetes and Hypertension at Urban Academic Medical Centers

Control of Cardiovascular Risk Factors in Patients With Diabetes and Hypertension at Urban Academic Medical Centers

Cardiac Events in 735 Type 2 Diabetic Patients Who Underwent Screening for Unknown Asymptomatic Coronary Heart Disease

Knowledge, attitudes and current practice of Jordanian family physicians about prescribing aspirin in primary and secondary prevention of vascular diseases: a self-reported survey

Contact Info

Product

Resources

About