• Component Description
• Eligible Sample
• Interview Setting and Mode of Administration
• Quality Assurance & Quality Control
• Data Processing and Editing
• Analytic Notes
• References
• Codebook
  • SEQN - Respondent sequence number
  • RXQ510 - Dr told to take daily low-dose aspirin?
  • RXQ515 - Followed advice, took low-dose aspirin?
  • RXQ520 - Taking low-dose aspirin on your own?
  • RXQ525G - Schedule/frequency of aspirin use
  • RXQ525Q - Another ASA schedule: number of doses
  • RXQ525U - Another ASA schedule: frequency of doses
  • RXD530 - Aspirin dose in milligrams (mg)

National Health and Nutrition Examination Survey

2017-2018 Data Documentation, Codebook, and Frequencies

Preventive Aspirin Use (RXQASA_J)

Data File: RXQASA_J.xpt

First Published: April 2020

Last Revised: NA

Component Description

The NHANES 2017-18 Preventive Aspirin Use questionnaire (RXQASA_J) provides data on low-dose aspirin taken to prevent heart attacks, strokes, and cancer. It is a continuous NHANES data collection specifically designed to estimate the prevalence of low-dose, over the counter preventive aspirin use in the United States. Cardiovascular disease (CVD) remains the leading cause of death in the United States. Low-dose aspirin might be considered for primary prevention of CVD among select adults aged 40-70 years who are at higher CVD risk but not at increased bleeding risk (Arnett DK et al, 2019). Increasing aspirin use among individuals who are at high risk for CVD is one of the key Public Health objectives in the U.S. (Frieden & Berwick, 2011).

RXQASA_J data collection topics include:

• Whether a doctor recommended low dose aspirin for preventive use.
• Adherence to this medical advice; and whether aspirin was stopped due to side effects.
• Whether the low-dose aspirin was taken on one’s own initiative.
• The schedule and frequency of aspirin use.
• The specific aspirin dose taken.

The RXQASA_J data collection format was designed to provide both current and lifetime prevalence estimates of preventive aspirin use: overall use; doctor recommended use; and self-initiated use. When combined with other 2017-18 NHANES data, the prevalence of low-dose aspirin use for both primary and secondary prevention can be estimated, as well as the prevalence of aspirin use in key population subgroups: those with coronary artery disease, angina, heart attack, stroke, and diabetes. Also, preventive aspirin use prevalence can be monitored across the major demographic subgroups, such as age, gender, and race and Hispanic origin. Person-level population-based estimates of the distributions of aspirin doses taken and of scheduled frequency of use are also supported.

Eligible Sample

Participants aged 40 years and over were eligible.

In addition, participants between 20 and 39 years of age who reported to have a history of coronary heart disease, heart attack, angina, and/or stroke were also eligible. Data obtained from this small subgroup are available through the NCHS Research Data Center only.

Interview Setting and Mode of Administration

The preventive aspirin use questions were asked, in the home, by trained interviewers using the Computer-Assisted Personal Interview (CAPI) system. They were administrated as part of Dietary Supplements and Prescription Medication section of the Sample Person Questionnaire, which collects information on dietary supplements, nonprescription antacids and prescription medication. The Interviewer Procedure Manuals and Survey Questionnaires can be found on the NHANES website https://wwwn.cdc.gov/nchs/data/nhanes/2017-2018/questionnaires/DSQ_J.pdf

Quality Assurance & Quality Control

The CAPI system is programmed with built-in consistency checks to reduce data entry errors. CAPI also uses online help screens to assist interviewers in defining key terms used in the questionnaire.

Data Processing and Editing

Frequency counts were checked, “skip” patterns were verified, and the reasonableness of question responses was reviewed. Edits were made to some variables to ensure the completeness, consistency, and analytic usefulness of the data.

RXD530: Aspirin dose in milligrams (mg). This variable captured data on the actual dose of aspirin taken by the participant. While most survey participants were taking 81 mg aspirin, the data for this variable was not grouped, to provide data analysts with the actual doses of aspirin reported by the survey participants. Aspirin dose higher than 500 mg was coded as “500” mg.

Analytic Notes

The 2017-18 data file is similar to the 2011-16 publicly release data file. It is formatted as person-level data, where each participant has only one record. The low-dose aspirin reported in this data file is usually available over-the-counter without prescription. However, some state laws might require prescriptions for such over-the-counter medications. Also, sometimes physicians might write prescriptions for preventive aspirin. The RXQASA_J data for the most part represents the non-prescription over-the-counter aspirin use; however, the few instances where prescription aspirin was used for preventive purposes are also included in this data file.

The analysis of NHANES 2017–18 aspirin use questionnaire data must be conducted using the appropriate survey design variables, sample weights, and the basic demographic variables. Interview weights should only be used if questionnaire data are analyzed by themselves. However, if RXQASA_J data are merged with the MEC examination data or laboratory data, the MEC examination weights should be used for analyses. If RXQASA_J data are merged with laboratory sub-sample data, sub-sample weights should be used for analyses.

Please refer to the NHANES Analytic Guidelines and the on-line NHANES Tutorial for further details on the use of sample weights and other analytic issues.

References

• Arnett DK, Blumenthal RS, Albert MA et. al. 2019 ACC/AHA Guidelines on the Primary Prevention of Cardiovascular Disease: Executive Summary. A Report of the American College of Cardiovascular/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019; 140: e563-e594.
• Frieden TR, Berwick DM. The "Million Hearts" initiative--preventing heart attacks and strokes. N Engl J Med. 2011 Sep 29;365(13):e27.

Codebook and Frequencies