Recent Trends in Aspirin Use for Cardiovascular Disease Prevention in the United States - 2015-2023

Abstract

Recent trials show a lack of benefit of routine aspirin use for primary prevention and potential for harm. We assessed recent trends in aspirin use for both primary and secondary prevention in the United States population Methods: We used National Health Interview Survey (NHIS) data from 2015-2021 and reported the annual weighted proportion of aspirin use among patients ≥40 years without a self-reported history of angina, coronary heart disease, myocardial infarction, or stroke (primary prevention cohort) and those with (secondary prevention cohort) overall and by subgroups of sex, age ≥70 years and diabetes status. Results: The proportion of patients on aspirin for primary prevention reduced from 24.8% in 2015 to 13.9% in 2021 and secondary prevention reduced from 67.6% to 45.9%. The reduction in aspirin use was observed across all subgroups and in both cohorts. Conclusion: In response to recent data regarding lack of benefit of aspirin for primary prevention there has been a significant reduction in aspirin use for both primary and secondary prevention, the latter may be unintended and warrants further scrutiny.

Prevalence of Acetylsalicylic Acid Use for Primary Prevention of Cardiovascular Disease Amongst Older Adults From 2017—2021: a Retrospective Cross-Sectional Study

“…In 2017, data from the National Health Interview Survey (NHIS) in the United States found that 25% of adults 40 years of age and older were taking ASA for primary prevention, including 47% of those 70 years of age and older. (23) The population in the present study was older (mean age 79 years) than that in the NHIS study, and only 20% were using ASA for primary prevention. The downward trend of ASA use for primary prevention from 2017 to 2021 seen in this study was similar to the results of the NHIS study, where the use of ASA for primary prevention declined between 2017 to 2021 from 25% to 14% in those aged ≥40 years, and 47% to 26% in those aged ≥70 years.…”

“…The downward trend of ASA use for primary prevention from 2017 to 2021 seen in this study was similar to the results of the NHIS study, where the use of ASA for primary prevention declined between 2017 to 2021 from 25% to 14% in those aged ≥40 years, and 47% to 26% in those aged ≥70 years. (23) This rate of decline is greater than what was observed in the previous decade. Between 2011 and 2019, the rate of ASA for primary prevention in Americans ≥40 years of age in the Behavioural Risk Factor Surveillance Study only decreased from 31% to 28%.…”