Aspirin Use Among Adults With Diabetes

Estimates from the Third National Health and Nutrition Examination Survey

  1. Deborah B. Rolka, MS,
  2. Anne Fagot-Campagna, MD, PHD and
  3. K.M. Venkat Narayan, MD, MSC, MBA
  1. From the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
  1. Address correspondence and reprint requests to Deborah B. Rolka, MS, Mailstop K-68, 4770 Buford Highway NE, Atlanta, GA 30341. E-mail: drolka{at} .


OBJECTIVE— Since 1997, the American Diabetes Association has recommended that aspirin therapy be considered for adults with diabetes who have cardiovascular disease (CVD) or CVD risk factors. We examined the prevalence of regular aspirin use among adults in the U.S. with diagnosed diabetes.

RESEARCH DESIGN AND METHODS— The Third National Health and Nutrition Examination Survey (1988-1994) used a probability sample of the U.S. population and included an interview, physical examination, and laboratory studies. Among the survey participants were 1,503 adults (age ≥21 years) with self-reported diabetes. We defined regular aspirin use as reported having taken aspirin ≥15 times in the previous month. CVD conditions were self-reported heart attack and stroke and symptoms of angina and claudication. CVD risk factors included smoking, hypertension, obesity, albuminuria, lipid abnormalities, and family history of heart attack.

RESULTS— An estimated 27% of adults with diabetes had CVD, and an additional 71% had one or more CVD risk factors. Aspirin was used regularly by 37% of those with CVD and by 13% of those with risk factors only. Adjusted odds of regular aspirin use were significantly greater for individuals with CVD than for those with one CVD risk factor (odds ratio [OR] = 4.3); for non-Hispanic whites than for blacks, Mexican-Americans, and others (OR = 2.5); and for individuals age 40-59 years than for those <40 years (OR = 33.3).

CONCLUSIONS— Nearly every adult in the U.S. with diabetes has at least one risk factor for CVD and thus may be considered a potential candidate for aspirin therapy. During 1988-1994, only 20% (95% CI 16-23) took aspirin regularly. Major efforts are needed to increase aspirin use.


  • Abbreviations: ADA, American Diabetes Association; CVD, cardiovascular disease; ETDRS, Early Treatment Diabetic Retinopathy Study; HOT, Hypertension Optimal Treatment; NHANES III, Third National Health and Nutrition Examination Survey; OR, odds ratio.

  • A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted September 19, 2000.
    • Received February 29, 2000.
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