Author(s):
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 ; Cífková, R ; Lunet, N ; Gurung, MS ; Mwangi, JK ; Martins, J ; Haghshenas, R ; Sturua, L ; Vollmer, S ; Bärnighausen, T ; Atun, R ; Sussman, JB ; Singh, K ; Saeedi Moghaddam, S ; Guwatudde, D ; Geldsetzer, P ; Manne-Goehler, J ; Huffman, MD ; Davies, JI ; Flood, D
Date: 2023
Persistent ID: https://hdl.handle.net/10216/158112
Origin: Repositório Aberto da Universidade do Porto
Description
"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."
