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. 2021 May;69(5):1272-1282.
doi: 10.1111/jgs.17038. Epub 2021 Feb 17.

Age-Related Trajectories of Cardiovascular Risk and Use of Aspirin and Statin Among U.S. Adults Aged 50 or Older, 2011-2018

Taeho Greg Rhee  1   2 , Manish Kumar  3   4 , Joseph S Ross  5   6   7 , Patrick P Coll  8   9
Affiliations

Age-Related Trajectories of Cardiovascular Risk and Use of Aspirin and Statin Among U.S. Adults Aged 50 or Older, 2011-2018

Taeho Greg Rhee et al. J Am Geriatr Soc. 2021 May.

Abstract

Objectives: To examine age-related trajectories of cardiovascular risk and use of aspirin and statin among U.S. adults aged 50 or older.

Design: Repeated cross-sectional study using data from 2011 to 2018 National Health and Nutrition Examination Surveys.

Setting: Nationally representative health interview survey in the United States.

Participants: Non-institutionalized adults aged 50 years and older (n = 11,392 unweighted).

Measurements: Primary prevention was defined as the prevention of a first cardiovascular event including coronary heart disease, angina/angina pectoris, heart attack, or stroke, whereas secondary prevention was defined as those with a history of these clinical conditions. Medication use was determined by self-report; aspirin use included dose and frequency, and statin use included generic names, days of prescription fills, and indications. We examined linear trends between age and each medication use, after controlling for period, sex, and race/ethnicity.

Results: Prevalence of those eligible for primary prevention treatment increased with age from 31.8% in ages 50-54 to 52.0% in ages ≥75 (p < 0.001). Similarly, those eligible for secondary prevention treatment increased with age from 2.7% in ages 50-54 to 21.1% in ages ≥75 (p < 0.001). Low-dose daily aspirin use increased with age (p < 0.001), and 45.3% of adults aged ≥75 took low-dose aspirin daily for primary prevention. Statin use also increased with age (p < 0.001), and 56.4% of adults aged ≥75 had long-term statin use for secondary prevention.

Conclusion: While adults aged ≥75 do not benefit from the use of aspirin to prevent the first CVD, many continue to take aspirin on a regular basis. In spite of the clear benefit of statin use to prevent a subsequent CVD event, many older adults in this risk category are not taking a statin. Further education and guidance for both healthcare providers and older adults regarding the appropriate use of aspirin and statins to prevent CVD is needed.

Keywords: aspirin; cardiovascular; pharmaco-epidemiology; statin.

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Conflict of interest statement

Conflicts of interest: In the past 36 months, Dr. Rhee was supported in part by the National Institute on Aging (#T32AG019134) through Yale School of Medicine. Rhee is currently funded by the National Institute of Mental Health (#R21MH117438) and the Institute for Collaboration on Health, Intervention, and Policy (InCHIP) at the University of Connecticut. Dr. Ross received research support through Yale from Johnson and Johnson to develop methods of clinical trial data sharing, from Medtronic, Inc. and the Food and Drug Administration (FDA) to develop methods for post-market surveillance of medical devices (U01FD004585), from the Centers of Medicare and Medicaid Services (CMS) to develop and maintain performance measures that are used for public reporting, from the FDA to establish a Center for Excellence in Regulatory Science and Innovation (CERSI) at Yale University and the Mayo Clinic (U01FD005938), from the Blue Cross Blue Shield Association to better understand medical technology evaluation, and from the Agency for Healthcare Research and Quality (R01HS022882).

Figures

Figure 1.
Figure 1.
Prevalence of aspirin and statin use by age and prevention type among US adults aged 50 and older, 2011–2018 Note: Data are from National Health and Nutrition Examination Survey (NHANES). Whiskers represent 95% confidence intervals
Figure 2.
Figure 2.
Patterns of aspirin and statin use by age and prevention type among US adults aged 50 and older, 2011–2018 Note: Data are from National Health and Nutrition Examination Survey (NHANES). Whiskers represent 95% confidence intervals.
See this image and copyright information in PMC

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