Association between prophylactic aspirin use and hypertension using data from NHANES 2011–2018

Aspirin may be necessary for some patients with cardiovascular disease, but previous studies on the use and dosage of aspirin and the association with hypertension have been inadequate. The results of existing studies have been somewhat inconsistent. Our study was designed to assess the association between prophylactic aspirin use and hypertension in U.S. adults. This cross-sectional study analyzed a nationally representative sample of U.S. adults aged 40 and older from the National Health and Nutrition Examination Survey (2011-2018). Aspirin was categorized as no use, low dose (≤ 100 mg), and high dose (> 100 mg). Hypertension was defined as the average of three consecutive blood pressure readings (systolic ≥ 140 mmHg or diastolic ≥ 90 mmHg). There were 5297 participants, comprising 52.5% male and 47.4% female. The median age was 64 years (range: 56 to 72) and 3635 individuals were diagnosed with high blood pressure. Among the groups, the incidence of hypertension was 70.2% in the non-aspirin group, 68.3% in the low-dose group, and 68.0% in the high-dose group, with no statistically significant difference observed (p = 0.71). Using a fully adjusted weighted multivariate logistic regression model 4, prophylactic aspirin use was not associated with hypertension [(odds ratio [OR] 1.11; 95% CI (0.89-1.38), (odds ratio [OR] 1.15; 95% CI 0.82-1.61), P = 0.31]. Subgroup analyses, along with sensitivity analyses that excluded patients with diabetes and reclassified aspirin use status, confirmed the findings of the main study. In this nationally representative cohort of U.S. adults, no significant association was found between aspirin use or dosage and the prevalence of hypertension.