Aspirin is a common, inexpensive medication that has been proven to significantly reduce the risk of having another heart attack or stroke for those who have already suffered from one.
Despite its clear benefits and low cost, a study led by researchers from the Washington University School of Medicine in St. Louis and the University of Michigan reveals a surprising fact: less than half of the people around the world who have had a heart attack or stroke take aspirin to prevent another one.
Heart attacks and strokes are the leading causes of death globally, making the prevention of these cardiovascular events a critical public health issue.
Research from the 1970s and 1980s established that aspirin, as part of antiplatelet therapy, can lower the risk of a subsequent cardiovascular event by about 25%.
Given its effectiveness and affordability, with a monthly supply costing between $2 to $8 in the U.S., daily aspirin therapy is widely recommended for people with a history of these conditions.
The study analyzed data from health surveys conducted in 51 countries of varying income levels and found that the use of aspirin among those eligible—those who have had a previous heart attack or stroke—was disappointingly low.
This underuse was most pronounced in low-income countries, where only 16.6% of those eligible were taking aspirin.
The percentage was slightly higher in lower-middle-income countries at 24.5%, and it increased to 51.1% and 65% in upper-middle and high-income countries, respectively.
Dr. David Flood, a senior author of the study and an assistant professor at the University of Michigan, along with first author Dr. Sang Gune Yoo, point out the high risk of subsequent heart attacks or strokes among survivors.
They emphasize the life-saving potential of daily aspirin use, which remains largely unexploited.
The researchers suggest several reasons for the underuse of aspirin, including limited access to healthcare, inconsistent advice on aspirin use, and the requirement of a prescription in some countries.
Despite its benefits, aspirin is severely underutilized, a situation that hasn’t improved significantly despite international efforts to enhance access to essential cardiovascular disease medicines since 2011.
The study underscores the urgent need for interventions to promote the use of aspirin among those at risk of a second heart attack or stroke.
Dr. Yoo suggests that these interventions should be multifaceted, taking into account the specific contexts of different countries.
He proposes leveraging existing healthcare infrastructure used for managing chronic conditions like HIV/AIDS, especially in lower-middle-income countries, to improve access to aspirin and other cardiovascular disease treatments.
By targeting places where aspirin is readily available, such as pharmacies and primary care settings, and understanding the barriers to its use, the researchers hope to develop strategies that increase the adoption of this evidence-based therapy.
Their goal is to prevent further heart attacks and strokes, saving lives and improving health outcomes for individuals with cardiovascular disease worldwide.
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The research findings can be found in JAMA.
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