OBJECTIVES: Available evidence suggests a possible increase in blood pressure (BP) and a blunting effect on antihypertensive medication linked to NSAIDs use. However, uncertainties persist regarding similar effects with aspirin. Given the important role of low-dose aspirin in preventing adverse cardiovascular outcomes and the established link between high BP and cardiovascular risk, aspirin is widely used among individuals with hypertension. However, there is a gap in evidence regarding the benefits and risks of aspirin use in this population. Our study aims to investigate the potential relationship between self-reported hypertension, aspirin use, and associated adverse effects.

METHODS: We used the 2019 Behavioral Risk Factor Surveillance System (BRFSS) survey to assess the likelihood of self-reported aspirin use and associated adverse effects in individuals with and without hypertension. Logistic regression was employed to evaluate the odds of aspirin use and associated adverse effects, with all analyses adjusted for sex, education, marital status, household income, and self-reported history of diabetes, kidney disease, asthma, high cholesterol, heart attack, coronary heart disease, and stroke.

RESULTS: Among 59,374 adults, unadjusted rates of daily aspirin use were higher for respondents with self-reported hypertension compared to those without (17% vs 8%, p < 0.001). In adjusted analyses, respondents with hypertension had higher adjusted odds (OR = 1.67, 95% CI = 1.50–1.87, p<0.001) of experiencing adverse effects from aspirin, and higher adjusted odds (OR = 2.14, 95% CI = 2.05–2.23, p<0.001) of using aspirin on a daily or frequent basis.

CONCLUSIONS: Our study revealed a higher likelihood of both aspirin use and adverse effects among adults with hypertension. To gain a more comprehensive understanding of the link between hypertension awareness and aspirin usage, additional studies are warranted. Evidence is also needed to determine whether the benefits of aspirin in individuals with hypertension outweigh the potential risks of adverse effects.