Uncle Zhang, 65 years old this year, suddenly developed symptoms of speech disorder and numbness in the right limb last week, and was diagnosed with severe cerebral artery stenosis after going to the hospital for examination, considering that the symptoms on his body were caused by acute cerebral infarction. The doctor immediately arranged for Uncle Zhang to be hospitalized, and at the same time prescribed him aspirin, clopidogrel combined with antiplatelet therapy, and atorvastatin to lower blood lipids.
Uncle Zhang was very suspicious about the prescription of these medicines, why did he have to take so many medicines at once, statins and aspirin? Aren't these two drugs both to prevent cardiovascular diseases? Is it to make money by prescribing so many medicines to himself?
1. Is aspirin the same as statins?
Atherosclerosis is the main cause of cardiovascular disease, which refers to the entry of low-density lipoprotein cholesterol in the blood into the lining of the arteries to form plaques, and once the plaques rupture, they will induce platelet aggregation to form blood clots.
For patients with definite atherosclerotic disease, drug control is basically required, and statins and aspirin are the two most common drugs, so what is the difference between the two?
Statins are a general term for a class of drugs, and there are 7 main types of drugs that are commonly used, namely lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin, rosuvastatin, and pitavastatin.
The main effect of this class of drugs is to lower LDL cholesterol and increase HDL cholesterol, and at the same time can be anti-inflammatory, protect the vascular endothelium, stabilize vascular plaque, and prevent thrombosis. These drugs are indicated for patients with definite coronary artery disease, myocardial infarction, cerebral infarction, and cardiac stent/bypass surgery.
Aspirin is the basic drug for the treatment of cardiovascular and cerebrovascular diseases, which can play a role in antiplatelet aggregation and thrombosis prevention. Like statins, it is indicated for patients with definite coronary heart disease, myocardial infarction, cerebral infarction, and after heart surgery.
Aspirin is mainly divided into ordinary tablets and enteric-coated tablets, the main components of the two are the same, but there are differences in pharmaceutical technology, compared with aspirin ordinary tablets, aspirin enteric-coated tablets have less and milder irritation to the gastrointestinal tract.
Aspirin enteric-coated tablets are available in 25 mg, 50 mg, 100 mg and other specifications, small doses of aspirin are mainly used to prevent cardiovascular diseases, and aspirin ordinary tablets are mostly used for antipyretic and analgesic, with a dose of up to 500 mg.
2. Can aspirin enteric-coated tablets and atorvastatin be taken together?
Clinically, the combination of aspirin enteric-coated tablets and atorvastatin is very common, so can everyone take it like this? The answer is no. Whether the two need to be combined depends on the patient's actual situation.
It is generally believed that patients with cardiovascular disease who have had coronary heart disease and ischemic stroke need to be combined with two drugs to prevent recurrence of cardiovascular and cerebrovascular diseases.
However, for some patients who do not suffer from cardiovascular and cerebrovascular diseases, such as simple hyperlipidemia and hypertension, in most cases, they do not need to take aspirin, and only take statin lipid-lowering drugs, especially in some people who do not have cardiovascular disease, and want to prevent cardiovascular disease by taking aspirin, they may face the risk of bleeding, and the risks far outweigh the benefits.
Do aspirin and statins have to be taken for a long time once they have been taken?
Aspirin is an antiplatelet aggregation drug, and statins can inhibit the progression of atherosclerotic plaques.
3. Long-term use of aspirin and statins, these 4 points should be noted
During the period of taking the drug, it is necessary to pay attention to these things to avoid the adverse effects of improper medication on health.
1. Reasonable choice of drugs
There are many types of statins, such as atorvastatin is recommended for patients with renal insufficiency, rosuvastatin is recommended for the elderly, pravastatin can be considered for people with high muscle pain/blood sugar, etc., and aspirin is recommended to choose a low-dose enteric-coated tablet of about 100mg, which can reduce the adverse effects of the drug.
2. Pay attention to the time of taking medicine
Statins can be divided into short-acting and long-acting drugs, the former includes simvastatin, lovastatin, etc., which are generally recommended to be taken after dinner or before bedtime, while atorvastatin and pitavastatin are long-acting drugs, which can be taken at a fixed time point every day. Aspirin enteric-coated tablets are recommended to be taken after meals to avoid damage to the gastric mucosa.
3. Monitor adverse reactions
When taking statins, it is necessary to pay attention to regular testing of liver function, creatine kinase value, and blood glucose, and seek medical attention in time once the index is found to be abnormally elevated;
4. Check blood lipids regularly
Whether aspirin is effective or not is difficult to judge by clinical indicators, but statins can be used to monitor response by measuring LDL cholesterol levels. It is generally recommended that patients who have already had a cardiovascular event have their LDL cholesterol level below 1.8 mmol/L.
Whether it is statins or aspirin, they are commonly used drugs to prevent cardiovascular and cerebrovascular diseases, but it should be noted that you cannot blindly take drugs in your daily life, and you must have professional doctor's guidance before taking drugs.
Resources:
[1] "Aspirin and Statins, Do They Work Well in the Morning or in the Evening?". Health Press 2022-04-09
[2] "Famous Doctor Says | "After acute cerebral infarction, do I need to take aspirin and statins for a long time?" Prof. Yaoming Xu-The Affiliated Hospital of Inner Mongolia University for Nationalities. Cerebrovascular Disease Branch of Chinese Geriatrics Society 2023-11-13
[3] "Secondary Prevention of Cardiovascular Diseases ▏ Statin with Aspirin", Department of Pharmacy, Handan People's Hospital, 2022-02-18
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