title: Use of aspirin for primary and secondary cardiovascular disease prevention in the United States, 2011-2012.
abstract: BACKGROUND
  Aspirin use has been shown to be an effective tool in cardiovascular disease (CVD) prevention among high-risk patients. The patient-reported physician recommendation for aspirin as preventive therapy among high- and low-risk patients is unknown.
  
  
  RESULTS
  We conducted an analysis of the National Health and Nutrition Examination Survey 2011-2012 to examine the use of aspirin for CVD prevention. Patients without previously diagnosed CVD were classified into high and low risk based on their Framingham Risk Score (10-year coronary heart disease risk). Among patients without previously diagnosed CVD, 22.5% were classified as high risk. Of the high-risk individuals, 40.9% reported being told by their physician to take aspirin, with 79.0% complying. Among those who were at low risk, 26.0% were told by their physician to take aspirin, with 76.5% complying. Logistic regression analysis indicated that age, access to a regular source of care, education, and insurance status were significant predictors of patient-reported physician recommendations for aspirin use for primary prevention. Among high-risk patients, age, race, and insurance status were significant predictors of reported recommendations for aspirin use. Among low-risk patients, age, education, obesity, and insurance status were significant predictors of reported recommendations for aspirin use.
  
  
  CONCLUSIONS
  Patient reports indicate nonideal rates of being told to take aspirin, for both high- and low-risk patients for primary prevention. Clinical decision support tools that could assist physicians in identifying patients at risk may increase patient reports of physician recommendations for aspirin use.
authors.affiliation: Department of Health Services Research Management, and Policy, University of Florida, Gainesville, FL (A.G.M., R.J.T.) Department of Community Health and Family Medicine, University of Florida, Gainesville, FL (A.G.M.).
authors.forename: Arch G
authors.initials: AG
authors.lastname: Mainous
authors.affiliation: Department of Health Services Research Management, and Policy, University of Florida, Gainesville, FL (A.G.M., R.J.T.).
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Tanner
authors.affiliation: Geriatric Research Education & Clinical Center, Malcom Randall VAMC and Department of Epidemiology, University of Florida, Gainesville, FL (R.I.S.).
authors.forename: Ronald I
authors.initials: RI
authors.lastname: Shorr
authors.affiliation: Division of Cardiology, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL (M.C.L.).
authors.forename: Marian C
authors.initials: MC
authors.lastname: Limacher
mesh_terms: D000328:Adult; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011322:Primary Prevention; D018570:Risk Assessment; D055502:Secondary Prevention; D057566:Self Report; D014481:United States; D016903:Drug Monitoring
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
keywords: aspirin; cardiovascular diseases; prevention