Instead, the research found, many doctors are opting to prescribe the more expensive, heavily marketed statin drugs, which are no more effective than aspirin in preventing heart disease.
"What really concerns us is the degree of aspirin underutilization among patients who have already had a heart attack or a stroke because this is the group for which there is conclusive clinical evidence that aspirin reduces the risk for cardiovascular disease," said Jun Ma, MD, PhD, research associate at the Stanford Prevention Research Center and senior author of the study that appears in the November issue of the Public Library of Science-Medicine.
Of those with the highest risk for cardiovascular disease, the study showed that only 33 percent of their outpatient visits were associated with aspirin therapy in 2003. That's an increase from the 1993 rate of 22 percent, but Ma said the gain is minimal considering the abundant proof of aspirin's benefits for such patients.
And although aspirin use remains low, the study found that U.S. physicians are increasingly prioritizing a class of drugs known as statins as the primary drug strategy for preventing heart disease. Statins, while as effective as aspirin in preventing heart attacks, cost substantially more. The researchers speculate that the heavy marketing of statins in the United States is spurring patients and doctors toward these newer - although not necessarily better - medications.
"Our concern is that physicians are failing to use the full range of strategies available to reduce patients' risk of heart disease and stroke," said Randa
Contact: Susan Ipaktchian
Stanford University Medical Center