Use of non-steroidal anti-inflammatory drugs in US adults: changes over time and by demographic

Abstract

Objective: Aspirin and non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) are preventive against cardiovascular disease (CVD) and several cancer types, but long-term use has been associated with significant health risks, resulting in conflicting recommendations on NSAID use for prevention of CVD and cancer. Previous research indicates that aspirin use increases with age and CVD risk factors and that a large percentage of the US population regularly use analgesics, including NSAIDs, but there has not been a recent, in-depth assessment of NSAID use prevalence, changes in use over time or predictors of NSAID use in the USA.

Methods: We used the cross-sectional, National Health And Nutrition Examination Survey (NHANES) from 1988 to 1994 and three continuous cycles (1999-2004) to assess regular NSAID use prevalence, changes over time and predictors of regular NSAID use.

Results: Overall, regular NSAID use increased over time and varied by demographic features. Participants over 60 years of age, women, participants with high body mass index, increased waist circumference or heart disease were significantly more likely to be regular NSAID users. By contrast, non-Hispanic African American and Mexican American participants were significantly less likely to regularly use NSAIDs.

Conclusions: This study uses a nationally representative data set (NHANES) to provide an exploration of regular NSAID use patterns over time, highlighting several demographic, lifestyle and clinical conditions associated with regular NSAID use. Understanding who is likely to regularly use NSAIDs enables more targeted messaging both for increasing the preventive benefits and for limiting the toxicities associated with regular use of NSAIDs.

Keywords: CVD prevention; Cancer prevention; NSAID use.

Figure 1

Prevalence of regular non-steroidal anti-inflammatory drug (NSAID) use by age and race/ethnicity. (A-C): Prevalence of NSAID use by race and age groups in National Health And Nutrition Examination Survey (NHANES) 1988-1994, (D-F): Prevalence of NSAID use by race and age groups in NHANES 1999-2004. Columns indicate weighted prevalence (%). Bars = SE of per cent. NH, Non-Hispanic.