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Aspirin use influences racial but not geographic stroke risk
4 July 2008
MedWire News: Racial variation in aspirin use may contribute to disparities in stroke risk but does not contribute to the Stroke Belt, data from REGARDS suggest.
The REGARDS (Reasons for Geographic And Racial Differences in Stroke) study was designed to determine why residents of the "Stroke Belt" (North and South Carolina, Georgia, Tennessee, Alabama, Mississippi, Arkansas, and Louisiana) have a higher stroke risk than residents of other US states.
"We hypothesized that use of aspirin might be lower in the Stroke Belt regions, and that this lower aspirin use could contribute to an increased stroke incidence in the Stroke Belt," say Stephen Glasser (University of Alabama at Birmingham, USA) and team.
"Counter to our hypothesis, rather than finding a lower rate of aspirin use in the Stroke Belt, the use of aspirin was actually approximately 6-10% higher than in other regions."
The REGARDS study includes 16,908 people aged at least 45 years from across the USA. Recruitment was weighted toward Stroke Belt residents and African Americans (about 50% of each).
In the Stroke Belt, 32.1% of participants used aspirin, compared with 30.8% of people from the rest of the USA. This difference was significant after accounting for socioeconomic status, at an odds ratio of 0.9 for aspirin use in non-Stroke Belt versus Stroke Belt regions.
The team highlights the importance of considering socioeconomic status, saying that, relative to the Stroke Belt, aspirin use "is lower in the rest of the nation despite the rest of the nation having a higher socioeconomic status."
There was a clear increase in the proportion of White versus African-American participants who used aspirin, at 34.7% versus 27.7%.
"Thus, differential aspirin use could contribute to the known racial disparity in stroke mortality," the researchers write in the journal Preventive Medicine.
They conclude: "There is an opportunity for decreasing stroke rates through education of patients and healthcare providers on the importance of aspirin in stroke prevention, with an emphasis on increasing aspirin use in African-American, female, or lower socioeconomic status patients."
