Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Feb 8:21:100941.
doi: 10.1016/j.ajpc.2025.100941. eCollection 2025 Mar.

Population cessation of aspirin use for the prevention of cardiovascular disease

Stephanea Roeser  1   2 , Sue Duval  3 , Russell V Luepker  2   3 , Milton Eder  4 , John R Finnegan  2 , Jeremy R Van't Hof  3
Affiliations

Population cessation of aspirin use for the prevention of cardiovascular disease

Stephanea Roeser et al. Am J Prev Cardiol. .

Abstract

Importance: Aspirin use for primary prevention of cardiovascular diseases (CVD) is widespread with over a third of the adult population using despite guidelines recommending against.

Objective: This population-based research documents rates of use and reasons for cessation from 2015 to 2020, a period when guidelines changed.

Design: Three cross-sectional telephone surveys were conducted during 2015, 2017, and 2019-20.

Setting: A population-based survey in the states of Iowa, Minnesota, North Dakota, South Dakota, and Wisconsin.

Participants: The surveys included non-institutionalized resident adults ages 55-79 for women and 45-79 for men with landline telephones.

Main outcomes and measures: The analysis included 8,197 participants, 4,161 women and 4,036 men after excluding those with a history of cardiovascular disease (secondary prevention). Aspirin use for primary prevention was stable for the first two survey years (39 % in 2015 and 41 % in 2017) but fell significantly to 34 % in the final survey (2019-2020). The most common reason for cessation was "doctor's advice" (38 % of quitters) followed by "heard negative news" with a significant increase from 2015 to 2020 (4 % to 29 % of quitters).

Conclusions and relevance: Despite recent research findings and new guidelines, aspirin is still widely used for primary prevention of CVD in the general population. A combination of slow diffusion and implementation of guidelines, self-medication, and wide availability of low-cost aspirin underlies these trends. Physician advice is effective but more is needed. The influence of the popular media is also substantial. Appropriate implementation of aspirin guidelines requires additional clinician effort.

Trial registration: Clinicaltrials.gov registered on December 1, 2014, NCT02607917.

Keywords: Aspirin; Guidelines; Media influences; Physician advice; Primary prevention.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Unlabelled image
Central Illustration
See this image and copyright information in PMC

References

    1. O'Brien C.W., Juraschek S.P., Wee C.C. Prevalence of aspirin use for primary prevention of cardiovascular disease in the United States: results from the 2017 National Health Interview Survey. Ann Intern Med. 2019;171(8):596–598. doi: 10.7326/M19-0953. - DOI - PMC - PubMed
    1. Boakye E., Uddin S.M.I., Obisesan O.H., Osei A.D., Dzaye O., Sharma G., et al. Aspirin for cardiovascular disease prevention among adults in the United States: trends, prevalence, and participant characteristics associated with use. Am J Prev Cardiol. 2021;8 doi: 10.1016/j.ajpc.2021.100256. - DOI - PMC - PubMed
    1. Steering Committee of the Physicians' Health Study Research Group. Final report on the aspirin component of the ongoing Physicians' Health Study. N Engl J Med. 1989;321(3):129–135. doi: 10.1056/NEJM198907203210301. - DOI - PubMed
    1. Ridker P.M., Cook N.R., Lee I.M., Gordon D., Gaziano J.M., Manson J.E., et al. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N Engl J Med. 2005;352(13):1293–1304. doi: 10.1056/NEJMoa050613. - DOI - PubMed
    1. U.S. Preventive Services Task Force Aspirin for the primary prevention of cardiovascular events: recommendation and rationale. Ann Intern Med. 2002;136(2):157–160. doi: 10.7326/0003-4819-136-2-200201150-00015. - DOI - PubMed

Associated data

LinkOut - more resources