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The British Journal of General Practice logoLink to The British Journal of General Practice
. 1997 Jul;47(420):417–421.

Aspirin use in middle-aged men with cardiovascular disease: are opportunities being missed?

A K McCallum 1, P H Whincup 1, R W Morris 1, A Thomson 1, M Walker 1, S Ebrahim 1
PMCID: PMC1313050  PMID: 9281867

Abstract

BACKGROUND: Since the 1980s, clinical trial evidence has supported aspirin use in the secondary prevention of cardiovascular disease (CVD). AIM: To explore aspirin use among British men with known CVD in a population-based study. METHOD: Longitudinal study (British Regional Heart Study), in which subjects have been followed up for cardiovascular morbidity and mortality since 1978-1980. Aspirin use was assessed by questionnaires to study participants in November 1992 (Q92); cardiovascular diagnoses are based on general practice notifications to October 1992. A total of 5751 men aged 52-73 years (87% of survivors) completed questions on aspirin use. RESULTS: Overall, 547 men (9.5%) were taking aspirin daily, of whom 321 (59%) had documented CVD. Among men with pre-existing disease, 153 out of 345 (44%) men with myocardial infarction, 42 out of 109 (39%) with stroke, and 75 out of 247 (29%) with angina were taking aspirin daily. Among men with angina (54% versus 26%) or myocardial infarction (59% versus 42%), those who had undergone coronary artery bypass surgery (CABG) or angioplasty were more likely to be receiving aspirin. Higher rates of aspirin use were also found in those whose last major event occurred after January 1990 (47% versus 34%). There was no association between aspirin use and social class or region of residence. CONCLUSION: Despite strong evidence of its effectiveness, many patients with established CVD were not receiving aspirin. Daily aspirin treatment was less likely in men with less recent major CVD events and in those who had not received invasive treatment.

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Selected References

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  1. Deeks J., Watt I., Freemantle N. Aspirin and acute myocardial infarction: clarifying the message. Br J Gen Pract. 1995 Aug;45(397):395–396. [PMC free article] [PubMed] [Google Scholar]
  2. Eccles M., Bradshaw C. Use of secondary prophylaxis against myocardial infarction in the north of England. BMJ. 1991 Jan 12;302(6768):91–92. doi: 10.1136/bmj.302.6768.91. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Field K., Thorogood M., Silagy C., Normand C., O'Neill C., Muir J. Strategies for reducing coronary risk factors in primary care: which is most cost effective? BMJ. 1995 Apr 29;310(6987):1109–1112. doi: 10.1136/bmj.310.6987.1109. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Hargreaves M. R., Firoozan S., Forfar J. C. Prescription of regular aspirin in patients with chest pain referred to a cardiology outpatient clinic. BMJ. 1995 Mar 25;310(6982):777–777. doi: 10.1136/bmj.310.6982.777. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Komiya T., Kudo M., Urabe T., Mizuno Y. Compliance with antiplatelet therapy in patients with ischemic cerebrovascular disease. Assessment by platelet aggregation testing. Stroke. 1994 Dec;25(12):2337–2342. doi: 10.1161/01.str.25.12.2337. [DOI] [PubMed] [Google Scholar]
  6. Moher M., Johnson N. Use of aspirin by general practitioners in suspected acute myocardial infarction. BMJ. 1994 Mar 19;308(6931):760–760. doi: 10.1136/bmj.308.6931.760. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Shaper A. G., Cook D. G., Walker M., Macfarlane P. W. Prevalence of ischaemic heart disease in middle aged British men. Br Heart J. 1984 Jun;51(6):595–605. doi: 10.1136/hrt.51.6.595. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Shaper A. G., Pocock S. J., Walker M., Cohen N. M., Wale C. J., Thomson A. G. British Regional Heart Study: cardiovascular risk factors in middle-aged men in 24 towns. Br Med J (Clin Res Ed) 1981 Jul 18;283(6285):179–186. doi: 10.1136/bmj.283.6285.179. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Shaper A. G., Pocock S. J., Walker M., Phillips A. N., Whitehead T. P., Macfarlane P. W. Risk factors for ischaemic heart disease: the prospective phase of the British Regional Heart Study. J Epidemiol Community Health. 1985 Sep;39(3):197–209. doi: 10.1136/jech.39.3.197. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Silagy C. A., McNeil J. J., Donnan G. A., Tonkin A. M., Worsam B., Campion K. Adverse effects of low-dose aspirin in a healthy elderly population. Clin Pharmacol Ther. 1993 Jul;54(1):84–89. doi: 10.1038/clpt.1993.115. [DOI] [PubMed] [Google Scholar]
  11. Stone S. P., Whincup P. Standards for the hospital management of stroke patients. J R Coll Physicians Lond. 1994 Jan-Feb;28(1):52–58. [PMC free article] [PubMed] [Google Scholar]
  12. Underwood M. J., More R. S. The aspirin papers. BMJ. 1994 Jan 8;308(6921):71–72. doi: 10.1136/bmj.308.6921.71. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Walker M., Shaper A. G. Follow-up of subjects in prospective studies based in general practice. J R Coll Gen Pract. 1984 Jul;34(264):365–370. [PMC free article] [PubMed] [Google Scholar]
  14. Whitford D. L., Southern A. J. Audit of secondary prophylaxis after myocardial infarction. BMJ. 1994 Nov 12;309(6964):1268–1269. doi: 10.1136/bmj.309.6964.1268. [DOI] [PMC free article] [PubMed] [Google Scholar]

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