Rolka D B, Fagot-Campagna A, Narayan K M
Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Diabetes Care. 2001 Feb;24(2):197-201. doi: 10.2337/diacare.24.2.197.
Since 1997, the American Diabetes Association has recommended that aspirin therapy be considered for adults with diabetes who have cardiovascular disease (CVD) or CVD risk factors. We examined the prevalence of regular aspirin use among adults in the U.S. with diagnosed diabetes.
The Third National Health and Nutrition Examination Survey (1988-1994) used a probability sample of the U.S. population and included an interview, physical examination, and laboratory studies. Among the survey participants were 1,503 adults (age > or =21 years) with self-reported diabetes. We defined regular aspirin use as reported having taken aspirin > or = 15 times in the previous month. CVD conditions were self-reported heart attack and stroke and symptoms of angina and claudication. CVD risk factors included smoking, hypertension, obesity, albuminuria, lipid abnormalities, and family history of heart attack.
An estimated 27% of adults with diabetes had CVD, and an additional 71% had one or more CVD risk factors. Aspirin was used regularly by 37% of those with CVD and by 13% of those with risk factors only Adjusted odds of regular aspirin use were significantly greater for individuals with CVD than for those with one CVD risk factor (odds ratio [OR] = 4.3); for non-Hispanic whites than for blacks, Mexican-Americans, and others (OR = 2.5); and for individuals age 40-59 years than for those <40 years (OR = 33.3).
Nearly every adult in the U.S. with diabetes has at least one risk factor for CVD and thus may be considered a potential candidate for aspirin therapy. During 1988-1994, only 20% (95% CI 16-23) took aspirin regularly Major efforts are needed to increase aspirin use.
自1997年以来，美国糖尿病协会建议，对于患有心血管疾病（CVD）或有CVD风险因素的糖尿病成年人，应考虑采用阿司匹林治疗。我们调查了美国已确诊糖尿病的成年人中经常使用阿司匹林的情况。
第三次全国健康和营养检查调查（1988 - 1994年）采用了美国人口概率样本，包括访谈、体格检查和实验室研究。调查参与者中有1503名自我报告患有糖尿病的成年人（年龄≥21岁）。我们将经常使用阿司匹林定义为报告在前一个月服用阿司匹林≥15次。CVD状况为自我报告的心脏病发作、中风以及心绞痛和间歇性跛行症状。CVD风险因素包括吸烟、高血压、肥胖、蛋白尿、血脂异常以及心脏病发作家族史。
估计27%的糖尿病成年人患有CVD，另外71%有一个或多个CVD风险因素。患有CVD的人中有37%经常使用阿司匹林，仅有风险因素的人中有13%经常使用。CVD患者经常使用阿司匹林的校正比值比显著高于仅有一个CVD风险因素的人（比值比[OR]=4.3）；非西班牙裔白人高于黑人、墨西哥裔美国人及其他人（OR = 2.5）；40 - 59岁的人高于40岁以下的人（OR = 33.3）。
美国几乎每位患有糖尿病的成年人都至少有一个CVD风险因素，因此可能被视为阿司匹林治疗的潜在候选者。在1988 - 1994年期间，只有20%（95%可信区间16 - 23）的人经常服用阿司匹林。需要做出重大努力来增加阿司匹林的使用。
