Global Prevalence of Aspirin Use for Primary Prevention of Cardiovascular Disease: A Cross-Sectional Study of Nationally Representative, Individual-Level Data

Sang Gune K Yoo¹, Grace S Chung², Silver K Bahendeka^{3

4}, Abla M Sibai⁵, Albertino Damasceno^{6

7}, Farshad Farzadfar⁸, Peter Rohloff^{9

10}, Corine Houehanou¹¹, Bolormaa Norov¹², Khem B Karki¹³, Mohammadreza Azangou-Khyavy⁸, Maja E Marcus¹⁴, Krishna K Aryal^{15

16}, Luisa C C Brant^{17

18}, Michaela Theilmann^{19

20}, Renata Cífková^{21

22}, Nuno Lunet^{23

24

25}, Mongal S Gurung²⁶, Joseph Kibachio Mwangi^{27

28}, Joao Martins²⁹, Rosa Haghshenas⁸, Lela Sturua^{30

31}, Sebastian Vollmer³², Till Bärnighausen^{19

33

34}, Rifat Atun^{35

36}, Jeremy B Sussman^{2

37}, Kavita Singh^{19

38}, Sahar Saeedi Moghaddam^{39

40}, David Guwatudde⁴¹, Pascal Geldsetzer^{42

43}, Jennifer Manne-Goehler^{14

44}, Mark D Huffman^{45

46

47}, Justine I Davies^{48

49}, David Flood^{2

50

51}

Affiliations

¹ Cardiovascular Division, Department of Internal Medicine, Washington University in St Louis, St Louis, MO, USA.
² Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
³ Department of Internal Medicine, MKPGMS Uganda Martyrs University, Kampala.
⁴ St Francis Hospital, Nsambya, Kampala, Uganda.
⁵ Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
⁶ Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
⁷ Nucleo de Investigaçao, Departamento de Medicina, Hospital Central do Maputo, Maputo Mozambique.
⁸ Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁹ Center for Indigenous Health Research, Wuqu'Kawoq, Tecpán, Guatemala.
¹⁰ Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA.
¹¹ Laboratory of Epidemiology of Chronic and Neurological Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin.
¹² Nutrition Department, National Center for Public Health, Ulaanbaatar, Mongolia.
¹³ Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
¹⁴ Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
¹⁵ Bergen Centre for Ethics and Priority Setting in Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
¹⁶ Public Health Promotion and Development Organization, Kathmandu, Nepal.
¹⁷ Departamento de Clínica Médica, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
¹⁸ Telehealth Center, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
¹⁹ Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.
²⁰ Professorship of Behavioral Sciences in Prevention and Care, Technical University of Munich, Germany.
²¹ Center for Cardiovascular Prevention, First Faculty of Medicine and Thomayer University Hospital, Charles University in Prague, Prague, Czechia.
²² Department of Medicine II, First Faculty of Medicine, Charles University in Prague, Prague, Czechia.
²³ Department of Public Health and Forensic Health Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal.
²⁴ EPIUnit -Institute of Public Health, University of Porto, Porto, Portugal.
²⁵ ITR -Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal.
²⁶ Health Research and Epidemiology Unit, Ministry of Health, Thimphu, Bhutan.
²⁷ Division of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya.
²⁸ The Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
²⁹ Faculty of Medicine and Health Sciences, Universidade Nacional Timor Lorosa'e, Dili, Timor-Leste.
³⁰ Non-Communicable Disease Department, National Center for Disease Control and Public Health, Tbilisi, Georgia.
³¹ Public Health Department, Petre Shotadze Tbilisi Medical Academy, Georgia.
³² Department of Economics & Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany.
³³ Harvard Center for Population and Development Studies, Harvard University, Cambridge, USA.
³⁴ Africa Health Research Institute, Somkhele and Durban, South Africa.
³⁵ Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
³⁶ Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, USA.
³⁷ Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
³⁸ Centre For Chronic Disease Control, New Delhi, India.
³⁹ Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁴⁰ Kiel Institute for the World Economy, Kiel, Germany.
⁴¹ Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda.
⁴² Division of Primary Care and Population Health, Stanford University, USA.
⁴³ Chan Zuckerberg Biohub -San Francisco, San Francisco, California, USA.
⁴⁴ Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
⁴⁵ Department of Medicine and Global Health Center, Washington University in St Louis, St Louis, MO, USA.
⁴⁶ Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
⁴⁷ The George Institute for Global Health, University of New South Wales, Sydney, Australia.
⁴⁸ Institute for Applied Health Research, University of Birmingham, UK.
⁴⁹ Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa.
⁵⁰ Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit, Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
⁵¹ INCAP Research Center for Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala.

PMID: 38708405
PMCID: PMC11067965
DOI: 10.5334/gh.1323

Global Prevalence of Aspirin Use for Primary Prevention of Cardiovascular Disease: A Cross-Sectional Study of Nationally Representative, Individual-Level Data

Sang Gune K Yoo et al. Glob Heart. 2024.

. 2024 May 3;19(1):44.

doi: 10.5334/gh.1323. eCollection 2024.

Authors

Affiliations

¹ Cardiovascular Division, Department of Internal Medicine, Washington University in St Louis, St Louis, MO, USA.
² Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
³ Department of Internal Medicine, MKPGMS Uganda Martyrs University, Kampala.
⁴ St Francis Hospital, Nsambya, Kampala, Uganda.
⁵ Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
⁶ Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
⁷ Nucleo de Investigaçao, Departamento de Medicina, Hospital Central do Maputo, Maputo Mozambique.
⁸ Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁹ Center for Indigenous Health Research, Wuqu'Kawoq, Tecpán, Guatemala.
¹⁰ Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA.
¹¹ Laboratory of Epidemiology of Chronic and Neurological Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin.
¹² Nutrition Department, National Center for Public Health, Ulaanbaatar, Mongolia.
¹³ Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
¹⁴ Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
¹⁵ Bergen Centre for Ethics and Priority Setting in Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
¹⁶ Public Health Promotion and Development Organization, Kathmandu, Nepal.
¹⁷ Departamento de Clínica Médica, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
¹⁸ Telehealth Center, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
¹⁹ Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.
²⁰ Professorship of Behavioral Sciences in Prevention and Care, Technical University of Munich, Germany.
²¹ Center for Cardiovascular Prevention, First Faculty of Medicine and Thomayer University Hospital, Charles University in Prague, Prague, Czechia.
²² Department of Medicine II, First Faculty of Medicine, Charles University in Prague, Prague, Czechia.
²³ Department of Public Health and Forensic Health Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal.
²⁴ EPIUnit -Institute of Public Health, University of Porto, Porto, Portugal.
²⁵ ITR -Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal.
²⁶ Health Research and Epidemiology Unit, Ministry of Health, Thimphu, Bhutan.
²⁷ Division of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya.
²⁸ The Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
²⁹ Faculty of Medicine and Health Sciences, Universidade Nacional Timor Lorosa'e, Dili, Timor-Leste.
³⁰ Non-Communicable Disease Department, National Center for Disease Control and Public Health, Tbilisi, Georgia.
³¹ Public Health Department, Petre Shotadze Tbilisi Medical Academy, Georgia.
³² Department of Economics & Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany.
³³ Harvard Center for Population and Development Studies, Harvard University, Cambridge, USA.
³⁴ Africa Health Research Institute, Somkhele and Durban, South Africa.
³⁵ Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
³⁶ Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, USA.
³⁷ Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
³⁸ Centre For Chronic Disease Control, New Delhi, India.
³⁹ Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁴⁰ Kiel Institute for the World Economy, Kiel, Germany.
⁴¹ Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda.
⁴² Division of Primary Care and Population Health, Stanford University, USA.
⁴³ Chan Zuckerberg Biohub -San Francisco, San Francisco, California, USA.
⁴⁴ Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
⁴⁵ Department of Medicine and Global Health Center, Washington University in St Louis, St Louis, MO, USA.
⁴⁶ Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
⁴⁷ The George Institute for Global Health, University of New South Wales, Sydney, Australia.
⁴⁸ Institute for Applied Health Research, University of Birmingham, UK.
⁴⁹ Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa.
⁵⁰ Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit, Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
⁵¹ INCAP Research Center for Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala.

PMID: 38708405
PMCID: PMC11067965
DOI: 10.5334/gh.1323

No abstract available

Keywords: aspirin; cardiovascular disease; non-communicable disease; prevention.

PubMed Disclaimer

Conflict of interest statement

The authors have no competing interests to declare.

Figures

Survey inclusion flow chart, baseline characteristics, CVD risk among aspirin users — **Figure 1**
A) Survey inclusion flow chart. HPACC refers to The GHP Project on Access to Care for Cardiometabolic Diseases Collaboration. STEPS refers to STEPwise approach to NCD risk factor surveillance surveys. B) Use of aspirin for primary prevention of cardiovascular disease by income group, age, sex, education, and rurality. Estimates are weighted by each country’s 2019 population of individuals aged 40 to 69 years. Income group refers to World Bank per capita income categories in the year the survey was conducted. ^aEducation was unavailable in the survey from Tokelau. ^bUrban vs rural residence was unavailable in the surveys from Bermuda, Botswana, Brunei, Ecuador, Eswatini, Kiribati, Kuwait, Lebanon, Myanmar, Nauru, Solomon Islands, Sri Lanka, St Vincent and the Grenadines, Tajikistan, Timor-Leste, Tokelau, Tuvalu, and the US. C) CVD risk categories of individuals using aspirin for primary prevention by income group. Estimates are weighted by each country’s 2019 population of individuals aged 40 to 69 years. Income group refers to World Bank per capita income categories in the year the survey was conducted. Categories of 10-year predicted CVD risk are calculated using the 2019 regionally calibrated WHO laboratory-based risk-prediction models.

See this image and copyright information in PMC

References

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Global Prevalence of Aspirin Use for Primary Prevention of Cardiovascular Disease: A Cross-Sectional Study of Nationally Representative, Individual-Level Data

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Global Prevalence of Aspirin Use for Primary Prevention of Cardiovascular Disease: A Cross-Sectional Study of Nationally Representative, Individual-Level Data

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Conflict of interest statement

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