What are the pros and cons of taking an aspirin a day? Stop the drug in time in 4 situations

Uncle Xu has a history of hypertension for many years, and has been taking long-term medication since his diagnosis. However, two cerebral infarctions occurred this year, and he couldn't help wondering: Why did he insist on taking aspirin, but it didn't have any preventive effect?

With doubts, Uncle Xu came to the cardiovascular specialist hospital introduced by his friend. After reviewing Uncle Xu's examination report, the doctor told him that the cause of the cerebral infarction should be related to the medication problem.

It turns out that Uncle Xu is a patient with paroxysmal atrial fibrillation, and the place where the thrombus forms is mainly located in the left atrium. To prevent atrial fibrillation in this part, the most reliable way is to take anticoagulant drugs orally .

But most people can't tell the difference between anticoagulant drugs and antiplatelet drugs- aspirin is anti-platelet drugs , and it has no effect on Uncle Xu's atrial fibrillation.

So what exactly should you use aspirin for? Moreover, in recent years, there has been a saying that "aspirin has fallen from the altar", so what is going on?

1. Has the magic drug aspirin "fallen from the altar"?

In the past, aspirin has been used as primary prevention of cardiovascular disease, but in October last year, the US Preventive Task Force issued a statement: people over 60 years old should not take aspirin as primary prevention, does this mean that aspirin "falls Go down to the altar"?

Aspirin is the drug of choice for antiplatelet therapy. It can bind to cyclooxygenase on platelets to inhibit platelet aggregation. When plaque ruptures, it will block the possibility of platelet aggregation, thereby reducing the occurrence of thrombus .

But aspirin is a double-edged sword. Professor Guo Yifang of Hebei Provincial People's Hospital mentioned that this controversy has always existed: on the one hand, it can reduce the risk of thrombosis, but on the other hand, it can also increase bleeding events——

Three large-scale clinical studies and a meta-analysis in 2018 found that after diabetic patients used aspirin, although vascular events decreased, bleeding complications increased, and the merits and demerits outweighed each other .

A subsequent large-scale meta-analysis published in the "European Heart Journal" also mentioned that the use of aspirin for prevention in people without cardiovascular disease is not enough.

Some time ago, the United States Preventive Services Task Force (USPSTF) updated and promulgated a new version of the recommended statement of aspirin for the prevention of cardiovascular disease. The prevention of colon cancer and other aspects were evaluated, and the specific conclusions are as follows:

• 10-year cardiovascular disease risk ≥ 10%, age 40-59 years old, the net benefit of using aspirin for primary prevention of cardiovascular disease is very small;
• Patients without high risk factors for bleeding and taking low-dose aspirin for a long time may benefit;
• Aspirin is not recommended for primary prevention of cardiovascular disease in persons ≥ 60 years old.

2. What can you gain from taking an aspirin a day?

To be clear, not everyone needs to take aspirin.

For people with coronary heart disease and cerebral infarction , taking an aspirin every day can prevent platelets from aggregating together and reduce the occurrence of thrombus.

Then why do some people eat it, but the cerebral infarction relapses?

There are two reasons for cerebral infarction, one is the thrombus formed in the cerebral artery; the other is the atrial fibrillation, the atrial thrombus falls off, and the blood flows into the cerebral artery, thereby forming an embolism.

The former takes aspirin as the right medicine , while the latter needs anticoagulant drugs to inhibit platelet aggregation. If the medication is wrong, the purpose of anticoagulation cannot be achieved, thereby inducing cerebral infarction.

3. If you take aspirin for a long time, stop taking it in time if there are 4 situations

After years of clinical use, it has been found that aspirin generally has the following adverse reactions:

1. Bleeding

Aspirin can increase the risk of bleeding, including hematoma, gum bleeding, skin and mucous membrane bleeding, and urogenital bleeding.

2. Allergic reaction

Skin allergy is a relatively common side effect of aspirin. Patients may present with rashes, itchy skin, and may also cause severe asthma attacks.

3. Salicylic acid reaction

Taking more than 3 grams of aspirin every day can cause headache, tinnitus, dizziness, and weakened vision and hearing. This reaction is called salicylic acid reaction.

4. Gastrointestinal damage

Including gastrointestinal mucosal erosion, ulcer, and even life-threatening gastrointestinal bleeding and perforation, clinical manifestations may be nausea, vomiting, upper abdominal pain, vomiting blood, melena, etc.

All medicines are three-point toxic. Although aspirin has adverse reactions, it is only a special case. According to statistics, 90% of the patients showed good tolerance, so do not affect the overall medication situation because of individual cases .

4. How to take aspirin to be safe? 3 points are critical

Most elderly people will take aspirin for a long time to prevent the occurrence of cardiovascular diseases, but if they eat too much and worry about side effects, what is the optimal dose for the elderly?

For the risk of drug use in elderly patients, Liu Meilin and others from Peking University First Hospital evaluated and matched the selected elderly patients.

The results found that for elderly patients ≥ 60 years old who need long-term use of low-dose aspirin to prevent cardiovascular disease, aspirin 50 mg per day has the highest effectiveness and safety risks .

In addition, when taking aspirin, pay attention to the following points:

• dosage form

Published in "Chinese and Foreign Medicine", the research on aspirin's adverse intestinal reactions confirmed that the incidence of gastrointestinal adverse reactions of aspirin enteric-coated tablets was significantly lower than that of ordinary aspirin.

• Medication time

Aspirin enteric-coated tablets have the characteristics of anti-acid and alkali-resistant, and should be used on an empty stomach 30 minutes before meals . At this time, the acidic environment in the stomach is strong, and the drug stays in the stomach for a short time and is not easy to dissolve, which can reduce the occurrence of adverse reactions such as gastric discomfort.

• course of treatment

Compared with short-term medication, patients who take aspirin for a long time can develop tolerance in the gastrointestinal tract and weaken the stimulation of the intestinal tract, which can bring life-long benefits to patients.

The use of aspirin needs to be adjusted according to the doctor's advice. Long-term use can minimize adverse reactions and maximize the benefits for patients. But for patients with atrial fibrillation, blind medication will not have any preventive effect, and medication needs to be adjusted in time.

References:

[1] "Can aspirin be used as a health product?" You are afraid you have misunderstood it." Wuhan Third Hospital. 2022-11-18

[2] "Aspirin primary prevention of cardiovascular disease, should it step down from the altar?" ". Medical circles. 2021-10-13

[3] "Aspirin will withdraw from the stage of primary prevention? 6 core issues to master! ". Metz Medicine. 2021-12-08

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