BMC Cardiovascular Disorders | |
Aspirin use and knowledge in the community: a population- and health facility based survey for measuring local health system performance | |
Ali H Mokdad6  Christopher JL Murray6  Andy Stergachis1  David W Fleming3  Danny D Shen2  Ali A Mokdad4  Catherine W Gillespie5  Gregory A Roth6  | |
[1] Department of Global Health, University of Washington, Seattle, WA, USA;Department of Pharmacy, University of Washington, Seattle, WA, USA;Public Health—Seattle & King County, Seattle, WA, USA;Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA;Center for Translational Science, Children’s National Health System, Washington, DC, USA;Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA | |
关键词: Coronary disease; Prevention; Aspirin; | |
Others : 855432 DOI : 10.1186/1471-2261-14-16 |
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received in 2013-09-04, accepted in 2014-01-29, 发布年份 2014 | |
【 摘 要 】
Background
Little is known about the relationship between cardiovascular risk, disease and actual use of aspirin in the community.
Methods
The Measuring Disparities in Chronic Conditions (MDCC) study is a community and health facility-based survey designed to track disparities in the delivery of health interventions for common chronic diseases. MDCC includes a survey instrument designed to collect detailed information about aspirin use. In King County, WA between 2011 and 2012, we surveyed 4633 white, African American, or Hispanic adults (45% home address-based sample, 55% health facility sample). We examined self-reported counseling on, frequency of use and risks of aspirin for all respondents. For a subgroup free of CAD or cerebral infarction that underwent physical examination, we measured 10-year coronary heart disease risk and blood salicylate concentration.
Results
Two in five respondents reported using aspirin routinely while one in five with a history of CAD or cerebral infarction and without contraindication did not report routine use of aspirin. Women with these conditions used less aspirin than men (65.0% vs. 76.5%) and reported more health problems that would make aspirin unsafe (29.4% vs. 21.2%). In a subgroup undergoing phlebotomy a third of respondents with low cardiovascular risk used aspirin routinely and only 4.6% of all aspirin users had no detectable salicylate in their blood.
Conclusions
In this large urban county where health care delivery should be of high quality, there is insufficient aspirin use among those with high cardiovascular risk or disease and routine aspirin use by many at low risk. Further efforts are needed to promote shared-decision making between patients and clinicians as well as inform the public about appropriate use of routine aspirin to reduce the burden of atherosclerotic vascular disease.
【 授权许可】
2014 Roth et al.; licensee BioMed Central Ltd.
【 预 览 】
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20140722033740940.pdf | 252KB | download | |
33KB | Image | download |
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【 参考文献 】
- [1]Frieden TR, Berwick DM: The “million hearts” initiative — preventing heart attacks and strokes. N Engl J Med 2011, 365:e27.
- [2]From the U.S. Preventive Services Task Force, Agency for Healthcare Research and Quality, Rockville, Maryland: Aspirin for the prevention of cardiovascular disease: U.S. preventive services task force recommendation statement. Ann Intern Med 2009, 150:396-404.
- [3]Shahar E, Folsom AR, Romm FJ, Bisgard KM, Metcalf PA, Crum L, McGovern PG, Hutchinson RG, Heiss G: Patterns of aspirin use in middle-aged adults: the atherosclerosis risk in communities (ARIC) study. Am Heart J 1996, 131:915-922.
- [4]Cannon CP, Rhee KE, Califf RM, Boden WE, Hirsch AT, Alberts MJ, Cable G, Shao M, Ohman EM, Steg PG, Eagle KA, Bhatt DL: Current use of aspirin and antithrombotic agents in the United States among outpatients with atherothrombotic disease (from the REduction of Atherothrombosis for Continued Health [REACH] registry). Am J Cardiol 2010, 105:445-452.
- [5]STATISTICAL BRIEF #179: aspirin use among the adult U.S. Noninstitutionalized population, with and without indicators of heart disease, 2005 http://meps.ahrq.gov/mepsweb/data_files/publications/st179/stat179.shtml webcite
- [6]U.S. Census Bureau: generated by Greg Roth using State & county quickfacts. King County, WA; http://factfinder2.census.gov webcite
- [7]Stata statistical software: release 12. College Station, TX: StataCorp LP; 2011.
- [8]Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB: Prediction of coronary heart disease using risk factor categories. Circulation 1998, 97:1837-1847.
- [9]O’kruk RJ, Adams MA, Philp RB: Rapid and sensitive determination of acetylsalicylic acid and its metabolites using reversed-phase high-performance liquid chromatography. J Chromatogr B Biomed Sci Appl 1984, 310:343-352.
- [10]AGGRENOX (aspirin/extended-release dipyridamole) capsules package insert. Ingelheim, Germany: Boehringer Ingelheim Pharmaceuticals, Inc; 2014.
- [11]Paterson JR, Blacklock C, Campbell G, Wiles D, Lawrence JR: The identification of salicylates as normal constituents of serum: a link between diet and health? J Clin Pathol 1998, 51:502-505.
- [12]Blacklock CJ, Lawrence JR, Wiles D, Malcolm EA, Gibson IH, Kelly CJ, Paterson JR: Salicylic acid in the serum of subjects Not taking aspirin. Comparison of salicylic acid concentrations in the serum of vegetarians, Non-vegetarians, and patients taking Low dose aspirin. J Clin Pathol 2001, 54:553-555.
- [13]Glasser SP, Cushman M, Prineas R, Kleindorfer D, Prince V, You Z, Howard VJ, Howard G: Does differential prophylactic aspirin use contribute to racial and geographic disparities in stroke and coronary heart disease (CHD)? Prev Med 2008, 47:161-166.
- [14]Baigent C, Blackwell L, Collins R, Emberson J, Godwin J, Peto R, et al.: Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 2009, 373:1849-1860.
- [15]Mora S: Aspirin therapy in primary prevention < subtitle > comment on “effect of aspirin on vascular and nonvascular outcomes”. Arch Intern Med 2012, 172:217.
- [16]Seshasai SRK: Effect of aspirin on vascular and nonvascular outcomes < subtitle > meta-analysis of randomized controlled trials. Arch Intern Med 2012, 172:209.
- [17]Rembold CM: ACP journal club. Review: aspirin does not reduce CHD or cancer mortality but increases bleeding. Ann Intern Med 2012, 156:JC6-3.
- [18]Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Authors/Task Force Members, et al.: European guidelines on cardiovascular disease prevention in clinical practice (version 2012): the fifth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts) * developed with the special contribution of the European association for cardiovascular prevention & rehabilitation (EACPR). Eur Heart J 2012, 33:1635-1701.
- [19]Pignone M, Alberts MJ, Colwell JA, Cushman M, Inzucchi SE, Mukherjee D, Rosenson RS, Williams CD, Wilson PW, Kirkman MS: Aspirin for primary prevention of cardiovascular events in people with diabetes: a position statement of the American diabetes association, a scientific statement of the American heart association, and an expert consensus document of the American college of cardiology foundation. Circulation 2010, 121:2694-2701.
- [20]Bhatt DLSP: INternational prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA 2006, 295:180-189.
- [21]Bosetti C, Rosato V, Gallus S, Cuzick J, La Vecchia C: Aspirin and cancer risk: a quantitative review to 2011. Ann Oncol 2012, 23:1403-1415.
- [22]Rolka DB, Fagot-Campagna A, Narayan KMV: Aspirin use among adults with diabetes estimates from the third national health and nutrition examination survey. Dia Care 2001, 24:197-201.
- [23]Burney KD, Krishnan K, Ruffin MT, Zhang D, Brenner DE: Adherence to single daily dose of aspirin in a chemoprevention trial. An evaluation of self-report and microelectronic monitoring. Arch Fam Med 1996, 5:297.