Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries

Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries Publisher Pubmed

Yoo SGK¹ ; Chung GS² ; Bahendeka SK^{3, 4} ; Sibai AM⁵ ; Damasceno A^{6, 7} ; Farzadfar F⁸ ; Rohloff P^{9, 10} ; Houehanou C¹¹ ; Norov B¹² ; Karki KB¹³ ; Azangoukhyavy M⁸ ; Marcus ME¹⁴ ; Aryal KK^{15, 16} ; Brant LCC^{17, 18} Show All Authors

Yoo SGK¹
Chung GS²
Bahendeka SK^{3, 4}
Sibai AM⁵
Damasceno A^{6, 7}
Farzadfar F⁸
Rohloff P^{9, 10}
Houehanou C¹¹
Norov B¹²
Karki KB¹³
Azangoukhyavy M⁸
Marcus ME¹⁴
Aryal KK^{15, 16}
Brant LCC^{17, 18}
Theilmann M^{19, 20}
Cifkova R^{21, 22}
Lunet N^{23, 24, 25}
Gurung MS²⁶
Mwangi JK^{27, 28}
Martins J²⁹
Haghshenas R⁸
Sturua L^{30, 31}
Vollmer S¹⁴
Barnighausen T^{19, 32, 33}
Atun R^{34, 35}
Sussman JB^{2, 36}
Singh K^{19, 37}
Saeedi Moghaddam S^{38, 39}
Guwatudde D⁴⁰
Geldsetzer P⁴¹
Mannegoehler J^{42, 43}
Huffman MD^{44, 45, 46}
Davies JI^{47, 48, 49}
Flood D^{2, 9, 50}

Show Affiliations

1. Cardiovascular Division, Department of Internal Medicine, Washington University in St Louis, St Louis, MO, United States
2. Department of Internal Medicine, University of Michigan, Ann Arbor, United States
3. Department of Internal Medicine, MKPGMS Uganda Martyrs University, Kampala, Uganda
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 Investigacao, 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, Tecpan, Guatemala
10. Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, United States
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. Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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. Servico de Cardiologia e Cirurgia Cardiovascular, Hospital das Clinicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
18. Departamento de Clinica Medica, 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. Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
21. Center for Cardiovascular Prevention, First Faculty of Medicine, Thomayer University Hospital, Charles University in Prague, Prague, Czech Republic
22. Department of Medicine II, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
23. Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
24. EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
25. 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. Faculty of Medicine, The Institute of Global Health, University of Geneva, Geneva, Switzerland
29. Faculty of Medicine and Health Sciences, National University of East Timor, 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, Tbilisi, Georgia
32. Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, United States
33. Africa Health Research Institute, Somkhele, Durban, South Africa
34. Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, United States
35. Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, United States
36. Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
37. Centre for Chronic Disease Control, New Delhi, India
38. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
39. Kiel Institute for the World Economy, Kiel, Germany
40. Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
41. Division of Primary Care and Population Health, Stanford University, Stanford, CA, United States
42. Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
43. Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
44. Department of Medicine and Global Health Center, Washington University in St Louis, St Louis, MO, United States
45. Department of Preventive Medicine, Northwestern University Feinberg, School of Medicine, Chicago, IL, United States
46. The George Institute for Global Health, University of New South Wales, Sydney, Australia
47. Institute for Applied Health Research, University of Birmingham, Birmingham, United Kingdom
48. Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa
49. 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
50. INCAP Research Center for Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala

Source: JAMA Published:2023

Abstract

Importance: Aspirin is an effective and low-cost option for reducing atherosclerotic cardiovascular disease (CVD) events and improving mortality rates among individuals with established CVD. To guide efforts to mitigate the global CVD burden, there is a need to understand current levels of aspirin use for secondary prevention of CVD. Objective: To report and evaluate aspirin use for secondary prevention of CVD across low-, middle-, and high-income countries. Design, Setting, and Participants: Cross-sectional analysis using pooled, individual participant data from nationally representative health surveys conducted between 2013 and 2020 in 51 low-, middle-, and high-income countries. Included surveys contained data on self-reported history of CVD and aspirin use. The sample of participants included nonpregnant adults aged 40 to 69 years. Exposures: Countries' per capita income levels and world region; individuals' socioeconomic demographics. Main Outcomes and Measures: Self-reported use of aspirin for secondary prevention of CVD. Results: The overall pooled sample included 124505 individuals. The median age was 52 (IQR, 45-59) years, and 50.5% (95% CI, 49.9%-51.1%) were women. A total of 10589 individuals had a self-reported history of CVD (8.1% [95% CI, 7.6%-8.6%]). Among individuals with a history of CVD, aspirin use for secondary prevention in the overall pooled sample was 40.3% (95% CI, 37.6%-43.0%). By income group, estimates were 16.6% (95% CI, 12.4%-21.9%) in low-income countries, 24.5% (95% CI, 20.8%-28.6%) in lower-middle-income countries, 51.1% (95% CI, 48.2%-54.0%) in upper-middle-income countries, and 65.0% (95% CI, 59.1%-70.4%) in high-income countries. Conclusion and Relevance: Worldwide, aspirin is underused in secondary prevention, particularly in low-income countries. National health policies and health systems must develop, implement, and evaluate strategies to promote aspirin therapy.. © 2023 American Medical Association. All rights reserved.

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Experts (# of related papers)

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Farshad Farzadfar (26)

Sadaf Ghajarieh Sepanlou (22)

Style	Citing Format
MLA	Yoo SGK, et al.. "Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries." JAMA, vol. 330, no. 8, 2023, pp. 715-724.
APA	Yoo SGK, Chung GS, Bahendeka SK, Sibai AM, Damasceno A, Farzadfar F, Rohloff P, Houehanou C, Norov B, Karki KB, Azangoukhyavy M, Marcus ME, Aryal KK, Brant LCC, Theilmann M, Cifkova R, Lunet N, Gurung MS, Mwangi JK, ... Flood D (2023). Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries. JAMA, 330(8), 715-724.
Chicago	Yoo SGK, Chung GS, Bahendeka SK, Sibai AM, Damasceno A, Farzadfar F, Rohloff P, et al.. "Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries." JAMA 330, no. 8 (2023): 715-724.
Harvard	Yoo SGK et al. (2023) 'Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries', JAMA, 330(8), pp. 715-724.
Vancouver	Yoo SGK, Chung GS, Bahendeka SK, Sibai AM, Damasceno A, Farzadfar F, et al.. Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries. JAMA. 2023;330(8):715-724.
BibTex	@article{ author = {Yoo SGK and Chung GS and Bahendeka SK and Sibai AM and Damasceno A and Farzadfar F and Rohloff P and Houehanou C and Norov B and Karki KB and Azangoukhyavy M and Marcus ME and Aryal KK and Brant LCC and Theilmann M and Cifkova R and Lunet N and Gurung MS and Mwangi JK and Martins J and Haghshenas R and Sturua L and Vollmer S and Barnighausen T and Atun R and Sussman JB and Singh K and Saeedi Moghaddam S and Guwatudde D and Geldsetzer P and Mannegoehler J and Huffman MD and Davies JI and Flood D}, title = {Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries}, journal = {JAMA}, volume = {330}, number = {8}, pages = {715-724}, year = {2023} }
RIS	TY - JOUR AU - Yoo SGK AU - Chung GS AU - Bahendeka SK AU - Sibai AM AU - Damasceno A AU - Farzadfar F AU - Rohloff P AU - Houehanou C AU - Norov B AU - Karki KB AU - Azangoukhyavy M AU - Marcus ME AU - Aryal KK AU - Brant LCC AU - Theilmann M AU - Cifkova R AU - Lunet N AU - Gurung MS AU - Mwangi JK AU - Martins J AU - Haghshenas R AU - Sturua L AU - Vollmer S AU - Barnighausen T AU - Atun R AU - Sussman JB AU - Singh K AU - Saeedi Moghaddam S AU - Guwatudde D AU - Geldsetzer P AU - Mannegoehler J AU - Huffman MD AU - Davies JI AU - Flood D TI - Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries JO - JAMA VL - 330 IS - 8 SP - 715 EP - 724 PY - 2023 ER -

Style

Citing Format

MLA

Yoo SGK, et al.. "Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries." JAMA, vol. 330, no. 8, 2023, pp. 715-724.

APA

Yoo SGK, Chung GS, Bahendeka SK, Sibai AM, Damasceno A, Farzadfar F, Rohloff P, Houehanou C, Norov B, Karki KB, Azangoukhyavy M, Marcus ME, Aryal KK, Brant LCC, Theilmann M, Cifkova R, Lunet N, Gurung MS, Mwangi JK, ... Flood D (2023). Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries. JAMA, 330(8), 715-724.

Chicago

Yoo SGK, Chung GS, Bahendeka SK, Sibai AM, Damasceno A, Farzadfar F, Rohloff P, et al.. "Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries." JAMA 330, no. 8 (2023): 715-724.

Harvard

Yoo SGK et al. (2023) 'Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries', JAMA, 330(8), pp. 715-724.

Vancouver

Yoo SGK, Chung GS, Bahendeka SK, Sibai AM, Damasceno A, Farzadfar F, et al.. Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries. JAMA. 2023;330(8):715-724.

BibTex

@article{ author = {Yoo SGK and Chung GS and Bahendeka SK and Sibai AM and Damasceno A and Farzadfar F and Rohloff P and Houehanou C and Norov B and Karki KB and Azangoukhyavy M and Marcus ME and Aryal KK and Brant LCC and Theilmann M and Cifkova R and Lunet N and Gurung MS and Mwangi JK and Martins J and Haghshenas R and Sturua L and Vollmer S and Barnighausen T and Atun R and Sussman JB and Singh K and Saeedi Moghaddam S and Guwatudde D and Geldsetzer P and Mannegoehler J and Huffman MD and Davies JI and Flood D}, title = {Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries}, journal = {JAMA}, volume = {330}, number = {8}, pages = {715-724}, year = {2023} }

RIS

TY - JOUR
AU - Yoo SGK
AU - Chung GS
AU - Bahendeka SK
AU - Sibai AM
AU - Damasceno A
AU - Farzadfar F
AU - Rohloff P
AU - Houehanou C
AU - Norov B
AU - Karki KB
AU - Azangoukhyavy M
AU - Marcus ME
AU - Aryal KK
AU - Brant LCC
AU - Theilmann M
AU - Cifkova R
AU - Lunet N
AU - Gurung MS
AU - Mwangi JK
AU - Martins J
AU - Haghshenas R
AU - Sturua L
AU - Vollmer S
AU - Barnighausen T
AU - Atun R
AU - Sussman JB
AU - Singh K
AU - Saeedi Moghaddam S
AU - Guwatudde D
AU - Geldsetzer P
AU - Mannegoehler J
AU - Huffman MD
AU - Davies JI
AU - Flood D
TI - Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries
JO - JAMA
VL - 330
IS - 8
SP - 715
EP - 724
PY - 2023
ER -

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