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Community programs increase aspirin use among individuals at high-risk for heart disease

Photo via flickr user Keith Ivey

Community-based programs combining a public health media campaign and health professional education have been shown to improve population-based aspirin use to reduce heart attack and stroke risk, according to new research from the Lillehei Heart Institute and School of Public Health at the University of Minnesota.

Results were published in the Center for Disease Control and Prevention’s journal Preventing Chronic Disease.

Aspirin has long been known to be effective in prevention of blood clots causing heart attack and stroke among high-risk patients. Its use may be particularly beneficial in preventing a first heart attack or stroke in certain individuals.

Current use of aspirin among potentially at-risk individuals without a history of heart disease remains low in Minnesota and across the nation. For the first time, this project sought to evaluate a community program to improve rates of aspirin use among this high-risk population.

The study was conducted by Niki C. Oldenburg, Dr.P.H., vascular research project manager, Alan T. Hirsch, M.D., director of the Vascular Medicine Program, Russell V. Luepker, M.D., professor in the Division of Epidemiology & Community Health, John R. Finnegan, Ph.D., dean of the School of Public Health, and others.

The study utilized the US Preventive Services Task Force recommendations, suggesting aspirin use for men between 45- and 79-years old to prevent a first heart attack and women between 55- and 79-years-old to prevent a first stroke.

Over 18 months, researchers collaborated with three health systems in Hibbing, Minnesota. They utilized several formats to increase awareness and education about aspirin use:

  • Clinic-based educational programs in all primary care clinics
  • Simple aspirin health messages were distributed in 3 media waves
  • Web-based public awareness and social media campaigns

Researchers also utilized cross-sectional population surveys to track aspirin use within the population.

“In most public health efforts to improve preventive behaviors, only small changes are achieved over many years,” said Oldenburg. “However, our research showed regular aspirin use increased rapidly among primary prevention candidates, from 36 percent to 54 percent after 4 months. Equally important, this increase was sustained at 52 percent after 16 months.”

The findings are particularly important as recent public interest in aspirin use is rising, generated by the Food and Drug Administration (FDA) denial of a primary prevention label for marketing aspirin to Bayer Healthcare.  National guidelines recommend aspirin use in populations in which the benefit exceeds risk, but it has previously been unclear how these guidelines might best be applied in real world practice.

“The recent FDA aspirin review simply clarifies that the decision to use aspirin to prevent a first heart attack or stroke is best made in partnership with a health professional,” said Hirsch. “Our study provides a pathway within which an entire community, supported by its health care systems, might safely use aspirin for preventative purposes.”

Funding for this project was provided by generous support from the Lillehei Heart Institute at the University of Minnesota.