Age-Related Trajectories of Cardiovascular Risk and Use of Aspirin and Statin Among U.S. Adults Aged 50 or Older, 2011-2018.
J Am Geriatr Soc. 2021 05; 69(5):1272-1282.JA

Abstract

OBJECTIVES

To examine age-related trajectories of cardiovascular risk and use of aspirin and statin among U.S. adults aged 50 or older.

DESIGN

Repeated cross-sectional study using data from 2011 to 2018 National Health and Nutrition Examination Surveys.

SETTING

Nationally representative health interview survey in the United States.

PARTICIPANTS

Non-institutionalized adults aged 50 years and older (n = 11,392 unweighted).

MEASUREMENTS

Primary prevention was defined as the prevention of a first cardiovascular event including coronary heart disease, angina/angina pectoris, heart attack, or stroke, whereas secondary prevention was defined as those with a history of these clinical conditions. Medication use was determined by self-report; aspirin use included dose and frequency, and statin use included generic names, days of prescription fills, and indications. We examined linear trends between age and each medication use, after controlling for period, sex, and race/ethnicity.

RESULTS

Prevalence of those eligible for primary prevention treatment increased with age from 31.8% in ages 50-54 to 52.0% in ages ≥75 (p < 0.001). Similarly, those eligible for secondary prevention treatment increased with age from 2.7% in ages 50-54 to 21.1% in ages ≥75 (p < 0.001). Low-dose daily aspirin use increased with age (p < 0.001), and 45.3% of adults aged ≥75 took low-dose aspirin daily for primary prevention. Statin use also increased with age (p < 0.001), and 56.4% of adults aged ≥75 had long-term statin use for secondary prevention.

CONCLUSION

While adults aged ≥75 do not benefit from the use of aspirin to prevent the first CVD, many continue to take aspirin on a regular basis. In spite of the clear benefit of statin use to prevent a subsequent CVD event, many older adults in this risk category are not taking a statin. Further education and guidance for both healthcare providers and older adults regarding the appropriate use of aspirin and statins to prevent CVD is needed.

Links

PMC Free PDF

Authors+Show Affiliations

Rhee TG

Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut, USA. Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.

Kumar M

Pat and Jim Calhoun Cardiology Center, University of Connecticut Health, Farmington, Connecticut, USA. Department of Internal Medicine, University of Connecticut School of Medicine, Farmington, Connecticut, USA.

Ross JS

Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA. Yale Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Health System, New Haven, Connecticut, USA. Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA.

Coll PP

Center on Aging, University of Connecticut Health, Farmington, Connecticut, USA. Department of Family Medicine, University of Connecticut School of Medicine, Farmington, Connecticut, USA.

MeSH

Age FactorsAgedAged, 80 and overAspirinCardiovascular DiseasesCross-Sectional StudiesFemaleHeart Disease Risk FactorsHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedNutrition SurveysPrevalencePrimary PreventionSecondary PreventionUnited States

Pub Type(s)

Journal Article

Research Support, N.I.H., Extramural

Research Support, Non-U.S. Gov't

Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

33598936

Citation

Rhee, Taeho Greg, et al. "Age-Related Trajectories of Cardiovascular Risk and Use of Aspirin and Statin Among U.S. Adults Aged 50 or Older, 2011-2018." Journal of the American Geriatrics Society, vol. 69, no. 5, 2021, pp. 1272-1282.

Rhee TG, Kumar M, Ross JS, et al. Age-Related Trajectories of Cardiovascular Risk and Use of Aspirin and Statin Among U.S. Adults Aged 50 or Older, 2011-2018. J Am Geriatr Soc. 2021;69(5):1272-1282.

Rhee, T. G., Kumar, M., Ross, J. S., & Coll, P. P. (2021). Age-Related Trajectories of Cardiovascular Risk and Use of Aspirin and Statin Among U.S. Adults Aged 50 or Older, 2011-2018. Journal of the American Geriatrics Society, 69(5), 1272-1282. https://doi.org/10.1111/jgs.17038

Rhee TG, et al. Age-Related Trajectories of Cardiovascular Risk and Use of Aspirin and Statin Among U.S. Adults Aged 50 or Older, 2011-2018. J Am Geriatr Soc. 2021;69(5):1272-1282. PubMed PMID: 33598936.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Age-Related Trajectories of Cardiovascular Risk and Use of Aspirin and Statin Among U.S. Adults Aged 50 or Older, 2011-2018. AU - Rhee,Taeho Greg, AU - Kumar,Manish, AU - Ross,Joseph S, AU - Coll,Patrick P, Y1 - 2021/02/17/ PY - 2021/2/19/pubmed PY - 2021/9/29/medline PY - 2021/2/18/entrez KW - aspirin KW - cardiovascular KW - pharmaco-epidemiology KW - statin SP - 1272 EP - 1282 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 69 IS - 5 N2 - OBJECTIVES: To examine age-related trajectories of cardiovascular risk and use of aspirin and statin among U.S. adults aged 50 or older. DESIGN: Repeated cross-sectional study using data from 2011 to 2018 National Health and Nutrition Examination Surveys. SETTING: Nationally representative health interview survey in the United States. PARTICIPANTS: Non-institutionalized adults aged 50 years and older (n = 11,392 unweighted). MEASUREMENTS: Primary prevention was defined as the prevention of a first cardiovascular event including coronary heart disease, angina/angina pectoris, heart attack, or stroke, whereas secondary prevention was defined as those with a history of these clinical conditions. Medication use was determined by self-report; aspirin use included dose and frequency, and statin use included generic names, days of prescription fills, and indications. We examined linear trends between age and each medication use, after controlling for period, sex, and race/ethnicity. RESULTS: Prevalence of those eligible for primary prevention treatment increased with age from 31.8% in ages 50-54 to 52.0% in ages ≥75 (p < 0.001). Similarly, those eligible for secondary prevention treatment increased with age from 2.7% in ages 50-54 to 21.1% in ages ≥75 (p < 0.001). Low-dose daily aspirin use increased with age (p < 0.001), and 45.3% of adults aged ≥75 took low-dose aspirin daily for primary prevention. Statin use also increased with age (p < 0.001), and 56.4% of adults aged ≥75 had long-term statin use for secondary prevention. CONCLUSION: While adults aged ≥75 do not benefit from the use of aspirin to prevent the first CVD, many continue to take aspirin on a regular basis. In spite of the clear benefit of statin use to prevent a subsequent CVD event, many older adults in this risk category are not taking a statin. Further education and guidance for both healthcare providers and older adults regarding the appropriate use of aspirin and statins to prevent CVD is needed. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/33598936/Age_Related_Trajectories_of_Cardiovascular_Risk_and_Use_of_Aspirin_and_Statin_Among_U_S__Adults_Aged_50_or_Older_2011_2018_ DB - PRIME DP - Unbound Medicine ER -

Tags

Age-Related Trajectories of Cardiovascular Risk and Use of Aspirin and Statin Among U.S. Adults Aged 50 or Older, 2011-2018.J Am Geriatr Soc. 2021 05; 69(5):1272-1282.JA