Graphic summary
Background and objectives
Aspirin therapy for the primary prevention of cardiovascular disease (CVD) is controversial and guideline recommendations have changed over the past decades.
We report temporal trends in aspirin use for primary prevention among people with and without diabetes and describe the characteristics of incident aspirin users.
Methods
Using Danish national registries, we identified incident and prevalent aspirin users in a population of subjects ≥40 years without CVD eligible for primary preventive aspirin therapy from 2000 to 2020. Temporal trends were assessed in aspirin users with and without diabetes, as well as CVD risk factors among incident users.
Results
A total of 522,680 people began aspirin therapy during the study period. The number of incident users peaked in 2002 (39,803 people, 1.78% of the eligible population) and was the lowest in 2019 (11,898 people, 0.49%), with similar trends for subjects with and without diabetes .
The percentage of incident users without CVD risk factors (diabetes, hypertension, hypercholesterolemia, or chronic obstructive pulmonary disease (an indicator of smoking)) decreased from 53.9% in 2000 to 30.9% in 2020.
Temporal trends in predominant aspirin users followed a unimodal curve, peaking at 7.7% in 2008 and being 3.3% in 2020. For subjects with diabetes, the peak was observed in 2009 with 38. 5% and decreased to 17.1% in 2020.
Conclusion Aspirin therapy for primary prevention of CVD has declined over the past two decades. However, the drug continued to be used in people with and without diabetes , and a large proportion of people who started aspirin therapy had no risk factors for CVD. |
