Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries

Journal article

Yoo SGK, Chung GS, Bahendeka SK, Sibai AM, Damasceno A, Farzadfar F, Rohloff P, Houehanou C, Norov B, Karki KB, Azangou-Khyavy M, Marcus ME, Aryal KK, Brant LCC, Theilmann M, Cifkova R, Lunet N, Gurung MS, Mwangi JK, Martins J, Haghshenas R, Sturua L, Vollmer S, Barnighausen T, Atun R, Sussman JB, Singh K, Saeedi Moghaddam S, Guwatudde D, Geldsetzer P, Manne-Goehler J, Huffman MD, Davies JI, Flood D
JAMA, vol. 330(8), 2023

DOI: 10.1001/jama.2023.12905

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APA Click to copy
SGK, Y., GS, C., SK, B., AM, S., A, D., F, F., … D, F. (2023). Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries. JAMA, 330(8). https://doi.org/10.1001/jama.2023.12905

Chicago/Turabian Click to copy
SGK, Yoo, Chung GS, Bahendeka SK, Sibai AM, Damasceno A, Farzadfar F, Rohloff P, et al. “Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries.” JAMA 330, no. 8 (2023).

MLA Click to copy
SGK, Yoo, et al. “Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries.” JAMA, vol. 330, no. 8, 2023, doi:10.1001/jama.2023.12905.

BibTeX Click to copy

@article{yoo2023a,
  title = {Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries},
  year = {2023},
  issue = {8},
  journal = {JAMA},
  volume = {330},
  doi = {10.1001/jama.2023.12905},
  author = {SGK, Yoo and GS, Chung and SK, Bahendeka and AM, Sibai and A, Damasceno and F, Farzadfar and P, Rohloff and C, Houehanou and B, Norov and KB, Karki and M, Azangou-Khyavy and ME, Marcus and KK, Aryal and LCC, Brant and M, Theilmann and R, Cifkova and N, Lunet and MS, Gurung and JK, Mwangi and J, Martins and R, Haghshenas and L, Sturua and S, Vollmer and T, Barnighausen and R, Atun and JB, Sussman and K, Singh and S, Saeedi Moghaddam and D, Guwatudde and P, Geldsetzer and J, Manne-Goehler and MD, Huffman and JI, Davies and D, Flood}
}

Abstract

Importance
Aspirin is an effective and low-cost option for reducing atherosclerotic cardiovascular disease (CVD) events and improving mortality rates among individuals with established CVD. To guide efforts to mitigate the global CVD burden, there is a need to understand current levels of aspirin use for secondary prevention of CVD.

Objective
To report and evaluate aspirin use for secondary prevention of CVD across low-, middle-, and high-income countries.

Design, Setting, and Participants
Cross-sectional analysis using pooled, individual participant data from nationally representative health surveys conducted between 2013 and 2020 in 51 low-, middle-, and high-income countries. Included surveys contained data on self-reported history of CVD and aspirin use. The sample of participants included nonpregnant adults aged 40 to 69 years.

Exposures
Countries’ per capita income levels and world region; individuals’ socioeconomic demographics.

Main Outcomes and Measures
Self-reported use of aspirin for secondary prevention of CVD.

Results
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 (8.2% [95% CI, 7.7%-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.

Conclusion and Relevance
Worldwide, aspirin is underused in secondary prevention, particularly in low-income countries. National health policies and health systems must develop, implement, and evaluate strategies to promote aspirin therapy.

Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries

Journal article

Cite

Abstract

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