Keywords: Cardiovascular Diseases, Adverse Drug Reaction Reporting Systems, Primary Prevention

Background:

Acetylsalicylic acid (aspirin) is commonly prescribed for the prevention of cardiovascular and cerebrovascular events. Despite its benefits, aspirin use carries risks such as gastrointestinal bleeding and ulcers. Inappropriate or unsupervised long-term use may increase morbidity. This study aimed to examine the demographic and clinical characteristics of aspirin users and to explore the frequency and predictors of aspirin-related side effects in adults.

Research questions:

What are the characteristics of aspirin use and the associated side effects among adults aged 40 and older in a primary care population?

Method:

A cross-sectional study was conducted with 617 individuals aged 34 to 84 years (mean age: 71.5±5.6), using a structured questionnaire. Data on sociodemographic factors, chronic diseases, BMI, smoking, alcohol consumption, and detailed aspirin use (dosage, indication, prescriber, duration, adverse effects) were collected. Participants were categorized based on aspirin use: current, previous, or never. Statistical analyses were performed using Chi-square and Fisher’s Exact tests (significance: p<0.05).

Results:

Among participants, 28.2% were current aspirin users, 21.9% were previous users, and 49.9% had never used aspirin. Aspirin was most often recommended by cardiologists (63.4%), primarily for secondary prevention (62.4%). The most common daily dose was 100 mg (85.2%). Only 34.1% of current users reported regular use. Aspirin use was significantly higher among those with hypertension (p<0.001), diabetes, dyslipidemia, or heart disease. Reported side effects included gastrointestinal bleeding (2.3%), ulcer (1.8%), and allergic reactions (1%). Side effects were more frequent in former users and those using ≥150 mg doses (p=0.048). Gastroprotective drug use was more prevalent among aspirin users (p=0.008).

Conclusions:

Aspirin use is widespread, especially for secondary prevention and under physician supervision. However, side effects—particularly gastrointestinal—remain noteworthy. Risk-benefit assessment and appropriate gastroprotection are essential in long-term aspirin therapy.

Points for discussion:

What are the clinical implications of aspirin use for primary prevention in individuals without a clear cardiovascular risk profile?

How should healthcare providers balance the cardiovascular benefits of aspirin with the risk of gastrointestinal complications in routine practice?

What role can family physicians and primary care providers play in reviewing inappropriate or unsupervised aspirin use in the community?