Aspirin use among adults with diabetes - Estimates from the Third NationalHealth and Nutrition Examination Survey

OBJECTIVE- Since 1997, the American Diabetes Association has recommended th at aspirin therapy be considered for adults with diabetes who have cardiova scular disease (CVD) or CVD risk factors. We examined the prevalence of reg ular aspirin use among adults in the U.S. with diagnosed diabetes. RESEARCH DESIGN AND METHODS- The Third National Health and Nutrition Examin ation Survey (1988-1994) used a probability sample of the U.S. population a nd included an interview physical examination, and laboratory studies. Amon g the survey participants were 1,503 adults (age greater than or equal to 2 1 years) with sell-reported diabetes. We defined regular aspirin use as rep orted having taken aspirin greater than or equal to 15 times in the previou s month. CVD conditions were self-reported heart attack and stroke and symp toms of angina and claudication. CVD risk factors included smoking, hyperte nsion, obesity albuminuria, lipid abnormalities, and family history of hear t attack. RESULTS- An estimated 27% of adults with diabetes had CVD, and an additiona l 71% had one or more CVD risk factors. Aspirin was used regularly by 37% o f those with CVD and by 13% of those with risk factors only. Adjusted odds of regular aspirin use were significantly greater for individuals with CVD than for those with one CVD risk factor (odds ratio [OR] = 4.3); for non-Hi spanic whites than for blacks, Mexican-Americans, and others (OR = 2.5); an d for individuals age 40-59 years than for those <40 years (OR = 33.3). CONCLUSIONS- Nearly every adult in the U.S. with diabetes has at least one risk factor for CVD and thus may be considered a potential candidate for as pirin therapy. During 1988-1994, only 20% (95% CI 16-23) took aspirin regul arly. Major efforts are needed to increase aspirin use.