Mis-medication and Under-utilization of Aspirin in the Prevention and Treatment of Cardiovascular Disease

CONTEXT: Aspirin has been clearly established as an important therapy in the secondary prevention of cardiovascular disease (CVD), and also plays a role in primary prevention. OBJECTIVE: To determine the prevalence of use of aspirin or other over-the-counter analgesics to prevent or treat CVD. DESIGN: Representative national survey conducted in 1996. SETTING: National Family Opinion (NFO) Mail Panel. PARTICIPANTS: 23,158 persons aged 40 or older with no prior CVD, and 3818 who reported prior CVD. MAIN OUTCOME MEASURES: Use of aspirin and other over-the-counter (OTC) analgesics to prevent or treat cardiovascular problems. RESULTS: Overall, 10% of survey respondents reported regular use of any analgesic for primary prevention, and 8% specifically reported using aspirin. The prevalence of aspirin use was associated with age and cardiovascular risk factors, including overweight, family history of heart problems, high cholesterol, and high stress. Of those reporting analgesic use, 11% used only non-aspirin analgesics to prevent CVD, and an additional 10% used these with aspirin. Such mis-medication was greater in women than in men, but was not related to age. Among those reporting prior CVD, only 43% used aspirin for secondary prevention. Of those using analgesics, 11% used only non-aspirin products and an additional 14% used these with aspirin. We project that 1.3 million people nationally may be erroneously taking non-aspirin products for CVD prevention, with another 1.4 million taking these along with aspirin. CONCLUSION: Efforts to increase public awareness and advocate the appropriate use of aspirin are needed, and could have an important impact on public health.