Low-dose aspirin fails to prevent ischemic cardiac death in black adults
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There is no evidence that low-dose aspirin helps prevent ischemic cardiac death among black adults, researchers reported in the Journal of the American Heart Association.
The researchers analyzed 62,231 non-Hispanic black and white participants from the Southern Community Cohort study aged 40 to 79 years with no history of CVD at baseline (mean age, 52 years; 60% women; 70.2% black) to determine the relationship between low-dose aspirin use and ischemic cardiac death according to race/ethnicity during a median follow-up of 11.3 years.
“Most available data show that African Americans have a higher risk of having a heart attack, stroke or other heart diseases compared to whites; however, previous studies didn’t include enough black participants to determine if taking a low-dose aspirin for primary prevention of heart disease was useful for this group of people,” Rodrigo Fernández-Jiménez, MD, PhD, a cardiologist and researcher at Centro Nacional de Investigaciones Cardiovasculares in Madrid, who during the time of the study was a researcher at Icahn School of Medicine at Mount Sinai, said in a press release.
During the study period, black participants were less likely to take low-dose aspirin than white participants (adjusted OR = 0.79; 95% CI, 0.75-0.82), according to the researchers.
In addition, Fernández-Jiménez and colleagues found, in white participants, there was a trend toward low-dose aspirin use being associated with decreased risk for ischemic cardiac death (aHR = 0.86; 95% CI, 0.68-1.1), driven by women (aHR = 0.72; 95% CI, 0.51-1.02), but the same was not true in black participants (aHR = 1.18; 95% CI, 0.98-1.4).
Among high-risk adults aged 50 to 69 years, the trends were similar (aHR for white adults = 0.78; 95% CI, 0.57-1.08; aHR for black adults = 1.1; 95% CI, 0.88-1.39), which was also the case among adults aged 50 to 59 years, the ages for which guidelines state aspirin may be considered for primary prevention (aHR for white adults = 0.74; 95% CI, 0.49-1.12; aHR for black adults = 1.04; 95% CI, 0.77-1.41).
“We think the reason aspirin use did not have a beneficial effect for African Americans could involve a different genetic response to aspirin therapy and poor control of other risk factors,” Fernández-Jiménez said in the release. “The need to better understand the association between aspirin use, race/ethnicity and socioeconomic status and how these factors play a role in cardiovascular disease are important in light of these findings.” – by Erik Swain
Disclosures: The authors report no relevant financial disclosures.
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