Aspirin is a common drug for the prevention of cardiovascular events and is essential for many patients with coronary heart disease and stroke.
In addition, there are many patients without cardiovascular disease who may also need to take aspirin.
01 What diseases can aspirin treat?
Aspirin was first used for antipyretic, analgesic, and anti-inflammatory (mainly for osteoarthritis, rheumatoid arthritis, etc.).
However, in the later period, it was found that when aspirin was used for antipyretic, analgesic, and anti-inflammatory, the dose required was relatively large. Generally more than 375mg to have analgesic effect, in order to achieve the treatment of osteoarthritis or rheumatoid arthritis, the dosage may need to reach 1-2g.
However, the use of a large amount of aspirin will produce strong stimulation of the stomach, as well as adverse reactions such as bleeding. And if younger children use aspirin, reeyi syndrome (a serious, fatal adverse effect, more on that later) may occur.
Therefore, in the clinic, small doses of aspirin are more used, and there are also strict restrictions on the use of children.
In recent decades, people have found that small doses of aspirin can also prevent thrombosis and reduce the risk of diseases caused by cardiovascular diseases, such as myocardial infarction, angina, ischemic stroke, etc. Aspirin has become one of the main drugs for preventing cardiovascular events.
02 Who needs to take aspirin?
Aspirin is used to prevent cardiovascular events, primarily as primary and secondary.
Primary prevention: for patients who do not currently have a disease such as coronary heart disease or ischemic stroke, but who have several risk factors.
If doctors assess the patient's risk of cardiovascular events in the next decade greater than 10%, long-term aspirin use is needed for prevention. Specifically, there are 7 risk factors for cardiovascular events:
●Age >45/50 years
●Obesity
●Diabetes
●Dyslipidemia
●Hypertension
●Chronic kidney disease
●Smoking
It is generally believed that 3 or more of these 7 factors may require aspirin treatment.
Of course, the specific situation still needs to be decided after a comprehensive assessment by the doctor.
Secondary prevention: mainly for patients with cardiovascular diseases such as coronary heart disease and ischemic stroke, it is recommended that such patients must use aspirin for a long time.
03 What are the adverse reactions to taking aspirin?
There are several types of adverse reactions that may occur when taking aspirin.
/ Stomach irritation /
The most common adverse effect of aspirin is the stimulation of the stomach, and patients may experience symptoms such as stomach pain, indigestion, and abdominal pain.
Of course, this stimulation is closely related to the dose of aspirin taken, and the larger the dose taken, the greater the stimulation to the stomach.
As mentioned above, at present, small doses of aspirin are mostly used clinically, and most of them are "enteric-coated" dosage forms.
Through the "enteric-coated" technology, aspirin can be released in the alkaline environment of the intestine, which can reduce the stimulation of the stomach by aspirin to a certain extent.
/ Bleeding Risk /
Since aspirin inhibits platelet aggregation and thrombosis, this also means that the risk of bleeding is increased.
For patients taking aspirin for a long time, there may be adverse reactions such as bleeding gums, bleeding from the mouth, and nosebleeds;
For the elderly, over 70 years old, eating aspirin may have gastrointestinal bleeding, the most obvious symptoms are black stools or bloody stools;
If you are a patient with an active peptic ulcer, taking large doses of aspirin may increase the bleeding of the ulcer. Of course, the aspirin currently used to prevent cardiovascular events is generally between 75-150 mg, and the risk of bleeding is relatively low.
/ Aspirin Asthma /
Patients with allergies or asthma, allergic rhinitis, and nasal polyps are more likely to develop asthma after taking aspirin than other patients.
/ Ruiyi syndrome /
In younger children, if aspirin is used to treat fever caused by viral infections such as influenza virus, Epstein-Barr virus, and herpes zoster virus, it may lead to a very serious adverse effect, that is, Ruiyi syndrome.
It is mainly manifested by persistent vomiting, nausea, and central nervous system first excitement and then inhibition, resulting in coma and even death.
Therefore, in the current clinic, except for the treatment of special cases such as Kawasaki disease in children, it is generally not recommended for children to use aspirin.
/ Elevated blood uric acid /
Patients who have been taking aspirin for a long time may have elevated blood uric acid. Especially patients with hyperuricemia and even gout need more attention.
References: Medical Microvision official website - Liu Zhijun, chief pharmacist "Aspirin"