Comparison of the Racial/ethnic Prevalence of Regular Aspirin Use for the Primary Prevention of Coronary Heart Disease from the Multi-ethnic Study of Atherosclerosis

In 2002, the United States Preventive Services Task Force and the American Heart Association recommended aspirin for the primary prevention of coronary heart disease in patients with Framingham risk scores ≥ 6% and ≥ 10%, respectively. The regular use of aspirin (≥ 3 days/week) was examined in a cohort of 6,452 White, Black, Hispanic, and Chinese patients without cardiovascular disease in 2000 to 2002 and 5,181 patients from the same cohort in 2005 to 2007. Framingham risk scores were stratified into low (<6%), increased (6% to 9.9%), and high (≥ 10%) risk. In 2000 to 2002 prevalences of aspirin use were 18% and 27% for those at increased and high risk, respectively. Whites (25%) used aspirin more than Blacks (14%), Hispanics (12%), or Chinese (14%) in the increased-risk group (p <0.001). Corresponding prevalences for the high-risk group were 38%, 25%, 17%, and 21%, respectively (p <0.001). In 2005 to 2007 prevalences of aspirin use were 31% and 44% for those at increased and high risk, respectively. Whites (41%) used aspirin more than Blacks (27%), Hispanics (24%), or Chinese (15%) in the increased-risk group (p <0.001). Corresponding prevalences for the high-risk group were 53%, 43%, 38%, and 28%, respectively (p <0.001). Racial/ethnic differences persisted after adjustment for age, gender, diabetes, income, and education. In conclusion, regular aspirin use in adults at increased and high risk for coronary heart disease remains suboptimal. Important racial/ethnic disparities exist for unclear reasons.