Despite aspirin being able to prevent a second heart attack or stroke only just over a third of survivors take it, a new study has revealed.
Taken daily, the low-cost pill can slash the risk of another attack by a quarter.
Yet despite cardiovascular disease being the leading cause of death globally an average of only 39.3% of people worldwide were taking aspirin following a heart attack or stroke.
In low income countries it was as low as 16.6%, rising to 65% in high-income countries such as the US.
Researchers from Washington University School of Medicine in St Louis and the University of Michigan produced the study, published in JAMA.
Since studies in the 1970s and 80s revealed that antiplatelet therapy can reduce recurrence of heart attacks and strokes, a daily aspirin has been recommended.
Myriad factors contribute to the risk of heart attacks and strokes such as smoking, diabetes, unhealthy diet, genetics, lack of exercise, obesity and even air pollution.
Aspirin works as a blood thinner, preventing small blood cells called platelets from forming clots.
‘Survivors of heart attacks and stroke often face a high risk of having subsequent events,’ said Dr Sang Gune Yoo, in the Cardiovascular Division at Washington University School of Medicine.
‘In fact, many people die from having recurring attacks.
‘Aspirin offers one effective and relatively low-cost option for reducing the likelihood of additional events in individuals with established cardiovascular disease, and yet most people who could benefit from a daily aspirin don’t take it.’
The team said there was no clear reason why so few people took it but possible explanations could be varying accessibility to health care in general, inconsistent messaging surrounding use of the drug, and the fact that aspirin is not always available over-the-counter, requiring a prescription in some countries.
The researchers analysed data from nationally representative health surveys that were conducted in 51 low, middle and high-income countries including 125,505 people with 10,590 self-reporting a history of cardiovascular disease.
In low-income countries, only 16.6% of eligible individuals were taking aspirin to prevent a second heart attack or stroke.
In lower-middle-income countries this number was 24.5%, increasing to 51.1% for upper-middle-income countries, and to 65% in high-income countries
An earlier study a decade ago found largely the same results.
‘We might expect that after 10 years there would be more widespread aspirin use, but things haven’t really changed,’ said Dr Yoo said.
‘This research deals with a disease process that affects many people, regardless of where you live. We have to remember that this could benefit a tremendous number of people.
‘In order to create interventions, we have to understand what is actually going on, which is what we’re trying to establish in this study.
‘Then we can start to think about how to develop strategies to increase evidence-based aspirin use in order to save lives.’
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