Low Dose Aspirin for Primary Prevention of Cardiovascular Disease: Use Patterns and Impact Across Race in the Southern Community Cohort Study

Abstract

Background: There are little data on the role of aspirin for primary prevention of cardiovascular disease (CVD) in racial groups. Our objective was to study the association between aspirin use patterns and CVD incidence by race in the Southern Community Cohort Study. Methods: A total of 44,177 adults (mean age 52.2 ± 8.6 years, 66.6% female, 67.4% blacks and 32.6% whites) with no history of CVD enrolled from 2002 through 2009 were followed for a median of 9.2 years. At cohort entry, the simplified 10-year Framingham risk was calculated, and data related to aspirin use and other socioeconomic covariates collected. Race-specific adjusted odds ratios (aOR) for aspirin use and hazard ratios (aHR) for first major adverse cardiac event (MACE) were estimated by using multivariate logistic and Cox regression models. Results: Blacks were less likely to take aspirin as compared to whites (aOR 0.80; 95% CI 0.76-0.84). Incidence rates of MACE were 8.23 (95% CI 7.73-8.75) vs. 6.85 (95% CI 6.55-7.17) per 1000 person-year in whites and blacks, respectively. Overall, aspirin use was associated with increased MACE (aHR 1.22; 95% CI 1.12-1.33). Notably, in the group of high risk individuals aged 50 to 69 years, aspirin use was associated with significantly increased first MACE in blacks, especially in women, but not in whites (Table). Conclusion: Blacks were less likely to take aspirin for primary prevention of CVD. Aspirin use was associated with an increased incidence of MACE, more so in blacks than whites in this high-risk population.