67-year-old Aunt Zeng has always been in good health. But in the past few years after retirement, people around have been suffering from high blood pressure, and Aunt Zeng was worried that she would be one of them sooner or later, so she began to collect various "blood pressure reduction manuals" and "high blood pressure prevention knowledge".
I accidentally learned that a friend with high blood pressure was taking aspirin to prevent cardiovascular disease, so I followed her example and began to take aspirin every day to prevent high blood pressure.
At first, Aunt Zeng did not feel any discomfort, but since last month, Aunt Zeng found that her stool was black, and at that time she only thought that it was "moisture" in her body, or she had eaten foods such as black sesame, black glutinous rice, and pig's blood, and did not care.
On this day, Aunt Zeng was eating lunch, just after eating a few bites, she felt sick and uncomfortable, and then spit out coffee-colored liquid, and the family was frightened and quickly sent Aunt Zeng to the emergency room.
Came to the hospital, Aunt Zeng was still spitting coffee-colored liquid, measuring blood pressure 90/56mmHg, the doctor judged that it may be gastric bleeding, gastroscopy was gastric ulcer, and the bleeding needed to be stopped immediately.
After the doctor stopped the bleeding of Aunt Zeng, after laboratory tests, it was found that Aunt Zeng's hemoglobin was less than 70g/L, which was severe anemia.
After the doctor's analysis, it was found that Aunt Zeng, who had no blood pressure problems, not only did not play a preventive role because of aspirin, but also caused stomach bleeding.
First, aspirin can not only prolong life, but also soften blood vessels?
The advent of aspirin dates back to the 18th century. In 1763, English priest Edward Stone discovered that willow bark could cure colds when dried, and the mechanism was related to the inclusion of aspirin.
Aspirin is widely used clinically, it has the effect of inhibiting platelet aggregation, and is often used to treat or prevent some thrombosis-related diseases. At the same time, aspirin has antipyretic and analgesic effects, and has a certain therapeutic effect on fever, pain and rheumatoid arthritis.
Many people believe that taking aspirin can prevent cardiovascular disease and prolong life, and the US Preventive Services Task Force issued a statement saying that it is not recommended to take aspirin for primary prevention of cardiovascular disease ≥ 60-year-olds, and its bleeding risk may be greater than the benefit of cardiovascular disease.
People who need aspirin for primary prevention are limited to hypertension, hyperlipidemia, diabetes, and risk factors such as obesity, early onset cardiovascular disease, and atherosclerosis, and the incidence of cardiovascular disease is > 10% within 10 years.
Cardiovascular prevention should be evaluated.
Drugs are recommended only if the efficacy benefit significantly outweighs the risk of adverse effects. For healthy people, aspirin does not play a role in preventing cardiovascular disease, and blind use can increase the risk of bleeding.
There were also earlier rumors that aspirin in older adults could help prolong life.
While aspirin use has a protective effect on older adults with heart disease, stroke and angina, an international team of researchers based on a controlled analysis of aspirin versus placebo in 19,000 healthy elderly people found that aspirin did not prolong the life expectancy of older adults.
Although aspirin has made outstanding achievements in the treatment of cardiovascular disease, it is not suitable for the following groups of people:
- Persons over 70 years of age or under 40 years of age;
- People with high bleeding risk, coagulopathy, severe liver disease;
- People who are assessed by doctors to have a higher risk of bleeding than blood clots.
Second, aspirin in combination with these 3 drugs, or equivalent to "poison"
Aspirin in combination with drugs is very common, but when these drugs are combined with them, they can become a deadly "poison".
1. Aspirin + anticoagulant drugs
Aspirin can replace the plasma protein binding site with the anticoagulant, thereby increasing the concentration of the anticoagulant and increasing the risk of bleeding in the patient.
2. Aspirin + ibuprofen
Ibuprofen competes with aspirin and attenuates aspirin's antiplatelet aggregation effect, thereby increasing the risk of cardiovascular events.
3. Aspirin + sulfonylurea hypoglycemic drugs
Aspirin has a hypoglycemic effect, and in combination with sulfonylurea hypoglycemic drugs, it will increase the concentration of free drugs, resulting in hypoglycemia in patients.
3. In the event of three situations, the drug should be stopped in time
Aspirin was once used as a recommended drug for prevention, leading some people to have the misconception that since it can be used for prevention, it means that there are no side effects.
In fact, the application of aspirin is only suitable for the corresponding indications, and the risk of side effects is lower than the risk of benefit, while for the general population, aspirin can cause gastrointestinal bleeding, allergies and dizziness and other neurological symptoms, and should be stopped in time under the guidance of a doctor. One of the most dangerous side effects is gastrointestinal bleeding, which can be life-threatening in severe cases.
Is there any way to reduce the occurrence of side effects?
1. Standardize dosage and taking time
Studies have found that 75 to 100 mg/day is the optimal dose of aspirin for long-term primary prophylaxis, when the benefit is greatest and the risk of bleeding is lowest.
In addition, the time of aspirin taking of different preparations is also different, enteric-coated tablets should be taken on an empty stomach, and ordinary dosage forms should be taken after meals.
2. Be alert to bleeding risks
Taking aspirin, you should pay attention to observe physical changes, whether there are bruises or bleeding spots on the skin, whether there is melena, and regularly check fecal occult blood and blood routine.
3. Stay away from high-risk factors
While taking aspirin, bad lifestyle habits should be corrected, smoking cessation and alcohol, alcohol and cigarettes will cause the drug to have strong irritation to the gastric mucosa, aggravating the risk of bleeding.
It is important to recognize that aspirin is a drug, not a health supplement. For people who do not need to take aspirin, taking medication without permission puts themselves at risk.
Resources:
[1] Can aspirin prevent blood clots? Take you to understand what it does". People's Daily Science.2019-08-07
[2] "U.S. Preventive Services Task Force Releases New Statement: People over 60 years old are not recommended to take aspirin to prevent cardiovascular disease!" 》. Health Times.2022-05-24
[3] Remember: Aspirin's Interactions with These Six Drugs! 》. Center for Drug Evaluation.2017-11-11
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