still eat aspirin?
Europeans also agree with Americans in this regard. The 2016 European Society of Cardiology (ESC) Cardiovascular Disease Prevention Guidelines also pointed out that eating aspirin will increase the risk of major bleeding, and it is not recommended for ordinary healthy people to take aspirin routinely to prevent cardiovascular disease. The occurrence of the disease.
Aspirin was once widely used on the land of China. Back more than ten years ago, even some young people who had just been diagnosed with hypertension and would start to take aspirin to prevent cardiovascular and cerebrovascular diseases. It can be said that aspirin was once the first "magic medicine" on the land of China, and it seems to have reached the level of curing all diseases. Eat to prevent cardiovascular and cerebrovascular diseases, and even to prevent tumors. However, in recent years, there has been more and more opposition to the use of aspirin. So, for ordinary healthy people, can aspirin still be eaten? Today, Doctor Zhang is here to talk to you about this issue. You will definitely see the end, and you will definitely gain.
"Aspirin" in wind and rain
1. Can aspirin be eaten?
Whether to take aspirin or not, I said that some people still have to take it, but some people don’t have to take it. Here is a concise answer for everyone:
First, after having diagnosed coronary heart disease and cerebral infarction For patients with cardiovascular and cerebrovascular diseases such as , as long as there are no contraindications and obvious adverse reactions, aspirin is still the cornerstone of drug treatment, and there is nothing to say.
Second, for those patients who have not been diagnosed with coronary heart disease, cerebral infarction and other cardiovascular and cerebrovascular diseases, if you want to use aspirin to prevent cardiovascular and cerebrovascular diseases, you need a rigorous evaluation at this time, instead of starting to eat at will as before. aspirin.
So, why do you say that? How to evaluate who should take aspirin? Everyone look down
2. Can aspirin still be used to prevent cardiovascular and cerebrovascular diseases?
In recent years, with the announcement of the results of several large international clinical trials, more and more evidence and guidelines believe that the use of aspirin to prevent cardiovascular and cerebrovascular diseases should be cautious. It is not absolutely unusable, nor is it absolutely necessary. Can it be used specifically for everyone? also depends on who has greater profit or risk! The main benefit of aspirin for disease prevention is that it can reduce non-fatal ischemic events, including myocardial infarction, transient ischemic attack, and ischemic stroke; the main risk comes from a significant increase in non-fatal bleeding events, including Gastrointestinal bleeding and intracranial bleeding.
Therefore, regarding whether aspirin can prevent the occurrence of cardiovascular and cerebrovascular diseases, we should realize that: on the one hand, aspirin must be very cautious when used in primary prevention of cardiovascular and cerebrovascular diseases; on the other hand, it is still The value of aspirin in the primary prevention of cardiovascular and cerebrovascular diseases cannot be completely denied. Only when the benefits of medication significantly exceed the risks of medication, aspirin can still be used to prevent cardiovascular and cerebrovascular diseases. The understanding of
is relatively objective and rigorous. So, how to evaluate who should take aspirin?
3. Who should take aspirin to prevent cardiovascular and cerebrovascular diseases?
Simply put, for those 40 to 70-year-old adults who are still at high risk of ischemic cardiovascular and cerebrovascular diseases after active intervention on risk factors (10-year expected risk ≥10%), and if the patient’s bleeding The risk is not high, and I am willing to take long-term prophylactic oral low-dose aspirin for patients who can consider long-term oral low-dose aspirin to prevent cardiovascular and cerebral vascular diseases.
patients with cardiovascular and cerebrovascular diseases
4. How to define the concept of "10-year expected risk exceeding 10%"?
To put it plainly, for adults aged 40 to 70, the 10-year expected cardiovascular disease risk ≥ 10% can be simply regarded as: after active therapeutic intervention, there are still 3 or more major risk factors that have not been controlled .
These risk factors include: hypertension, diabetes, hyperlipidemia, smoking, obesity, family history of early-onset cardiovascular disease (first-degree relatives are before 50 years of age), coronary artery calcification score ≥ 100 or non-obstructive Coronary artery stenosis (degree of stenosis <50%).>
Everyone, see if you have more than 3 risk factors. If so, cure it quickly. If it is not cured or difficult to change, then it can be defined as a group of people whose expected risk exceeds 10% in 10 years. In this case, if the risk of bleeding is not high, it is likely that you need to take aspirin to prevent cardiovascular and cerebrovascular diseases.
Aspirin Instructions Figure
5. Who do not recommend taking aspirin to prevent cardiovascular and cerebrovascular diseases?
According to my country’s latest aspirin primary prevention expert consensus recommendations, generally the following 3 types of people are not recommended to use aspirin for primary prevention of cardiovascular and cerebrovascular diseases:
1. People under the age of 40 or over 70, It is not recommended to use aspirin for primary prevention of cardiovascular and cerebrovascular diseases;
2. People at high risk of bleeding. For example, other drugs that increase the risk of bleeding are being used (including antiplatelet drugs, anticoagulants, glucocorticoids, non-steroidal anti-inflammatory drugs), gastrointestinal bleeding, gastrointestinal ulcers or other bleeding disorders are active Patients with stage, thrombocytopenia, coagulation dysfunction, severe liver disease, chronic kidney disease stage 4~5, uneradicated Helicobacter pylori infection, uncontrolled hypertension, etc. These people are not recommended to use aspirin for cardiovascular and cerebrovascular diseases It is not recommended to use aspirin for the primary prevention of cardiovascular and cerebrovascular diseases in patients whose bleeding risk is greater than the risk of thrombosis after being assessed. People with a high risk of bleeding should be cautious. In short, there have been some cutting-edge developments and different voices on the issue of whether aspirin can be eaten or not. I hope everyone can face it rationally. When every ordinary person faces this problem, I suggest that you still find a professional doctor, and must use aspirin under the guidance of a professional doctor. We can neither completely deny the effect of aspirin, we should eat it! However, it is also not possible for ordinary people and low-risk groups to take aspirin at every turn, as they did in previous years. This is inappropriate and not rigorous. What do you say?
Dr. Zhang Zhiying
References: 2019 Chinese Expert Consensus Writing Group on the Application of Aspirin in Primary Prevention of Cardiovascular Diseases. 2019 Chinese Expert Consensus on the Application of Aspirin in Primary Prevention of Cardiovascular Diseases[J/OL]. Chinese Journal of Cardiovascular Diseases ( Online version), 2019,2:e1-e5(2019-08-19).
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