A majority of middle-aged men and women eligible to take aspirin to prevent heart attack and stroke do not recall their doctors ever telling them to do so, according to a University of Rochester study of a national sample of more than 3,000 patients.
Published online by the Journal of General Internal Medicine, the finding illustrates a common disconnect between public health guidelines and what occurs in clinical practice. The UR study is consistent with other research showing that physicians often do not recommend aspirin as prevention therapy to the general population, despite established guidelines by the U.S. Preventative Services Task Force.
Several reasons might explain the reluctance, such as competing demands and limited time to properly assess a patient's eligibility for aspirin, according to lead author Kevin A. Fiscella, M.D., M.P.H., professor of Family Medicine at the UR School of Medicine and Dentistry.
Uncertainty about the benefits of aspirin therapy versus potential harms like bleeding in the digestive track, also hinder physicians' decisions, the study said.
For the JGIM study, Fiscella's group analyzed data from 3,439 patients included in the 2011-'12 National Health and Nutrition Examination Survey (NHANES). None of the patients had cardiovascular disease, but all qualified for aspirin therapy based on their 10-year risk score for factors such as diabetes, high blood pressure, obesity, smoking, and use of cholesterol-lowering medications.
Of the sample, 87 percent of men and 16 percent of women were eligible to take aspirin as a preventive measure. But when they were asked the question -- "Doctors and other health care providers sometimes recommend that you take a low-dose aspirin each day to prevent heart attack, strokes, or cancer. Have you ever been told to do this?" -- a low rate of 34 percent of the men and 42 percent of the women said yes.
Co-author John Bisognano, M.D., Ph.D., director o
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University of Rochester Medical Center