Prevalence of Acetylsalicylic Acid Use for Primary Prevention of Cardiovascular Disease Amongst Older Adults From 2017-2021: a Retrospective Cross-Sectional Study.

IF 1.6 Q4 GERIATRICS & GERONTOLOGY

Canadian Geriatrics Journal Pub Date : 2023-12-01 DOI:10.5770/cgj.26.693

Jennifer Bolt, Arden R Barry, Colleen Inglis, Stephanie Lin, Jeffrey Pan

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引用次数: 0

Abstract

Background: Three landmark trials on the use of acetylsalicylic acid (ASA) for primary prevention of cardiovascular disease (CVD) were published in 2018. Since then, major clinical practice guidelines have been updated with recommendations against the routine use of ASA for primary CVD prevention, particularly in older adults. However, little is known about the uptake of this evidence into real world practice. The purpose of this study was to assess the change in ASA usage for primary prevention of CVD in older adults between 2017 and 2021.

Methods: A retrospective cross-sectional study of ASA use for primary prevention in ambulatory older adults without known CVD in an urban Canadian city was conducted.

Results: Seven hundred and fifty-six participants were included. The mean age was 78.9 years (standard deviation 7.9) and 64.8% were female. One hundred and thirty (17.2%) participants used ASA for primary prevention, including 20.3% in 2017, 17.0% in 2018, 21.8% in 2019, 16.3% in 2020, and 11.0% in 2021 (p = .061). Female sex was associated with lower ASA use (odds ratio [OR] 0.44, 95% confidence interval [CI] 0.29-0.68) and hypertension was associated with higher ASA use (OR 2.72, 95% CI 1.73-4.29).

Conclusions: Use of ASA for primary CVD prevention in older Canadians decreased between 2017 and 2021, suggesting an uptake of clinical trial data and practice guideline recommendations. Focusing on deprescribing of ASA for primary CVD prevention continues to be warranted, given the risks associated with ASA in this population.

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2017-2021年老年人使用乙酰水杨酸一级预防心血管疾病的患病率:一项回顾性横断面研究

背景:2018年发表了三个关于乙酰水杨酸(ASA)用于心血管疾病(CVD)一级预防的具有里程碑意义的试验。从那时起，主要的临床实践指南已经更新，建议反对常规使用ASA预防原发性心血管疾病，特别是在老年人中。然而，人们对这一证据在现实世界中的应用知之甚少。本研究的目的是评估2017年至2021年间老年人心血管疾病一级预防中ASA使用的变化。方法:回顾性横断面研究ASA用于初级预防在加拿大城市的门诊老年人没有已知的心血管疾病进行。结果:共纳入756名受试者。平均年龄78.9岁(标准差7.9)，女性占64.8%。130名(17.2%)参与者使用ASA进行一级预防，其中2017年为20.3%，2018年为17.0%，2019年为21.8%，2020年为16.3%，2021年为11.0% (p = 0.061)。女性与较低的ASA使用相关(比值比[OR] 0.44, 95%可信区间[CI] 0.29-0.68)，高血压与较高的ASA使用相关(比值比[OR] 2.72, 95% CI 1.73-4.29)。结论:2017年至2021年期间，加拿大老年人使用ASA预防原发性心血管疾病的人数有所下降，这表明临床试验数据和实践指南建议得到了采纳。鉴于ASA在这一人群中的相关风险，将重点放在ASA的初级CVD预防处方上仍然是有必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Canadian Geriatrics Journal Nursing-Gerontology

CiteScore

5.20

自引率

0.00%

发文量

期刊介绍： The Canadian Geriatrics Journal (CGJ) is a peer-reviewed publication that is a home for innovative aging research of a high quality aimed at improving the health and the care provided to older persons residing in Canada and outside our borders. While we gratefully accept submissions from researchers outside our country, we are committed to encouraging aging research by Canadians. The CGJ is targeted to family physicians with training or an interest in the care of older persons, specialists in geriatric medicine, geriatric psychiatrists, and members of other health disciplines with a focus on gerontology.