ASPIRIN: To whom, to whom?
We see that many elderly, male and female patients who come for cardiology examination use aspirin as a blood thinner. Is it always good to dilute the blood? Aspirin to whom benefit and harm?
What is Aspirin?
Aspirin is the most widely recognized drug in the world for more than a hundred years. It was developed in 1897 by the German chemist Felix Hoffmann. This medicine has been used for a long time as a painkiller and antipyretic. It has been used for 40 years due to its protective effect in cardiovascular diseases.
How Should We Prevent Cardiovascular Disease?
The most common cause of cardiovascular disease is atherosclerosis called arteriosclerosis and it is directly related to our lifestyle and feeding habits. It is not possible to protect from heart disease by taking “blood thinners meden without giving up our habits such as still life, malnutrition, obesity and tobacco use that produce disease.
Is aspirin useful?
The positive effect of aspirin on heart attack was first demonstrated in 1974. Clinical studies over the past 40 years have shown that aspirin is useful in preventing recurrent events in men and women with cardiovascular disease, heart attacks, balloon-stent therapy, or coronary bypass surgery. Nowadays, patients with cardiovascular or cerebrovascular disease are advised to use low-dose aspirin for a lifetime if they do not have any inhibitory condition. The use of aspirin reduces the risk of vascular disease by 15% and the risk of non-lethal heart attack and stroke by 33%. However, aspirin, which is successful in preventing patients from becoming ill again, is not so successful in preventing healthy people from becoming ill. As the risk of becoming ill for these individuals increases, the benefit of aspirin increases. Aspirin is recommended to use moderate to high (> 10%) individuals at risk of developing cardiovascular disease in the next 10 years, while aspirin is not recommended for primary prevention in patients with <10% risk of coronary events.
In 2012, 9 large studies of more than 100,000 men and women without aspirin used aspirin for primary prevention: a 20% reduction in the incidence of heart attacks, but no risk of bleeding from stroke and cardiovascular disease increased by 54%. In the Women's Health Study, which included nearly 40,000 women over 45 years of age, it was shown that 100 mg aspirin daily had no protective effect on death from heart attack and cardiovascular disease during a 10-year follow-up, but reduced the risk of stroke.
According to the common results of major primary prevention studies, 3 heart-related events can be prevented in 3 women per 1000 women and 4 in 1000 men. However, this beneficial effect has a price and aspirin causes significant bleeding in 3.3 out of 1000 men and 2.5 out of 1000 women.
The most important side effect of aspirin is bleeding. Most of the bleeding is gastrointestinal bleeding and some bleeding may be life-threatening. The most fatal of these is brain hemorrhage. Those with the highest risk of aspirin-induced bleeding are those who have had an ulcer or bleeding, age> 60, those who received high-dose medication, and those who received cortisone or additional blood thinners. The bleeding effect of aspirin cannot be prevented by being enteric coated (opening in the intestine) or taking it in low doses. If patients with high risk of bleeding have to take aspirin, gastric sparing should be given.
Who should use Aspirin?
Aspirin is useful for all patients with coronary artery disease who have no obstacle to aspirin use and is recommended for life. A dosage of 75-100 mg per day is sufficient for this purpose; higher doses increase the risk of bleeding without increased benefit. Physicians should decide to use aspirin in patients without known heart disease. The total cardiovascular risk can be calculated and given to those with moderate or high (10-year risk> 10%).
Who should not use aspirin?
There is no point in using aspirin in patients with low risk of cardiovascular disease. Because while avoiding coronary heart disease, at least that much stomach bleeding may be exposed. In addition, aspirin use is not recommended for individuals under 50 years of age without cardiovascular disease and for diabetic patients who do not have cardiovascular disease clinically.
When aspirin is given to 1000 patients in their 60s with a risk of developing coronary artery disease 10 to 20% (moderately), with a risk of encountering any cancer in the next 10 years, 6 deaths, 17 heart attacks, 6 cancers can be prevented, stroke rates constant. However, additional 16 significant hemorrhage may occur including intracranial hemorrhage.
Aspirin and cancer:
The role of aspirin in primary prevention may change by showing that aspirin has positive effects on the incidence of cancer and death from cancer. It has been suggested that the use of low-dose aspirin for more than 5 years can reduce the incidence of large bowel cancer, female uterine cancer, lymphoma and sarcoma. A relatively 12% reduction in the incidence of cancer was achieved with aspirin over a period of 8-10 years. However, recommendations for the use of aspirin as a cancer prophylactic are not yet clear.
Finally, it is not right to recommend a drug (albeit aspirin) that you think is good for others. Drugs are products containing active substances and should not be used unless recommended by the doctor.
7AXX
Bayer Aspirin, Back & Body, 500 mg, Coated Tablets, 200 count
