Tchwenko Samuel, Fleming Eleanor, Perry Geraldine S
North Carolina Division of Public Health, Raleigh, North Carolina, and Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Epidemiology and Surveillance Branch, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 3311 Toledo Rd, Hyattsville, MD 20782. Email:
Prev Chronic Dis. 2015 Nov 19;12:E202. doi: 10.5888/pcd12.150342.
The US Preventive Services Task Force recommends aspirin use for men aged 45 to 79, when the potential benefit of preventing myocardial infarctions outweighs the potential harm of gastrointestinal hemorrhage. We determined prevalence and predictors of aspirin use for primary prevention of myocardial infarction vis-à-vis risk among men aged 45 to 79 in North Carolina.
The study used data for men aged 45 to 79 without contraindications to aspirin use or a history of cardiovascular disease from the 2013 North Carolina Behavioral Risk Factor Surveillance System survey. Stratification by risk of myocardial infarction was based on history of diabetes, high cholesterol, high blood pressure, and smoking. Analyses were performed in Stata version 13.0 (StataCorp LP); survey commands were used to account for complex sampling design.
Most respondents, 74.2% (95% confidence interval [CI], 71.2%-77.0%), had at least one risk factor for myocardial infarction. Prevalence of aspirin use among respondents with risk factors was 44.8% (95% CI, 41.0-48.5) and was significantly higher than the prevalence among respondents without risk factors (prevalence ratio: 1.44 [95% CI, 1.17-1.78]). No significant linear dose (number of risk factors)-response (taking aspirin) relationship was found (P for trend = .25). Older age predicted (P = .03) aspirin use among respondents with at least one myocardial infarction risk factor.
Most men aged 45 to 79 in North Carolina have at least one risk factor for myocardial infarction, but less than half use aspirin. Interventions aimed at boosting aspirin use are needed among at-risk men in North Carolina.
美国预防服务工作组建议，对于45至79岁的男性，当预防心肌梗死的潜在益处超过胃肠道出血的潜在危害时，可使用阿司匹林。我们确定了北卡罗来纳州45至79岁男性中，使用阿司匹林进行心肌梗死一级预防的患病率及其与风险的预测因素。
本研究使用了2013年北卡罗来纳州行为危险因素监测系统调查中，45至79岁且无阿司匹林使用禁忌或心血管疾病史男性的数据。根据糖尿病、高胆固醇、高血压和吸烟史对心肌梗死风险进行分层。分析使用的是Stata 13.0版本（StataCorp LP）；使用调查命令来考虑复杂的抽样设计。
大多数受访者（74.2%，95%置信区间[CI]，71.2%-77.0%）至少有一项心肌梗死危险因素。有危险因素的受访者中阿司匹林使用率为44.8%（95% CI，41.0-48.5），显著高于无危险因素的受访者（患病率比：1.44 [95% CI，1.17-1.78]）。未发现显著的线性剂量（危险因素数量）-反应（服用阿司匹林）关系（趋势P值 = 0.25）。年龄较大是至少有一项心肌梗死危险因素的受访者使用阿司匹林的预测因素（P = 0.03）。
北卡罗来纳州大多数45至79岁的男性至少有一项心肌梗死危险因素，但使用阿司匹林的不到一半。北卡罗来纳州有风险的男性需要采取干预措施来提高阿司匹林的使用率。
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