McCallum A K, Whincup P H, Morris R W, Thomson A, Walker M, Ebrahim S
Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, London.
Br J Gen Pract. 1997 Jul;47(420):417-21.
Since the 1980s, clinical trial evidence has supported aspirin use in the secondary prevention of cardiovascular disease (CVD).
To explore aspirin use among British men with known CVD in a population-based study.
Longitudinal study (British Regional Heart Study), in which subjects have been followed up for cardiovascular morbidity and mortality since 1978-1980. Aspirin use was assessed by questionnaires to study participants in November 1992 (Q92); cardiovascular diagnoses are based on general practice notifications to October 1992. A total of 5751 men aged 52-73 years (87% of survivors) completed questions on aspirin use.
Overall, 547 men (9.5%) were taking aspirin daily, of whom 321 (59%) had documented CVD. Among men with pre-existing disease, 153 out of 345 (44%) men with myocardial infarction, 42 out of 109 (39%) with stroke, and 75 out of 247 (29%) with angina were taking aspirin daily. Among men with angina (54% versus 26%) or myocardial infarction (59% versus 42%), those who had undergone coronary artery bypass surgery (CABG) or angioplasty were more likely to be receiving aspirin. Higher rates of aspirin use were also found in those whose last major event occurred after January 1990 (47% versus 34%). There was no association between aspirin use and social class or region of residence.
Despite strong evidence of its effectiveness, many patients with established CVD were not receiving aspirin. Daily aspirin treatment was less likely in men with less recent major CVD events and in those who had not received invasive treatment.
自20世纪80年代以来，临床试验证据支持阿司匹林用于心血管疾病（CVD）的二级预防。
在一项基于人群的研究中探讨已知患有CVD的英国男性使用阿司匹林的情况。
纵向研究（英国地区心脏研究），自1978 - 1980年以来对受试者进行心血管疾病发病率和死亡率的随访。1992年11月通过问卷调查研究参与者的阿司匹林使用情况（Q92）；心血管疾病诊断基于截至1992年10月的全科医疗通知。共有5751名年龄在52 - 73岁的男性（幸存者的87%）完成了关于阿司匹林使用的问题。
总体而言，547名男性（9.5%）每天服用阿司匹林，其中321名（59%）有记录的CVD。在已有疾病的男性中，345名心肌梗死男性中有153名（44%）、109名中风男性中有42名（39%）、247名心绞痛男性中有75名（29%）每天服用阿司匹林。在心绞痛（54%对26%）或心肌梗死（59%对42%）患者中，接受过冠状动脉搭桥手术（CABG）或血管成形术的患者更有可能接受阿司匹林治疗。在最后一次重大事件发生在1990年1月之后的患者中，阿司匹林使用率也更高（47%对34%）。阿司匹林使用与社会阶层或居住地区之间没有关联。
尽管有充分证据证明其有效性，但许多已确诊的CVD患者未接受阿司匹林治疗。近期重大CVD事件较少的男性以及未接受侵入性治疗的男性每天服用阿司匹林治疗的可能性较小。
