Increasing aspirin use among persons at risk for cardiovascular events in Oklahoma.

Background: Cardiovascular disease (CVD), including coronary heartdisease (CHD)and stroke, is the leading cause of death in the United States and in Oklahoma; Oklahoma ranks 48th worst in CVD deaths.This paper will present Oklahoma-specific data and review current recommendations regarding aspirin use for the prevention of CVD events.

Methods: Average annual age-adjusted death rates were calculated. Oklahoma Behavioral Risk Factor Surveillance System (BRFSS) data were used to determine past history of CHD, risk factors for CHD and stroke, and aspirin use among persons 45 years and older. A literature review of recommendations regarding aspirin use was conducted.

Results: Between 2005-2008, 14.8% of Oklahomans 45 years of age and older reported a history of coronary heart disease and 6.4% a history of stroke. Approximately 50% of Oklahomans 45 years and older reported a history of hypertension and hypercholesterolemia; 21.5% were current smokers and 16.0% had diabetes. Nearly 10,000 Oklahomans die annually from CHD or stroke. The United States Preventive Services Task Force recommends 81mg per day of aspirin for men 45 to 79 and women 55 to 79 years of age unless they are at risk for bleeding complications. Daily aspirin use in Oklahoma was 44-57% among those with risk factors but no history of CHD or stroke. Fewer than 50% of Oklahomans 45-79 years reported being counseled by a health professional to take aspirin. Among those persons without a history of CVD who were counseled by a healthcare professional regarding aspirin, 79% were taking daily aspirin compared to 18% among persons not counseled. Aspirin sales increased significantly in Stephens County following a multifaceted community-based aspirin campaign.

Conclusion: Low-dose aspirin is being underutilized as a strategy for reducing the excessive numbers of cardiovascular events and deaths in Oklahoma. Health professionals play an important role in educating patients about appropriate use of low-dose aspirin. Community-based interventions can also be effective.