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March 03, 2021
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More patient education needed to ensure proper use of aspirin, statins in older patients

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Many adults aged at least 75 years are taking aspirin for primary CVD prevention despite lack of evidence, whereas many are not taking statins for primary CVD prevention despite strong evidence, researchers reported.

Taeho Greg Rhee, PhD, assistant professor of medicine and public health at Yale School of Medicine and assistant professor of public health science at the University of Connecticut, and colleagues analyzed 11,392 U.S. adults aged 50 years or older (mean age, 64 years; 53% women) from the 2011 to 2018 National Health and Nutrition Examination Survey to determine frequency of aspirin and statin use for CVD prevention.

Aspirin
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Primary prevention treatment eligibility rose from 31.8% in those aged 50 to 54 years to 52% in those aged 75 years or older (P < .001), whereas secondary prevention treatment eligibility rose from 2.7% in those aged 50 to 54 years to 21.1% in those aged 75 years and older (P < .001), the researchers wrote.

Despite evidence that statins are effective and safe for secondary prevention of CVD in older adults, data from the study indicate that statins are underutilized in many adults aged 75 years or older with a history of CVD, the researchers reported. Although statin use increased with age (P < .001) and 56.4% of adults aged 75 years or older reported long-term use of statins, nearly half of those aged 75 years and older were not taking statins, they wrote.

Low-dose daily aspirin use, which is not recommended for primary CVD prevention in most adults, also increased with age (P < .001), the researchers wrote, noting 45.3% of adults aged 75 years and older took low-dose aspirin for primary CVD prevention.

“Further steps are required to increase the use of statins in older adults with existing CVD. The education of both health care providers and their older patients regarding the compelling benefits of using statins for the secondary prevention of CVD is important,” the researchers wrote. “Health care providers should inform their older patients about the appropriate aspirin use, so that they can avoid misuse of aspirin, which can easily be purchased over the counter.”