Low-Dose Aspirin Does Not Prevent Primary CV Events in Blacks

Low-dose aspirin use does not appear to provide any primary preventive benefits for cardiovascular (CV) events among black adults, according to findings of the Southern Community Cohort Study (SCCS).

To determine low‐dose aspirin’s role in the primary prevention of cardiovascular disease (CVD) among different racial and ethnic groups, the researchers enrolled 65,231 non‐Hispanic blacks and whites who were aged 40 to 79 years in the SCCS. These predominantly high‐risk, low‐income patients were all from the Southeastern United States and had no history of CVD. Study enrollment occurred from 2002 through 2009.

Upon entry, data on the participants’ low‐dose aspirin use and clinical and socioeconomic covariates were collected. Doing this, the researchers determined that—regardless of CVD risk and covariates—black participants were less likely to use low‐dose aspirin than their white counterparts for primary prevention of CVD (18% vs 27%).

At cohort entry, the researchers also calculated each participant’s simplified Framingham 10‐year CVD risk. 

The researchers then calculated the race‐ and ethnicity‐specific adjusted odds ratios for characteristics of low‐dose aspirin users as well as the hazard ratios for ischemic cardiac death according to aspirin use.

Over a median follow‐up of 11.3 years, low‐dose aspirin use was associated with a trend toward decreased risk of ischemic cardiac death in white participants—especially in women—but not in black participants.

When the researchers restricted their analysis to include only high‐risk individuals aged 50 to 69 years or aged 50 to 59 years, the trends were similar.

“Low‐dose aspirin use for primary prevention of [CVD] was consistently lower among black than white participants, and its use might be associated with a disparate impact on ischemic cardiac death according to race and ethnicity,” according to the researchers. “Although additional studies are required, our findings provide no evidence of a beneficial effect of aspirin use among black patients for [CVD] primary prevention.”

—Colleen Murphy

Reference:

Fernandez‐Jimenez R, Wang TJ, Fuster V, Blot WJ. Low‐dose aspirin for primary prevention of cardiovascular disease: use patterns and impact across race and ethnicity in the Southern Community Cohort Study. J Am Heart Assoc. 2019;8(24):e013404. https://doi.org/10.1161/JAHA.119.013404.