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Discuss Daily Aspirin Use: Charts |
Discuss Daily Aspirin Use for the Primary Prevention
of Cardiovascular Events |
| Burden of Disease |
Mortality1
480,000 Americans die each year from coronary heart disease (CHD) |
Morbidity2
565,000 Americans suffer an incident myocardial infarction each year; 300,000 suffer a recurrent myocardial infarction
Approximately 34% of MIs result in disabling congestive heart failure within 6 years.3 |
| Effectiveness |
Clinical trials indicate that aspirin prevents 30% of fatal and/or nonfatal CHD events.4 |
| Improvability |
Counseling Rates
The extent to which clinicians are currently counseling patients on the benefits and harms of aspirin use is unknown.
Aspirin Use5
36% of Americans 35 years and older take aspirin regularly |
| Cost6 |
Annual Per Person Medical Cost of Service: $25 |
| Annual Per Person Medical Cost of Savings: $95 |
| Annual Net Costs: $-70 |
| % of Service Recovered in Long Run: 380% |
Sources and Footnotes:
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1.
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Hoyert DL, Kung HC, Smith BL. Deaths:preliminary data for 2003. Natl Vital Stat Rep 2005 Feb 28;53(15):1-48. |
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2.
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Thom T, Haase N, Rosamond W, Howard VJ, Runsfeld J, Manolio T, Zheng ZJ, Flegal K, O'Donnell C, Kittner S, et al. Heart disease and stroke statistics 2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2006 Feb 14;113(6):e85-151. |
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3.
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Hurst's The Heart. Eleventh Edition ed. United States of American:McGraw-Hill Medical Publishing Division;2004. (Fuster, V; Alexander, RW; O'Rourke, RA, et al., editors. |
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4.
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Refer to the technical report on aspirin prophylaxis for a fuller discussion of these data and references. |
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5.
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Ajani UA, Ford ES, Greenland KJ, Giles WH, Mokdad AH. Aspirin use among U.S. adults behavioral risk factor surveillance system. Am J Prev Med 2006 Jan;30(1):74-7. |
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6.
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Five notes on costs and savings: 1) Costs and savings are expressed in year 2005 dollars. 2) Costs and savings are expressed as the per person cost per year over the recommended age range to facilitate use in estimating long-term budget impact. 3) Costs and savings are not discounted to facilitate use in estimating long-term budget impact. As a result, they are not comparable to estimates that would be used in formal cost-effectiveness analysis. Services that are cost-saving from a budgetary perspective may not be cost-saving in an economic analysis that discounts future events to their present value. 4) Costs and savings reflect non-adherence and the recommended frequency of delivery. Therefore, services with less frequent intervals or with lower adherence would have a lower cost than an otherwise identical service. 5) Costs reflect both initial preventive service costs (such as screening and counseling) and necessary follow-up costs such as diagnostic testing, pharmacotherapy, and intensive interventions for weight loss. |
CHD Deaths
479,304(2003) |
| |
Rate per 100,000 (2002) |
| Total* |
170.8 |
| Gender* |
|
| Male |
220.4 |
| Female |
133.6 |
| Race* |
|
| White |
169.8 |
| Black or African American |
203.0 |
| American Indian or Alaska Native |
114.0 |
| Asian or Pacific Islander |
98.6 |
| Hispanic or Latino |
138.3 |
| White, not Hispanic or Latino |
171.0 |
| Age |
|
| 20-24 years |
0.5 |
| 25-34 years |
2.5 |
| 35-44 years |
17.1 |
| 45-54 years |
63.8 |
| 55-64 years |
177.7 |
| 65-74 years |
458.9 |
| 75-84 years |
1220.2 |
| 85 years and over |
3775.0 |
Sources:
National Center for Health Statistics, Health United States 2005, With Chartbook on Trends in the Health of Americans. Hyattsville, MD: 2004.
Hoyert DL, Kung HC, Smith BL. Deaths: preliminary data for 2003. Natl Vital Stat Rep 2005 Feb 28;53(15):1-48.
CDC Wonder - Compressed Mortality File - Underlying cause-of-death. [Web Page]; http://wonder.cdc.gov/mortSQL.html. [Accessed 28 Mar 2006].
* age adjusted
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Morbidity
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| |
CHD |
MI |
CHF |
| |
% ever had CHD |
Annual incidence
of CHD per 1000* |
% ever had MI** |
% ever had CHF |
| Total |
6.9% |
|
3.5% |
2.3% |
| Total males |
8.4% |
|
5.0% |
2.6% |
| Total females |
5.6% |
|
2.3% |
2.1% |
| Non-Hispanic white males |
8.9% |
12.5 |
5.1% |
2.5% |
| Non-Hispanic white females |
5.4% |
10.6 |
2.4% |
1.9% |
| Non-Hispanic black males |
7.4% |
4.0 |
4.5% |
3.1% |
| Non-Hispanic black females |
7.5% |
5.1 |
2.7% |
3.5% |
| Mexican-American males |
5.6% |
|
3.4% |
2.7% |
| Mexican-American females |
4.3% |
|
1.6% |
1.6% |
| Hispanic or Latino |
4.5% |
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| Asian |
3.8% |
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| American Indian/Alaska Native |
8.2% |
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Source: Thom T, Haase N, Rosamond W, Howard VJ, Rumsfeld J, Manolio T, Zheng ZJ, Flegal K, O'Donnell C, Kittner S, et al. Heart disease and stroke statistics--2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2006 Feb 14;113(6):e85-151.
* estimated as rate per 1000 person years
** myocardial infarction (heart attack)
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Regular Aspirin Use
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| CHARACTERISTICS |
Taking Aspirin*
% |
Adjusted**
prevalence % |
| Age (years) |
|
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| 35-64 |
29.1% |
31.4% |
| > 65 |
60.7% |
54.0% |
| Gender |
|
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| Male |
39.0% |
38.5% |
| Female |
33.6% |
34.0% |
| Race/Ethnicity |
|
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| White |
38.2% |
37.6% |
| African American |
29.2% |
30.4% |
| Hispanic |
29.1% |
33.3% |
| Other |
30.6% |
32.6% |
| Education (years) |
|
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| < High school |
46.8% |
35.4% |
| High school |
37.9% |
35.9% |
| > High school |
33.3% |
36.6% |
| Cardiovascular disease |
|
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| Absent |
30.6% |
32.7% |
| Present |
82.9% |
69.3% |
| Diabetes mellitus |
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| Absent |
33.4% |
35.2% |
| Present |
62.6% |
46.6% |
Source:
Ajani UA, Ford ES, Greenland KJ, Giles WH, Mokdad AH. Aspirin use among U.S. adults behavioral risk factor surveillance system. Am J Prev Med 2006 Jan;30(1):74-7.
* Taking aspirin defined as daily or every-other-day aspirin use
**Adjusted for age (except age groups) and all other characteristics included in the table |
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