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首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >Does differential prophylactic aspirin use contribute to racial and geographic disparities in stroke and coronary heart disease (CHD)?
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Does differential prophylactic aspirin use contribute to racial and geographic disparities in stroke and coronary heart disease (CHD)?

机译：预防性使用阿司匹林是否会导致中风和冠心病（CHD）的种族和地理差异？

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CONTEXT: Aspirin use may reduce the risk of stroke and coronary heart disease. Differential use for vascular prophylaxis may contribute to racial and geographic disparities in stroke and coronary heart disease morbidity or mortality. OBJECTIVE: To assess the prevalence and predictors of aspirin use for primary prophylaxis of stroke in the general population free of clinically diagnosed stroke or coronary heart disease. DESIGN AND SETTING: Cross-sectional analysis of 16,908 participants (age 45 or greater), from a population-based national cohort study (REasons for Geographic And Racial Differences in Stroke) enrolled from February 2003-August 2006 with oversampling from the southeastern Stroke Belt and African Americans. Individuals with a prior stroke or coronary heart disease, or regular use of aspirin for pain relief were excluded from analyses. MAIN OUTCOME MEASURES: Aspirin use and reasons for use were assessed using a computer-assisted telephone interview. RESULTS: Prophylactic aspirin use was substantially higher among whites (34.7%) than African Americans (27.2%; p<0.0001). There was a higher prevalence of aspirin use for prophylaxis in the Stroke Belt (32.1%) than in the rest of the nation (30.8%; p=0.07). After adjustment for measures of socio-economic status, the odds ratio of aspirin use in the rest of the nation compared to Stroke Belt was 0.90 (95% CI 0.84-0.97). There was a higher likelihood of prophylactic aspirin use among participants who were white, male, older, past cigarette smokers, or of higher socio-economic status (higher income or education). CONCLUSIONS: In this study, aspirin use to prevent stroke and coronary heart disease was higher among whites than African Americans, raising the possibility that differential aspirin use could contribute to the racial disparities in vascular disease mortality. Counter to our hypothesis, aspirin use was more common in the Stroke Belt than the rest of the country, so differential aspirin use in the Stroke Belt is unlikely to contribute to geographic disparities in stroke.
机译：背景：使用阿司匹林可以减少中风和冠心病的风险。预防血管使用的差异可能会导致中风和冠心病发病率或死亡率的种族和地理差异。目的：评估无临床诊断中风或冠心病的普通人群中阿司匹林用于预防脑卒中的患病率和预测因素。设计与地点：2003年2月至2006年8月在东南部卒中带进行过抽样的一项基于人群的全国队列研究（卒中地理和种族差异的原因）对16908名参与者（45岁或以上）进行了横断面分析。和非裔美国人。分析排除了先前患有中风或冠心病或定期使用阿司匹林缓解疼痛的个体。主要观察指标：阿司匹林的使用和使用原因通过计算机辅助电话访谈进行评估。结果：白人的预防性使用阿司匹林的比例（34.7％）明显高于非洲裔美国人（27.2％; p <0.0001）。与全国其他地区（30.8％; p = 0.07）相比，中风带（32.1％）的阿司匹林预防使用率更高。调整社会经济地位指标后，全国其他地区使用阿司匹林的几率与中风带相比为0.90（95％CI 0.84-0.97）。白人，男性，年龄较大，过去吸烟的人或具有较高社会经济地位（较高收入或受教育程度）的参与者中，预防性使用阿司匹林的可能性较高。结论：在这项研究中，白人中使用阿司匹林预防中风和冠心病的比例高于非裔美国人，这增加了不同使用阿司匹林可能导致血管疾病死亡率种族差异的可能性。与我们的假设相反，在中风带中使用阿司匹林比在全国其他地区更常见，因此在中风带中使用阿司匹林的差异性不太可能导致中风的地理差异。

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