This article is from "Nankai Sun Pharmacist", which is used for medical science popularization for reference. Can aspirin and statin be taken together?Once the elderly take aspirin and statins, can they not stop taking the drug?Can I drink a little alcohol every day after taking aspirin and statins for a long time?
Aspirin is a commonly used antiplatelet drug in clinical practice, small doses (50-100mg) of aspirin can inhibit cyclooxygenase-1 in platelets, thereby reducing the production of thromboxane A2, has obvious antiplatelet effect, can inhibit the formation of arterial thrombosis, is suitable for the prevention of transient ischemic attack, myocardial infarction, atrial fibrillation, artificial heart valve and other postoperative thrombosis, and can reduce the risk of stable and unstable angina.
Statin is a commonly used blood lipid regulator in clinical practice, which can reduce endogenous cholesterol synthesis, trigger the liver to compensate for the increase of LDL receptor synthesis, thereby increasing LDL receptors, increasing the liver's uptake of LDL, resulting in a decrease in blood cholesterol and LDL cholesterol levels, and can also reduce serum triglycerides and increase blood HDL cholesterol levels, which is suitable for various types of hypercholesterolemia and mixed hyperlipidemia. In addition, statins also have anti-inflammatory, antioxidant, reduce endothelin production, reduce tissue factor expression, inhibit platelet aggregation, stabilize plaques, anti-thrombosis and other anti-atherosclerotic effects, which can reduce or regress atherosclerotic plaques for the prevention and treatment of coronary heart disease and stroke.
Healthy blood vessels are flexible and elastic, the wall is smooth, the blood vessels are smooth, the blood vessels are smooth, the blood flow is fast, with the increase of age, the blood vessels will slowly lose their elasticity, become brittle and hard, the control of blood pressure will decrease, the blood flow speed will slow down, the blood lipids will thicken, and it is easy to form atherosclerotic plaques, once the plaques are formed, the blood vessel walls will become hard and thick, and the diameter of the tubes will be reduced, resulting in ischemia, and once the plaques are ruptured, thrombosis will be formed, which can completely block the blood vessels and induce myocardial infarction and ischemic stroke. Risk factors such as hypertension, hyperlipidemia, diabetes, obesity, smoking, and alcohol abuse can not only promote the occurrence and development of atherosclerosis, but also damage blood vessels, causing platelets in blood vessels to gather at the injured site and hug together to promote hemostasis, and the aggregation of platelets will promote atherosclerotic thrombosis, block blood vessels, and lead to myocardial ischemia, cerebral ischemia, and even myocardial infarction and stroke.
Aspirin can achieve the purpose of inhibiting arterial thrombosis by continuously inhibiting platelet aggregation, and statins can not only regulate blood lipids, but also stabilize and shrink atherosclerotic plaques and prevent plaque rupture and thrombosis.
Not all older people need to take aspirin and statins. Family history of early-onset cardiovascular and cerebrovascular diseases (55 years old in men or 65 years old in women), postmenopausal in men 50 years old or women, hypertension (blood pressure control 150 90 mmHg), hypercholesterolemia, diabetes, obesity (body mass index 28kg m2), history of smoking, and patients with 3 or more cardiovascular risk factors should take low-dose aspirin for a long timePeople with severe hypertension (systolic blood pressure 160 mmHg or diastolic blood pressure 100 mmHg), obesity (body mass index 28 kg m2), smoking, diabetes mellitus, and dyslipidemia with 2 or more of the above cardiovascular risk factors should take statins for a long time. In addition, people with a history of myocardial infarction or stroke should take low-dose aspirin and statins for a long time, or even for life. Elderly people with the above indications should strictly follow the doctor's instructions to use aspirin and statins, and must not stop taking the drugs without authorization.
Aspirin can not only destroy the mucosal phospholipid layer barrier and directly lead to gastric mucosal damage, but also can inhibit prostaglandin synthesis and weaken the protective effect of prostaglandin E on the gastrointestinal mucosa, resulting in gastrointestinal mucosal damage, and long-term use of aspirin can lead to nausea, vomiting, abdominal pain, diarrhea, indigestion, and even gastric and duodenal ulcers, bleeding, perforation and other adverse reactions. Although the choice of aspirin enteric-coated formulation can reduce the direct damage of aspirin to the gastrointestinal mucosa, the mechanism of aspirin inhibition of prostaglandin E synthesis and weakening the protective barrier of the gastric mucosa cannot be avoided. Aspirin and alcohol have a cumulative effect, even a small amount of alcohol can increase the damage to the mucosa of the stomach and duodenum, and prolong the bleeding time, so you should not drink alcohol while taking aspirin.
Alcohol has a dual effect on drug metabolism, a small amount of alcohol can promote drug metabolism, so that the efficacy of the drug decreases, long-term, a large amount of alcohol can inhibit the activity of drug metabolism enzymes, so that the metabolism slows down, accumulation of poisoning. On the one hand, statins are mainly metabolized in the body by CYP3A4 enzyme (liver drug metabolizing enzyme), and long-term and heavy alcohol consumption can inhibit CYP3A4 enzyme activity, resulting in statin metabolism blockage, increased blood concentration, prolonged action time, and significantly increased risk of adverse reactionsOn the other hand, statins can cause liver damage, which is manifested as an increase in serum aminotransferases, and long-term heavy alcohol consumption is the cause of liver damage caused by statins, so you should not drink alcohol when taking statins.