Primary Prevention Aspirin Use Decreased After Recommendation Change

FRIDAY, Jan. 24, 2025 (HealthDay News) — Among older adults and adults with low atherosclerotic cardiovascular disease (ASCVD) risk for whom aspirin is not recommended, use of aspirin decreased after 2019 changes in guideline recommendations, according to a research letter published online Jan. 22 in the Journal of the American Medical Association.

Linnea M. Wilson, M.P.H., from Beth Israel Deaconess Medical Center in Boston, and Timothy S. Anderson, M.D., from the University of Pittsburgh, characterized national trends in preventive aspirin use (primary and secondary prevention) among populations at low and high ASCVD risk and with existing ASCVD. The study population included 18,294 participants (51.7 percent female; 10.3 percent non-Hispanic Black and 68.3 percent non-Hispanic White).

The researchers found that reported secondary prevention aspirin use remained stable among patients with ASCVD (69.9 percent in 2011-2012 and 66.3 percent in 2021-2023). In contrast, following updated recommendations, there was a significant decrease in reported primary prevention aspirin use from 23.5 percent in 2017-2020 to 17.2 percent in 2021-2023. Reported aspirin use decreased from 46.1 to 34.4 percent among adults older than 70 years, from 16.5 to 10.8 percent among adults with ASCVD risk <10 percent, and from 33.6 to 27.8 percent among adults with ASCVD risk ≥10 percent. In 2021-2023 compared with 2011-2020, aspirin use decreased significantly across all age categories and sexes in populations for whom primary prevention aspirin use is recommended against.

“Self-reported primary prevention aspirin use decreased among older adults and adults with low ASCVD risk for whom aspirin was not recommended, but also decreased among adults with higher ASCVD risk for whom aspirin may still be recommended,” the authors write.

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