Aspirin use in patients with diagnosed diabetes in the United States and China: Nationally representative analysis

Q: What are the key findings of this study?

Aspirin use for secondary prevention in diabetic patients was 73.8% in the United States and 53.5% in China, with similarly higher rates for primary prevention in the US.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Diabetes (n=2567). Intervention: Aspirin. Primary outcome: Percentage of aspirin use for primary and secondary cardiovascular prevention.

Xin Wang; Guang Hao; Zuo Chen; Linfeng Zhang; Yuting Kang; Ying Yang; Congyi Zheng; Haoqi Zhou; Lu Chen; Zengwu Wang; Runlin Gao

doi:10.1177/14791641211067416

November 1, 2021Diabetes and Vascular Disease ResearchOpen Access

Aspirin use in patients with diagnosed diabetes in the United States and China: Nationally representative analysis

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Key result

Aspirin use for secondary prevention in diabetes is ~20 points higher in the US than China.

n=2,567

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Why the study?

Epidemiological data on aspirin use in diabetic patients was very limited.

What is the prevalence of aspirin use for primary and secondary cardiovascular prevention among diabetic patients in the US and China?

Key Points

To examine the current status and patterns of aspirin use for primary and secondary cardiovascular prevention among adults with diagnosed diabetes in the United States and China.
Cross-sectional analysis of nationally representative data from the National Health and Nutrition Examination Survey (NHANES cycles 2011–2012, 2013–2014, and 2014–2015; N=964) and the China Hypertension Survey (CHS 2012–2015; N=1603 eligible) among individuals aged 40–75 years with diabetes.
Participants were categorized by established atherosclerotic cardiovascular disease (ASCVD) status and 10-year predicted ASCVD risk categories (low <7.5%, intermediate 7.5%–15%, and high ≥15%).
In the United States, aspirin was used by 73.8% (95% CI: 48.7–65.1%) of diabetic patients with established ASCVD, compared to 53.5% (95% CI: 36.2–70.0%) in China.
For primary prevention in the United States, aspirin use among high ASCVD risk patients was 54.5% (95% CI: 44.2–64.4%) in men and 37.1% (95% CI: 26.1–49.5%) in women (p = .052), with 55.1% in intermediate-risk and 35.0% in low-risk individuals.
In China, primary prevention aspirin use was 14.3% (95% CI: 6.2–29.9%) in high-risk, 9.7% (95% CI: 3.5–2.4%) in intermediate-risk, and 3.2% (95% CI: 1.1–8.8%) in low-risk diabetic patients, with significantly lower use in rural versus urban areas across all risk tiers (p < .001).

Study Design

Type

Cross-Sectional (n=2,567)

Multicenter

Yes

Structured PICO

What is the prevalence of aspirin use for primary and secondary cardiovascular prevention among diabetic patients in the US and China?

P

Population

2,567 diabetic adults aged 40-75 years from two nationally representative surveys in the US and China, assessed for aspirin use.

E

Exposure

Aspirin use

O

Outcome

Percentage of aspirin use

Aspirin use for cardiovascular prevention in diabetic patients remains suboptimal, especially in China and rural areas, emphasizing the need for improved guideline adherence.

Limitations

CHS did not collect data on traditional Chinese medicine for CVD prevention
Certain variables in NHANES and CHS are based on self-reporting, so recall bias may exist
Certain variables are based on self-reporting, so recall bias may exist

Implication

Disparities in aspirin use among diabetics signal need for targeted strategies; leaves open drivers of gaps and impact on outcomes.

Abstract

BACKGROUND: The epidemiological data on the use of aspirin in diabetic patients is very limited. The main purpose of this study is to examine the current status of aspirin use in the United States (US) and China in large representative populations. METHODS: Data came from the National Health and Nutrition Examination Survey (NHANES) and China Hypertension Survey (CHS), two nationally representative cross-sectional studies. The percentages of aspirin use in diabetic patients with intermediate and low ASCVD risk were 55.1% and 35.0%, respectively. In China, the percentage of aspirin use in diabetic patients with ASCVD was 53.5%, and were 14.3%, 9.7%, and 3.2% among diabetic patients with high, intermediate, and low ASCVD risk, respectively. CONCLUSIONS: In summary, the percentage of aspirin use in primary prevention in US diabetic patients in men was higher than in women, and this percentage for primary and secondary prevention in US patients was higher than that in Chinese patients.

Discussion

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Cite This Study

Wang et al. (2021) conducted a cross-sectional in Diabetes (n=2,567). Aspirin was evaluated on Percentage of aspirin use for primary and secondary cardiovascular prevention. Aspirin use for secondary prevention in diabetic patients was 73.8% in the United States and 53.5% in China, with similarly higher rates for primary prevention in the US.

synapsesocial.com/papers/6a2bd762cc08aa948afacbcc https://doi.org/10.1177/14791641211067416

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Aspirin use in patients with diagnosed diabetes in the United States and China: Nationally representative analysis

Figures

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Aspirin use in patients with diagnosed diabetes in the United States and China: Nationally representative analysis

Figures

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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