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Benson KRK, Diamantidis CJ, Davenport CA, Sandler RS, Boulware LE, Mohottige D. Racial Differences in Over-the-Counter Non-steroidal Anti-inflammatory Drug Use Among Individuals at Risk of Adverse Cardiovascular Events. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01743-x. [PMID: 37594625 DOI: 10.1007/s40615-023-01743-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/29/2023] [Accepted: 08/02/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE Black Americans are disproportionately affected by adverse cardiovascular events (ACEs). Over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs) confer increased risk for ACEs, yet racial differences in the use of these products remain understudied. This study sought to determine racial differences in OTC NSAID and high-potency powdered NSAID (HPP-NSAID) use. METHODS AND MATERIALS This retrospective analysis examined participants at risk of ACEs (defined as those with self-reported hypertension, diabetes, heart disease, or smoking history ≥ 20 years) from the North Carolina Colon Cancer Study, a population-based case-control study. We used multivariable logistic regression models to assess the independent associations of race with any OTC NSAID use, HPP-NSAID use, and regular use of these products. RESULTS Of the 1286 participants, 585 (45%) reported Black race and 701 (55%) reported non-Black race. Overall, 665 (52%) reported any OTC NSAID use and 204 (16%) reported HPP-NSAID use. Compared to non-Black individuals, Black individuals were more likely to report both any OTC NSAID use (57% versus 48%) and HPP-NSAID use (22% versus 11%). In multivariable analyses, Black (versus non-Black) race was independently associated with higher odds of both NSAID use (OR 1.4, 95% CI (1.1, 1.8)) and HPP-NSAID use (OR 1.8 (1.3, 2.5)). CONCLUSIONS Black individuals at risk of ACEs had higher odds of any OTC NSAID and HPP-NSAID use than non-Black individuals, after controlling for pain and socio-economic status. Further research is necessary to identify potential mechanisms driving this increased use.
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Affiliation(s)
- Kathryn R K Benson
- Department of Medicine, Division of General Internal Medicine, Duke University, Durham, NC, USA
- Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, NC, USA
| | - Clarissa J Diamantidis
- Department of Medicine, Division of General Internal Medicine, Duke University, Durham, NC, USA
- Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, NC, USA
- Department of Population Health Sciences, Duke University, Durham, NC, USA
- Department of Medicine, Division of Nephrology, Duke University, Durham, NC, USA
| | - Clemontina A Davenport
- Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, NC, USA
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Robert S Sandler
- Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, NC, USA
- Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC, USA
| | - L Ebony Boulware
- Department of Medicine, Division of General Internal Medicine, Duke University, Durham, NC, USA
- Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, NC, USA
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Dinushika Mohottige
- Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, NC, USA.
- Department of Population Health, Icahn School of Medicine at Mount Sinai, Institute for Health Equity Research, 1425 Madison Avenue Floor 2, New York, NY, 10029, USA.
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Barbara T. Murphy Division of Nephrology, 1425 Madison Avenue Floor 2, New York, NY, 10029, USA.
- Division of Data-Driven and Digital Medicine (D3M), Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Abstract
Over-the-counter analgesic medications are widely used amongst American adults and are also available in powder forms. Their adverse effects have been well documented in literature. Gastrocolic fistulas as a complication of peptic ulcer disease from analgesic powder usage have been previously unreported. Here, we report a patient with upper gastrointestinal bleeding and acute anaemia secondary to peptic ulcer complicated by gastrocolic fistula in a patient using analgesic powder.
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Affiliation(s)
- Raja Samir Khan
- Department of Medicine, West Virginia University, Morgantown, West Virginia, USA
| | - Sardar Momin Shah-Khan
- Department of Medicine, Section of Digestive Diseases, West Virginia University, Morgantown, West Virginia, USA
| | - Justin Kupec
- Department of Medicine, Section of Digestive Diseases, West Virginia University, Morgantown, West Virginia, USA
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