Aspirin is a century-old medicine, and it is also widely used in the field of cardiovascular diseases to prevent thrombosis. Aspirin has a specific antiplatelet effect, can last the whole life cycle of platelets, and has clear clinical benefits in preventing the risk of platelet aggregation and thrombosis caused by atherosclerotic plaque rupture. Therefore, for friends with atherosclerotic cardiovascular diseases, especially those with myocardial infarction or other platelet aggregation thrombosis, it is recommended to take aspirin for a long time to prevent the risk of cardiovascular diseases without taking contraindications.
However, the antiplatelet effect of aspirin will also increase the risk of bleeding, which may be manifested in many aspects, such as gingival bleeding, subcutaneous bleeding, gastrointestinal bleeding and even cerebral hemorrhage. Although these problems are often not only caused by taking aspirin, taking aspirin will increase the risk of bleeding in these areas, and it does exist. Therefore, before taking aspirin for a long time, and in the process of taking aspirin for a long time, we must pay attention to evaluating the risk of bleeding, pay attention to possible bleeding symptoms or risks in time, and stop taking aspirin in time once there is a problem of cerebral hemorrhage, so as to minimize the related influencing factors that lead to bleeding.
Many friends want to know, how much is the risk of cerebral hemorrhage caused by taking aspirin for a long time, or how much will it increase? On this issue, let's talk about it with relevant clinical research data.
A meta-analysis study published in Medline analyzed the therapeutic results of aspirin and cerebrovascular diseases through a multicenter randomized controlled clinical trial of 16. The results showed that for every 1 10,000 patients who took aspirin, long-term use of aspirin could reduce the incidence of cerebral infarction in 39 patients, while the risk of cerebral hemorrhage increased 12 patients. Therefore, taking aspirin for a long time can prevent cerebral infarction in terms of health benefits and risks.
The occurrence and development of atherosclerosis is indeed a very difficult problem. Thrombosis may occur, which may lead to the risk of myocardial infarction and cerebral infarction. However, severe arteriosclerosis in the same artery is also one of the important reasons for the increased risk of hemorrhagic stroke. Therefore, it is very important to weigh and evaluate the health benefits of taking aspirin for a long time and the benefit-risk ratio that leads to the increased risk of bleeding. If it is a high-risk patient with cerebral hemorrhage, it is more prudent to take aspirin for a long time to prevent infarction. If the risk of infarction is high, the risk of bleeding caused by long-term use is not great, or take aspirin for a long time. Therefore, whether to take this medicine or not depends mainly on risk assessment.
Clinically, the incidence of cerebral infarction is much higher than that of cerebral hemorrhage. So many times, although we know that taking aspirin may lead to the risk of cerebral hemorrhage, we still need to take aspirin for a long time to prevent cardiovascular and cerebrovascular diseases in order to prevent myocardial infarction and cerebral infarction. Under such circumstances, how to reduce the risk of cerebral hemorrhage during long-term medication is particularly important. In this regard, I give you the following four suggestions, hoping to help you.
1, do a good job in risk assessment of cerebral hemorrhage.
It must be recognized that there are many risk factors leading to cerebral hemorrhage, including long-term use of aspirin, the degree of atherosclerosis, aging factors, cerebral arterial amyloidosis, postoperative over-perfusion, long-term uncontrolled blood pressure and blood sugar, bad living habits, liver disease, coagulation dysfunction and so on. These are all risk factors leading to an increased risk of cerebral hemorrhage. Therefore, before taking aspirin for a long time, it is advisable to combine various factors to evaluate the risk of cerebral hemorrhage. If there is a high risk of cerebral hemorrhage, aspirin or other antiplatelet drugs should be used with caution, or used again on the premise of eliminating related risk factors and reducing the risk of cerebral hemorrhage.
2. Pay attention to the dosage selection of long-term medication.
Low dose aspirin can prevent thrombosis. It is generally recommended to take aspirin for a long time, with a daily dose of 75mg~ 150mg, without further increasing the dose. A retrospective analysis of clinical cases in China 17 years showed that the incidence of cerebral hemorrhage in the low-dose aspirin group (25~ 100mg/d) was not significantly different from that in the control group, while the incidence of cerebral hemorrhage in the middle-high dose aspirin group (300~900mg/d) was significantly different from that in the control group, indicating that long-term oral low-dose aspirin for secondary prevention would not increase the risk of cerebral hemorrhage. Therefore, for friends who have a certain risk of cerebral hemorrhage, if they really need to take aspirin for a long time, they can try to choose a low dose, and the daily dose should not exceed 100mg.
3. Strictly control blood pressure and blood sugar levels.
Chronic metabolic diseases such as hypertension and hyperglycemia are important risk factors for cerebral arteriosclerosis. Hypertension will increase vascular pressure and increase the risk of cerebral hemorrhage, while diabetes will affect blood wound agglutination and increase the risk of bleeding. Therefore, for patients with hypertension and diabetes, during the long-term use of aspirin, we must pay attention to strictly controlling blood pressure and blood sugar levels. If blood pressure and blood sugar can be strictly controlled to reach the standard, not only can the risk of cerebral hemorrhage caused by taking aspirin for a long time be reduced, but also the risk factors of cerebral hemorrhage can be further reduced, and the risk of cerebral hemorrhage can be reduced from two aspects.
4, actively do a good job in life conditioning control.
In order to prevent the risk of cerebral hemorrhage, it is also very important to do a good job of conditioning and control in life. Life factors such as smoking, long-term heavy drinking and emotional instability are also closely related to the increased risk of cerebral hemorrhage. Therefore, if you want to reduce the risk of cerebral hemorrhage as much as possible in the process of taking aspirin for a long time, since stopping taking aspirin may lead to an increase in the risk of thrombosis, and you can't quit, you might as well be strict in self-discipline, maintain healthy and good living habits, and maintain a peaceful and optimistic attitude. Minimize the risk of cerebral hemorrhage caused or induced by unhealthy life factors. Doing a good job in these aspects can not only reduce the risk of cerebral hemorrhage, but also be important for the prevention of infarct diseases caused by myocardial infarction. Long-term adherence to a healthy lifestyle is an important basis for preventing cardiovascular and cerebrovascular diseases. It's never too late to do it. As long as you keep doing it, you will benefit.