Racial differences in the use of aspirin: an important tool for preventing heart disease and stroke

Regular aspirin use, particularly as secondary prevention, reduces morbidity from heart disease and stroke. Few studies have examined racial/ethnic differences in aspirin use for the prevention of cardiovascular disease (CVD).

Data from the 2001 Behavioral Risk Factor Surveillance System (n=2,514 African Americans; n=865 Hispanics; n=28,038 Whites) were used to assess racial/ethnic differences in aspirin use. Multivariable logistic regression was used to examine whether the likelihood of aspirin use differs by race/ethnicity after accounting for sociodemographic and CVD risk factors.

Regular aspirin use was associated with increasing age, male gender, lower educational attainment, hypertension, diabetes, overweight, and histories of myocardial infarction, coronary heart disease, and stroke. Aspirin use was lower among African Americans and Hispanics than Whites (28.6% and 28.7% vs 37.1%, respectively). After adjustment for sociodemographic and CVD risk factors, African Americans and Hispanics were 30%-40% less likely than Whites (OR=0.6, 95% C1=0.5, 0.7, African Americans; OR=0.7, 95% CI=0.5, 1.0, Hispanics) to take aspirin. Although aspirin use was higher among those with CVD (73.6% African Americans, 73.6% Hispanics, and 82.7% Whites), after multivariable adjustment, African Americans and Hispanics with CVD remained 30% to 50% less likely to use aspirin than Whites (OR=0.7, 95% CI=0.4, 1.2, African Americans; OR=0.5, 95% CI=0.2, 1.1, Hispanics).

African Americans and Hispanics are less likely to take aspirin than their White counterparts. Differences in sociodemographic characteristics and CVD risk factors do not account for lower aspirin use among racial/ethnic minorities. Additional studies should examine methods to increase aspirin use in these populations.