Recently, patients have been asked a lot whether aspirin should be used, whether it can be used to prevent cardiovascular disease, whether aspirin increases the risk of major bleeding, and whether it can be used. Today let's talk about aspirin, if you have any questions, you can also leave a message below.
Aspirin** Mechanism of cardiovascular disease.
Aspirin has a history of more than 100 years since it was marketed, and it was found that aspirin has an antiplatelet effect in the 60s of the last century, while myocardial infarction is mainly caused by the rupture of atherosclerotic plaques and the formation of thrombotic thrombosis here, aspirin can inhibit platelet aggregation, which is the cause of aspirin** cardiovascular disease.
The century-old drug aspirin, after being found to be able to ** cardiovascular disease, has been rejuvenated, and has been widely used in the primary prevention of atherosclerotic cardiovascular disease (referred to as cardiovascular disease). However, pooled analyses in recent years have shown that aspirin, as a primary prevention of cardiovascular disease, does not significantly reduce mortality, but increases the incidence of major bleeding, including gastrointestinal bleeding and intracranial hemorrhage. The increased risk of bleeding with aspirin negates the benefit of reducing cardiovascular attacks. When patients were grouped according to their risk of developing the disease, it was found that the benefits of aspirin in high-risk patients far outweighed the risk of bleeding. Today, let's talk about who is a good candidate for aspirin.
In recent years, due to the widespread use of preventive measures such as smoking cessation, blood pressure lowering, and lipid lowering, the benefit-risk ratio of aspirin primary prevention has decreased compared with the past. Because aspirin increases the risk of major bleeding, guidelines in Europe, the United States, and China do not recommend routine aspirin prophylaxis in asymptomatic patients with cardiovascular disease.
Aspirin is no longer recommended as a routine prophylactic drug, but for some patients, ie40 to 70-year-olds** who are at high risk of cardiovascular disease (10% expected 10% risk over 10 years) but have a low risk of bleeding may be considered for first-degree cardiovascular disease prognosis with low-dose aspirin (100 mg days).Prevention, aspirin remains an important preventive measure, clearly definedAspirin is not recommended for the following two groups
Adults over the age of ** should not routinely take low-dose aspirin (100 mg d) for primary prevention of ASCVD
2. At any age** with an increased risk of bleeding, low-dose aspirin should not be taken for the primary prevention of cardiovascular disease.
Conditions at high risk of bleeding include:
1. Are using other drugs that increase the risk of bleeding, including antiplatelet drugs, anticoagulant drugs, glucocorticoids, non-steroidal anti-inflammatory drugs).
2. History of gastrointestinal bleeding, peptic ulcer or bleeding from other sites.
3. Age > 70 years old.
4. Thrombocytopenia.
5. Coagulation dysfunction.
6. Severe liver disease.
7. Chronic kidney disease 4 5 stage, 8, Helicobacter pylori infection.
9. Uncontrolled hypertension.
Precautions for using aspirin.
To reduce the risk of bleeding from aspirin, there are a few things to keep in mind before using aspirin:
1. Be carefulWeigh the benefit-bleeding risk ratio, screen and exclude high-risk groups of bleeding, and regularly or dynamically evaluate during use, and deal with problems in a timely manner.
2. TakePrecautions to reduce the risk of gastrointestinal bleeding, in advance** active lesions of the digestive tract (including** Helicobacter pylori), if necessary, prophylactic application of gastric acid secretion drugs (such as omeprazole, esomeprazole, pantoprazole, etc.).
3. PersistenceHealthy lifestyle(Quit smoking, be cautious of alcohol, eat scientifically and exercise).and actively control blood pressure, blood sugar, and lipid levels。Patients with hypertension should have their blood pressure controlled at <140 90 mmHg before considering aspirin.
4. Eating before or after meals, this is related to the aspirin dosage form. Ordinary tablets are dissolved and absorbed in the stomach, aspirin stimulates the gastric mucosa, and food can reduce the irritation of aspirin to the gastric mucosaOrdinary tablets should be eaten after meals。Enteric-coated tablets, wrapped with a protective layer on the outside, can resist gastric acid, will not dissolve in the stomach, and begin to dissolve and absorb after entering the intestine, which can reduce gastric mucosal irritation, and eating before meals can quickly enter the intestine for digestion and absorption, recommendedEnteric-coated tablets to be eaten before meals
5. Communicate with doctors and patients before prescribing aspirin, and start using it after the patient agrees.
Tips: Primary prevention (prevention of disease) is to start when the disease does not appear**, control the risk factors, and reduce the occurrence of the disease.
Secondary prevention (treatment of the disease), the occurrence of the disease, the prevention of the disease**, the progression, and the reduction of the risk of death.
Well, that's all for today's topic about aspirin, welcome to like it, ** so that more readers can see it. I'm Dr. Li, and I like to follow Baijiahao. This number is committed to the popularization of cardiovascular diseases, and will publish cardiovascular disease health science articles or micro-headline articles from time to time. Let's protect the health of our hearts together.