Aspirin Use for the Primary Prevention of Myocardial Infarction Among Men in North Carolina, 2013.

Samuel Tchwenko,Geraldine S Perry,Eleanor Fleming

doi:10.5888/pcd12.150342

Abstract

IntroductionThe US Preventive Services Task Force recommends aspirin use for men aged 45 to 79, when the potential benefit of preventing myocardial infarctions outweighs the potential harm of gastrointestinal hemorrhage. We determined prevalence and predictors of aspirin use for primary prevention of myocardial infarction vis-à-vis risk among men aged 45 to 79 in North Carolina.MethodsThe study used data for men aged 45 to 79 without contraindications to aspirin use or a history of cardiovascular disease from the 2013 North Carolina Behavioral Risk Factor Surveillance System survey. Stratification by risk of myocardial infarction was based on history of diabetes, high cholesterol, high blood pressure, and smoking. Analyses were performed in Stata version 13.0 (StataCorp LP); survey commands were used to account for complex sampling design.ResultsMost respondents, 74.2% (95% confidence interval [CI], 71.2%–77.0%), had at least one risk factor for myocardial infarction. Prevalence of aspirin use among respondents with risk factors was 44.8% (95% CI, 41.0–48.5) and was significantly higher than the prevalence among respondents without risk factors (prevalence ratio: 1.44 [95% CI, 1.17–1.78]). No significant linear dose (number of risk factors)–response (taking aspirin) relationship was found (P for trend = .25). Older age predicted (P = .03) aspirin use among respondents with at least one myocardial infarction risk factor.ConclusionMost men aged 45 to 79 in North Carolina have at least one risk factor for myocardial infarction, but less than half use aspirin. Interventions aimed at boosting aspirin use are needed among at-risk men in North Carolina.

Highlights

Introduction The US Preventive Services TaskForce recommends aspirin use for men aged 45 to 79, when the potential benefit of preventing myocardial infarctions outweighs the potential harm of gastrointestinal hemorrhage
Prevalence of aspirin use among respondents with risk factors was 44.8% and was significantly higher than the prevalence among respondents without risk factors
Interventions aimed at boosting aspirin use are needed among at-risk men in North Carolina

Summary

Introduction

Force recommends aspirin use for men aged 45 to 79, when the potential benefit of preventing myocardial infarctions outweighs the potential harm of gastrointestinal hemorrhage. We determined prevalence and predictors of aspirin use for primary prevention of myocardial infarction vis-à-vis risk among men aged 45 to 79 in North Carolina. In North Carolina, about 5.6% of men have had a heart attack and about 45 per 100,000 die from acute MI each year [2,3]. Evidence supports aspirin use for primary prevention of cardiovascular disease (CVD) events, including MI [4,5]. In 2009, the US Preventive Services Task Force (USPSTF) recommended aspirin for primary prevention of MI in men aged 45 to 79 years, when the potential benefit (reduction in MI) outweighs the potential harm of gastrointestinal hemorrhage [6].

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