| Title: |
Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries |
| Authors: |
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 |
| Contributors: |
Instituto de Saúde Pública |
| Publisher Information: |
American Medical Association |
| Publication Year: |
2023 |
| Collection: |
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." |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
JAMA. 2023 Aug 22;330(8):715-724. doi:10.1001/jama.2023.12905.; https://jamanetwork.com/journals/jama/article-abstract/2808523; https://hdl.handle.net/10216/158112 |
| DOI: |
10.1001/jama.2023.12905 |
| Availability: |
https://hdl.handle.net/10216/158112; https://doi.org/10.1001/jama.2023.12905 |
| Rights: |
info:eu-repo/semantics/restrictedAccess |
| Accession Number: |
edsbas.1C5ECD4A |
| Database: |
BASE |