Patterns of aspirin use in middle-aged adults: The atherosclerosis risk in communities (ARIC) study

Shahar, Eyal; Folsom, Aaron R.; Romm, Fredric J.; Bisgard, Kristine M.; Metcalf, Patricia; Crum, Larry; McGovern, Paul G.; Hutchinson, Richard G.; Heiss, Gerardo

doi:10.1016/s0002-8703(96)90173-8

Cited by 77 publications

(56 citation statements)

References 26 publications

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“…Among all adults (those with diabetes and others) with CVD or risk factors, aspirin was less likely to be used by women than by men. Others have observed similar differences in aspirin use (24)(25)(26), and we note reports that other CVD treatments may be underused by ethnic minorities in the U.S. (27,28).…”

Section: Research Design and Methods -supporting

confidence: 66%

Aspirin Use Among Adults With Diabetes

2001

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OBJECTIVE -Since 1997, the American Diabetes Association has recommended that aspirin therapy be considered for adults with diabetes who have cardiovascular disease (CVD) or CVD risk factors. We examined the prevalence of regular aspirin use among adults in the U.S. with diagnosed diabetes. Examination Survey (1988-1994) used a probability sample of the U.S. population and included an interview, physical examination, and laboratory studies. Among the survey participants were 1,503 adults (age Ն21 years) with self-reported diabetes. We defined regular aspirin use as reported having taken aspirin Ն15 times in the previous month. CVD conditions were self-reported heart attack and stroke and symptoms of angina and claudication. CVD risk factors included smoking, hypertension, obesity, albuminuria, lipid abnormalities, and family history of heart attack. RESEARCH DESIGN AND METHODS -The Third National Health and NutritionRESULTS -An estimated 27% of adults with diabetes had CVD, and an additional 71% had one or more CVD risk factors. Aspirin was used regularly by 37% of those with CVD and by 13% of those with risk factors only. Adjusted odds of regular aspirin use were significantly greater for individuals with CVD than for those with one CVD risk factor (odds ratio [OR] = 4.3); for non-Hispanic whites than for blacks, Mexican-Americans, and others (OR = 2.5); and for individuals age 40-59 years than for those Ͻ40 years (OR = 33.3).CONCLUSIONS -Nearly every adult in the U.S. with diabetes has at least one risk factor for CVD and thus may be considered a potential candidate for aspirin therapy. During 1988-1994) took aspirin regularly. Major efforts are needed to increase aspirin use.

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Section: Research Design and Methods -supporting

confidence: 66%

Aspirin Use Among Adults With Diabetes

2001

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“…4 There is some evidence of altered NHL risk associated with the use of common medications. 40,42 If aspirin use, which has been associated with decreased risk of NHL, increased disproportionately in whites after the publication of results from primary prevention trials of aspirin and heart disease in the late 1980s, 43 then this change may have contributed to the trends we observed. However, this risk was described only in one large, population-based study.…”

Section: Discussionmentioning

confidence: 92%

Changing incidence of non‐Hodgkin lymphomas in the United States

Clarke

Glaser

2002

Cancer

164

108

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BACKGROUNDThe incidence of non‐Hodgkin lymphoma (NHL) has been rising in many regions and populations during the last few decades. Data from the Surveillance, Epidemiology, and End Results (SEER) Program show that age‐adjusted rates of NHL increased through the 1980s but leveled off in the 1990s.METHODSTo determine whether the incidence of NHL stabilized in all population subgroups, particularly in age‐defined groups with distinctive risks of NHL, the authors investigated trends in NHL incidence among persons aged 0–14 years, 15–24 years, 25–34 years, 35–44 years, 45–54 years, 55–64 years, 65–74 years, and > 75 years by gender and race using 1973–1998 data from the SEER Program, which covered approximately 10% of the U.S. population. Joinpoint regression was used to assess changes in trends across the period.RESULTSNHL incidence trends changed significantly among males aged 25–54 years, in whom rates began to decrease (6–16% per year) in the middle to late 1990s, as well as among most whites aged ≥ 55 years, in whom rate increases slowed from 3–4% to 1–2% per year in the late 1980s. Incidence trends were steady in other groups, with uniform increases among whites aged 15–24 years (2–3% per year), women aged 25–54 years (1–6% per year), and blacks aged ≥ 55 years (2–4% per year). Although recent age specific incidence rates were generally higher in males compared with females and in whites compared with blacks, among males aged 25–54 years, rates were significantly higher in black males compared with white males.CONCLUSIONSThere have been changes in the demographic groups impacted by NHL. The trends for human immunodeficiency virus probably are related to recent decreases in NHL incidence among males aged 25–54 years. The rate change in the older white population is unexplained but represents both an alleviation of the burden of NHL in this population and a potential opportunity to generate hypotheses regarding risk factors for the development of NHL. Cancer 2002;94:2015–23. © 2002 American Cancer Society.DOI 10.1002/cncr.10403

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“…The administration of such platelet inhibitors reduces by one third the incidence of myocardial infarct as well as stroke in patients with cardiovascular risks or diseases (1). The unverified discontinuation of this medication may lead, however, to life-threatening iatrogenic coagulopathies such as stent thromboses (3)(4)(5). Even though the problems of perioperative discontinuation of such medication have frequently been described in the guidelines, there is no guideline for high-risk cardiovascular patients on antiplatelet medication before non-cardiac surgical interventions.…”

Section: Discussionmentioning

confidence: 99%

“…Before surgical interventions such as transurethral resection of prostate (TURP) or bladder tumours (TURB), the administration of these medicines is often discontinued due to possible bleeding complications (2). The perioperative discontinuation of platelet inhibitors without checking the indication or their necessity can lead to potentially fatal arterial thromboses (3)(4)(5). We studied the performance of TURP and TURB, taking into account the current recommendations of the American College of Chest Vol.…”

Section: Introductionmentioning

confidence: 99%

Perioperative platelet inhibition in transurethral interventions: TURP/TURB

et al. 2012

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ARTICLE INFO _________________________________________________________ ___________________Purpose: To determine whether transurethral surgery under platelet inhibition is a feasible procedure. Before transurethral resection of prostate (TURP) or bladder tumours (TURB), the administration of platelet-inhibiting medication is often interrupted due to possible bleeding complications. We studied the performance of TURP and TURB under the current recommendations of the American College of Chest Physicians (ACCP) on perioperative platelet inhibition. Materials and Methods: Patients assigned for transurethral intervention were preoperatively divided into the following risk groups: low, medium and high cardio-or cerebrovascular risk. In patients with a low-risk profile, acetylsalicylic acid (ASA) was discontinued. Patients of the medium risk group continued taking 100 mg of ASA. Patients of the high-risk group receiving dual platelet inhibition (ASA + clopidogrel) were not treated operatively. In total 346 patients from the low and medium risk groups underwent transurethral intervention. Results: Forty-two out of 198 TURP were performed under 100 mg of ASA. Without ASA, a significantly shorter length of stay and earlier removal of the transurethral catheter was documented. In the parameters postoperative haemorrhage and operative revision, no significant differences were observed. Thirty-two out of 148 TURB were performed under 100 mg of ASA. Regarding the length of stay, time until catheter removal, postoperative haemorrhage and operative revision, no significant differences were found under ASA. Only significantly longer continuous irrigation was documented under ASA. Conclusion: In the case of a verified indication for use of platelet inhibitors, it is possible to avoid discontinuation and the consequent increased risk of thromboembolic incidents in transurethral surgery is admissible.

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Patterns of aspirin use in middle-aged adults: The atherosclerosis risk in communities (ARIC) study

Cited by 77 publications

References 26 publications

Aspirin Use Among Adults With Diabetes

Aspirin Use Among Adults With Diabetes

Changing incidence of non‐Hodgkin lymphomas in the United States

Perioperative platelet inhibition in transurethral interventions: TURP/TURB

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