As the population ages, the prevention of cardiovascular disease is becoming a growing concern. People who are at risk of cardiovascular disease are often advised by doctors to take aspirin and statins for prevention, and alopah encounters the most inquiries about these two drugs. People want to know why they should take these two drugs to prevent cardiovascular disease. Will there be any side effects?
Aspirin and statins are a “good match”
You may find that when suffering from coronary heart disease, myocardial infarction, cerebral infarction, lower extremity artery thrombosis and other thrombosis-related diseases, or when there is a potential risk of these diseases, doctors often recommend long-term use of aspirin and statin drugs. This is because these two drugs can work well together to prevent serious disease events from occurring.
The primary cause of thrombotic disease is atherosclerosis of the arteries, which occurs when lipids in the blood (mainly LDL cholesterol LDL-C) enter the lining of the blood vessels and form hardened plaques. If left unchecked, the hardened plaque will gradually grow, the inner diameter of the blood vessels will become narrower and blood flow will become less and less. The surface of the plaque is rough and not smooth like the normal blood vessel lining, so it is easy to gather platelets and form blood clots. Moreover, the plaque itself is unstable and prone to rupture, releasing the lipid substances in it to form emboli and block small arteries.
Therefore, for the cause of thrombosis, taking aspirin with statins can be a good prevention. Aspirin inhibits platelet activity and prevents platelets from aggregating on the surface of plaques, which can prevent the creation of blood clots in the blood vessels. With a meta-analysis of data from various large clinical trials around the world, taking aspirin can reduce the overall risk of myocardial infarction and stroke by about 15%. And for those with hypertension, diabetes, and excess blood lipids, the risk of disease decreases by more than 25%.
Statins reduce the concentration of lipids in the blood and stop the process of plaque growth. And in addition to lowering blood lipids, statins also stabilize the intima, prevent plaque breakdown, increase plaque density, reduce the volume of vascular plaque, and have the effect of reversing plaque. Some studies have confirmed that when the blood LDL-C concentration drops to 2.0mmol/L, the process of lipids entering the intima stops, and when LDL-C drops to 1.8mmol/L, the lipids will be reversed from the intima back to the blood.
Second, the need for long-term medication
Statins can only make limited reversal of plaque, because after LDL-C in blood enters the intima, it will be engulfed by macrophages and form foam cells, which cannot be removed. Therefore, after atherosclerosis has occurred in the arteries, it cannot be completely cured. The disease needs to be prevented, and it needs to be controlled by long-term medication.
The vast majority of people take aspirin, and a small dose of 100 mg per day is good enough to inhibit the activity of platelets. But the body produces a steady stream of new platelets every day, and if you stop taking aspirin for more than 48 hours, the risk of blood clots will return to unmedicated levels. Aspirin, therefore, needs to be taken regularly every day. Similarly, statin drugs are the same and need to be taken on a regular basis every day to produce the effect of inhibiting blood lipids and reversing plaque.
Third, about the side effects of drugs
Recently, a lot of people have asked alopah that aspirin has gone down and statins have been boycotted by the “experts”. Alopah told them that this is just a misinterpretation of some recent clinical trials by some people and a rumor spread by unknown people. In the rest of the world, aspirin and statins are still the two “cornerstones” of cardiovascular disease prevention. People who are at risk of developing the disease need to take them for primary prevention, and those who have already had the disease are at very high risk of recurrence and need to take them for secondary prevention.
Both aspirin and statin have side effects, with aspirin mainly causing mucosal damage and clotting disorders in the digestive tract and statins causing hyperglycemia and myopathy. But for people at high risk of cardiovascular disease, the benefits of taking the drugs outweigh the risks. And the risk of side effects can be monitored and well controlled while taking the medication. Most people will not experience intolerable adverse reactions as long as they follow medical advice, pay more attention to gastrointestinal reactions and regular creatine kinase testing, and intervene promptly if problems are detected. Compared with the occurrence of serious diseases such as myocardial infarction and cerebral infarction, the damage of side effects of drugs is much less.
Therefore, the two “cornerstones” of aspirin and statins are still indispensable to prevent attacks in people at high risk of cardiovascular disease and to prevent recurrence in people who have had an attack of related disease. However, the medication should be evaluated by a doctor before use and should not be self-administered. If you have any problems with your medication, please contact your doctor or pharmacist.