Aspirin Underused by Women and Younger Adults With Diabetes

New research indicates that certain high-risk individuals, particularly women and adults younger than 50 years, are under-using this effective and inexpensive agent.

The findings, are based on telephone surveys conducted in several states between 1997 and 2001. Data from more than 8000 diabetics were included in the analysis.

Aspirin use rose from 37.5% in 1997 to 48.7% in 2001, Dr. Stephen D. Persell and Dr. David W. Baker, from Northwestern University in Chicago, note.

In 2001, the use of aspirin among diabetics was high in the presence of cardiovascular disease — 74.2%, but low in its absence — 37.9%. Moreover, less than 40% of diabetics with hypertension, high cholesterol or current smoking used aspirin.

Compared with men 65 years or older, women 35 to 49 years were 65% less likely to use aspirin. The corresponding rates for women 50 to 64 years, and men 35 to 49 years were 31% and 38%, respectively. This disparity was attenuated, but still apparent when the analysis was confined to patients diagnosed with cardiovascular disease.

There are several possible explanations for low use of aspirin among women, the researchers said. Physicians may not counsel women with diabetes to use aspirin if the physicians underestimate the women’s risk for cardiovascular disease events. "However, even though women are at lower risk of new-onset cardiovascular disease than men, diabetes greatly reduces this female advantage," one investigator said

The authors believe that clinicians may play a key role in increasing aspirin usage in the groups identified. They add that "interventions that aim to increase professional counseling about aspirin for women, as well as young and middle-aged adults, may be especially helpful."

Arch Intern Med 2004;164:2492-2499.