Adherence to European guidelines for the use of aspirin in primary health care

Abstract

Introduction and objectives: Cardiovascular disease remains a leading cause of global morbidity and mortality. The administration of low doses of aspirin in secondary prevention of atherosclerotic cardiovascular disease (ASCVD) has been clearly established. However, the most recent guidelines do not recommend aspirin in primary prevention, reserving it for high-risk patients and after a risk/benefit assessment. The aim of this study was to assess adherence to European guidelines for the use of aspirin in primary and secondary prevention of ASCVD in primary health care.

Methods: The study population consisted of individuals aged >50 years registered at two primary health care units without (primary prevention) and with previous ASCVD events (secondary prevention).

Results: We studied a total of 1262 individuals, 720 in primary prevention and 542 in secondary prevention. A total of 61 individuals (8.5%) were under aspirin therapy in primary prevention, most of them taking 150 mg/day (57%). In secondary prevention, 195 patients (27%) were receiving aspirin only, most taking 150 mg/day (52%), and 166 patients (31%) were not under any antithrombotic or anticoagulant therapy. The 100 mg dosage was predominant in patients with ischemic heart disease with (64%) and without (64%) angina, as well as those with myocardial infarction (61.5%) and peripheral vascular disease (62%).

Conclusions: In this study, the prevalence of aspirin use in primary prevention was 8.5%. We found that 30% of patients were not taking either antithrombotic or anticoagulation therapy in secondary prevention. In both primary and secondary prevention, the 150 mg dosage was predominant.

Keywords: Aspirin; Cardiometabolic risk factors; Cuidados de saúde primários; Fatores de risco cardiovascular; Prevenção primária; Prevenção secundária; Primary health care; Primary prevention; Secondary prevention; Ácido acetilsalicílico.