الگوي مصرف آسپيرين در بالغين مبتلا به ديابت : مطالعه قند و ليپيد تهران

Pattern of aspirin use among adults with diabetes:Tehran Lipid and Glucose Study

lntroduction: Several studies have demonstrated that aspirin therapy can be used as primary and especially secondary prevention of cardiovascular disease (CVD) in people with diabetes. Since 1997, American Diabetes Association has recommended aspirin therapy for adults with diabetes who have CVD or CVD risk factors. In this study, we examined the prevalence of aspirin use among adults with diabetes in an Iranian population. Materials and Methods: 623 urban adults with self-reported diabetes and fasting blood glucosez126 mgldL or antidiabetic drug use were selected from adult population aged 21 years in the cross-sectional phase of Tehran Lipid and Glucose Study (TLGS) which is a longitudinal study on CVD risk factors in east of Tehran. In the study after a cluster random sampling, individuals were invited to TLGS center and a complete medical history record, physical examination, anthropometric and laboratory studies (with fasting blood sample) were done. CVD conditions were self-reported history of coronary heart disease and stroke and symptoms of angina and claudication according to Rose questionnaire. CVD risk factors included smoking, hypertension, obesity, lipid abnormalities and family history of CVD. Results: An estimated 26% of adults with diabetes had CVD and z99% of others had one or more CVD risk factors. Aspirin was used regularly by 34.6% of diabetics with CVD and by 9.8% of those with risk factors. 16.3% (95% CI: 13.4%-19.2%) of all diabetics took aspirin regularly. In a logistic regression model, adjusted odds ratio of regular aspirin use was significantly greater for individuals with CVD than for those with 0-1 CVD risk factors (OR= 4.9; 95% CI: 2.3-10.6) ; for individuals older than 50 years than for those below 50 (OR= 2.1; 95% CI: 1.1-4.3) and for men than women (OR= 1.6; 95% CI: 1.02-2.56). Conclusions: Almost every adult in Tehran with diabetes has CVD or at least one risk factor for CVD and thereby may be considered a potential candidate for aspirin therapy. According to estimated low prevalence of regular aspirin use, major efforts are needed to increase it and prevent CVD in diabetic patients.