Low-Dose Aspirin Recommendations for Preeclampsia Risk Reduction: A Systematic Review Focused on Black Patients: Current Hypertension Reports

TL;DR

This paper reviews how low-dose aspirin is prescribed and used to prevent preeclampsia in Black patients compared to other groups in the U.S.

Contribution

The study highlights disparities in aspirin adherence among Black patients despite similar prescription rates.

Findings

Black patients have similar LDA prescription rates as White patients.

Adherence rates are lower among Black patients compared to White patients.

Barriers include inconsistent counseling and distrust in healthcare.

Abstract

Daily low-dose aspirin (LDA) is guideline recommended for preeclampsia prevention, but racial/ethnic disparities persist in its implementation. This systematic review examines disparities in LDA prescription, recommendation and adherence for preeclampsia risk reduction among Black patients compared with other racial/ethnic groups in the United States.

Overall, LDA prescription/recommendation rates range widely across included studies, from 10.7% to 95% among eligible patients. Black patients are shown to have a similar prescription/recommendation rate compared to White patients. Adherence rates average around 70%, with Black patients showing lower adherence rates despite similar prescription/recommendation rates than White patients. Barriers identified included inconsistent counseling, limited access to prenatal care, and distrust of the healthcare system.

While prescribing practices for LDA appear increasingly equitable across racial/ethnic groups, significant disparities remain in adherence among Black women, potentially contributing to worse maternal outcomes. Reducing these gaps requires culturally tailored patient education, improved physician–patient communication, and systems-level interventions that integrate adherence monitoring into prenatal care.

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