Statins and aspirin are the cornerstone drugs for patients with cardiovascular and cerebrovascular disease, the two can effectively prevent the occurrence of cardiovascular and cerebrovascular accidents, as a drug, in addition to the existence of due therapeutic effect, there are non-therapeutic purpose of the adverse effects, in order to enhance the efficacy and minimize the adverse effects of the two ways of taking, taking the time and so on, there are matters that must be paid attention to;

aspirin (loanword)

Because of the strong irritation of aspirin to the gastric mucosa, the way and timing of the drug should try to avoid direct contact between aspirin and the gastric mucosa, so, like aspirin tablets or aspirin effervescent tablets that can be directly dissolved in gastric juices, we need to time their administration in themeal times或About 30 minutes after a meal, allowing the drug to be mixed with food to reduce the chance of direct contact between the drug and the gastric mucosa for the purpose of protecting the gastric mucosa;

The enteric solvent form of aspirin, due to the unique acid-intolerant and alkali-intolerant coating on the surface of the drug, can greatly reduce the dissolution rate of aspirin in the gastric juice, which in turn reduces the direct stimulating effect of the drug on the gastric mucosa. There have been patients who have asked, since enteric-coated tablets can avoid the dissolution of aspirin in the stomach, why is it still required that the drug be taken on an empty stomach? This is of course for a reason, the dissolution rate of the drug is only pure simulation of the acidic environment of the gastric juice, did not take into account the influence of food, and under normal circumstances, the pH value of the gastric juice will be affected by food, such as gastric acid decomposition of the normal consumption of food, or the presence of certain alkaline food accelerates the consumption of gastric acid, etc., will cause the pH value of the stomach to change, in which case, the original acidity in the gastric juice in the standard difficult to dissolve the enteric-coated preparation In this case, enteric preparations that are difficult to dissolve in standard acidity gastric fluid become easily dissolved because of the change in the pH value of gastric fluid.Aspirin enteric-coated preparations should be taken on an empty stomach whenever possible, because the acidity of the gastric juice at this time ensures the integrity of the drug before it enters the alkaline environment of the intestine, reducing the direct irritating effect of aspirin on the gastric mucosa!

Finally, one more thing needs to be said that there is a possibility of induced bleeding with long-term aspirin use, so you should pay attention to monitoring platelet levels and coagulation function while taking the medication so that you can adjust the medication in a timely manner to prevent accidents from occurring!

Statins

At present, there are seven kinds of statins on sale in the domestic drug market, namely, lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin, reseruvastatin and pitavastatin, and the differences among the seven kinds of statins are not small, especially the length of the half-life, of which fluvastatin, which has the shortest half-life, only has a half-life of 1.2 hours, while the half-life of atorvastatin has a half-life of up to 14 hours, and the half-life of reservastatin has a half-life of 13 to 20 hours. ～We all know that the mechanism of cholesterol regulation by statins lies in the inhibitory effect on the liver's ability to synthesize cholesterol, and the most active time for cholesterol synthesis is at night, so in order to ensure the best therapeutic effect of statins, their efficacy should be maintained at night, that is to say, the shorter the half-life of the statin, the more it is necessary to take it in the evening, and the half-life of the longer atorvastatin and Rosuvastatin can be taken at any time of the day;

In addition, it should be noted that no matter which statin drugs, their adverse effects are similar, such as muscle damage, liver and kidney damage, hyperglycemia, memory and cognitive function decline, etc. Therefore, as long as in the long-term use of statin drugs, should be timely testing of creatine kinase, liver and kidney function, glucose and blood sugar and lipids and other items, in order to avoid the harm, but also to facilitate timely adjustment of drugs;

Finally, it is important to note that the contraindication between statins and fruits containing furanocoumarins, such as grapefruit, which we often talk about, is not really such a concern.Not all statins can't eat grapefruit; only three drugs, atorvastatin, simvastatin, and lovastatin, are affected by furanocoumarins, while the other four are not!

The above is for reference only!

Many elderly people who are at risk of cardiovascular disease are taking statin and aspirin for a long period of time, so can statin and aspirin be taken at the same time for a long period of time? What should we pay attention to during taking? Today we will discuss this briefly with you.

Aspirin can be taken at the same time as statins

In terms of drug action, aspirin is taken long term to avoid the risk of thrombotic cardiovascular disease caused by platelet aggregation, while statins are taken long term to control lipids, stabilize plaque, and similarly reduce the risk of cardiovascular disease.

Taking these two drugs at the same time has no effect in terms of drug interactions. Aspirin and statins each do their own thing, and their metabolism and excretion in the body have essentially no effect on each other.

Considerations for long-term aspirin and statin use

Compared with cold medicine, antibiotics and other types of drugs, long-term use of drugs should pay more attention to the effectiveness and safety of the drug. Some friends pay too much attention to the effectiveness of the medication, insist on taking the medication, the body appeared intolerable adverse reactions also do not care, and ultimately because of the medication led to other big problems, such as internal bleeding, such as liver damage, such as rhabdomyolysis, etc., and some friends too much attention to the safety of the medication, for fear of long-term medication to bring about adverse effects on the body, and so eat eat stop, or do not take according to the dosage, which ultimately led to the medication is also eaten, and also not play a preventivecardiovascular diseaseRole. Both of these approaches, are undesirable.

Long-term use of aspirin and statin drugs, first of all, pay attention to the effectiveness of the drug, in fact, there are relevant indications, the need for long-term use of these two kinds of drugs before taking the case, and during the period of medication, pay attention to the monitoring of blood lipids, to ensure that the relevant lipid indexes of the standard, in the blood lipids on the basis of the standard, try to choose a low-dose statin drugs taken to reduce the risk of side effects brought about by the drug. For aspirin, it is still necessary to go through the clinician's assessment, and then take it if you really need to take it, don't use the drug privately.

There is an answer that statin at night, aspirin morning after meals, so that is not accurate, statin drugs for a generation of simvastatin, lovastatin and other drugs, the evening to take better results, but for long-acting atorvastatin, resuvastatin and other drugs, every day to choose a fixed time to take can be, meals and time of day, for the effectiveness of the drug and does not have a great impact; aspirin is now a long-term use of the Low-dose aspirin, generally choose enteric-coated tablets, enteric-coated tablets are recommended to be taken on an empty stomach, half an hour before meals or bedtime can be taken, fasting is conducive to the rapid entry of drugs into the intestinal tract, reducing the direct stimulation of the gastric mucosa.

When taking aspirin and statins for long periods of time, it is important to be aware of the safety risks of the drugs, in addition to regular monitoring of indicators to confirm the effectiveness of the drugs.For the adverse effects of drugs, we must have a correct understanding of the adverse effects of the occurrence of a certain probability, not necessarily occur, this is a point that should be clear。

Long-term use of aspirin, the main thing to pay attention to the risk of bleeding, especially the risk of gastrointestinal bleeding, generally in the first 12 months of taking the drug, the risk of gastrointestinal bleeding is the greatest, in the third month of taking the drug, the risk will reach its peak, for their own gastrointestinal problems of the friends, more should pay attention to, you can consider in the first 12 months of the drug, plus gastric mucosal protective agent to prevent gastrointestinal bleeding problems. In addition to gastrointestinal bleeding, if other bleeding symptoms occur during the medication, such as subcutaneous bleeding, bleeding gums, etc., you should consult a doctor to determine whether the medication is triggered.

When taking statins for a long period of time, there are even more safety issues to be aware of. During the period of taking statin drugs, we should check the liver function regularly, once the transaminase is elevated more than 3 times, we should stop taking the drugs; if there is the problem of muscle pain, we must also check the value of creatine kinase as soon as possible, if it does not care about it for a long time, it may lead to rhabdomyolysis or renal failure and other big problems; long term use of statin drugs, but also pay attention to the monitoring of the blood sugar problem, if there is a rise in blood glucose caused by the drug, we should also seek medical treatment in time. If there is a rise in blood glucose caused by taking the drug, you should also seek medical treatment in a timely manner.

You need to be careful when you take aspirin:

The body's blood viscosity is higher from 6 to 10 a.m., and blood pressure and heart rate levels are also higher, making it a time of high incidence of cardiovascular and cerebrovascular events. Therefore, in order to achieve the best results in the prevention and treatment of cardiovascular diseases, it is more appropriate to take aspirin in the morning in its normal dosage form. However, the strong acidic effect of salicylic acid stimulates the gastric mucosa after oral intake of common dosage form of aspirin, which may easily cause damage to the gastric mucosa and thus induce gastric hemorrhage, so it is generally recommended to take it after meals.

At present, the vast majority of clinical use of aspirin enteric-coated tablets, most of the enteric solvent type is pH-dependent, basically insoluble in the acidic environment of the stomach, after reaching the duodenum in the alkaline environment of the intestinal tract only began to dissolve, so it is better to take aspirin enteric-coated tablets before meals. If the enteric-coated tablets are taken after a meal, on the one hand, food can dilute or neutralize gastric acid, "alkalize" the acidity of the stomach, or even reach alkaline conditions, resulting in the dissolution of the enteric-coated aspirin coat in the stomach; on the other hand, the food will also delay the rapid passage of the drug through the stomach to the intestines, and the resulting release of aspirin will strongly irritate the stomach. When taken before a meal, because the stomach is acidic in the fasting state, aspirin enteric-coated tablets will not be released in the stomach, and will not cause stomach pain and other irritation. If a large dose of an acid-suppressing drug or antacid is taken before a meal, which increases the alkalinity of the stomach, the enteric-coated coat of aspirin may be dissolved prematurely, releasing aspirin.

In special circumstances, such as emergency percutaneous coronary intervention (PCI) or acute attack of cerebral infarction, in order to allow high-dose aspirin to be absorbed as quickly as possible, and to rapidly exert antiplatelet aggregation efficacy, the patient will be allowed to chew the enteric-cleaned aspirin, which is a special, but reasonable method of administration, and the patient needs to be alerted to the presence of gastric ulcer contraindications.

Oral statins need attention:

Since cholesterol synthase has a circadian rhythm and the liver's ability to synthesize cholesterol is strongest at night, it is recommended that statins be taken in the evening or just before bedtime to inhibit cholesterol synthesis.

Patients with coronary artery disease, if there are no contraindications, basically need to take statins and aspirin for a long time. The purpose is to prevent the occurrence of acute myocardial infarction. Shang doctor treats the disease before it occurs, if you wait until myocardial infarction occurs to deal with it, the effect is much worse, it is best to prevent it from occurring.

Aspirin is the classic antipyretic and analgesic, but if it is a low-dose aspirin can inhibit platelet aggregation, this role is very important ah, because patients with coronary heart disease, if the coronary artery thrombosis that is myocardial infarction ah, and the formation of thrombus and platelet aggregation is inseparable, so inhibit the aggregation of platelets, can reduce the formation of blood clots, can also reduce the occurrence of myocardial infarction. In addition to the prevention of coronary heart disease, it can also be used for the prevention of cerebral infarction. However, the main adverse reaction of aspirin is gastrointestinal bleeding or allergic to aspirin, if it is known that gastrointestinal bleeding, gastric ulcer is not suitable for the use of aspirin, this time you can use another platelet aggregation inhibiting drugs (clopidogrel). In addition, some asthmatics using aspirin may trigger an asthma attack, also not suitable for use.

Statins, such as atorvastatin and so on, are lipid-lowering and have a good preventive effect on patients with coronary heart disease and cerebral infarction. They also need to be used for a long time. Statins are effective in lowering cholesterol and LDL cholesterol levels, stabilizing plaque, and can be given to any patient with coronary artery disease, regardless of lipid levels, unless there are contraindications. The overall safety of statins is good, but it is still necessary to test for changes in aminotransferases and creatine kinase at the time of application, as rhabdomyolysis may occur in a very small number of patients, and testing for these markers can detect this problem earlier, as well as detecting the presence of liver damage.

Statin and aspirin are mainly used in patients with cardiovascular diseases. The main effects of statin are to lower cholesterol, stabilize arterial plaques, and prevent plaque rupture; the main effects of aspirin are to fight platelet aggregation, prevent thrombosis, avoid arterial blockage, and reduce vital organ infarction. The combination of the two can significantly reduce the incidence of cardiovascular events.

The use of statin need to pay attention to: (1) the latest generation of statin for the third generation of statin, such as atorvastatin, resuvastatin, etc., the third generation of statin half-life is long, can be taken at any time of the day, the first and second generation of statin half-life is short, due to the peak of cholesterol synthesis at night, it is recommended to take the drug before bedtime, cholesterol-lowering effect is better; (2) statin can cause transaminase abnormality, to alanine aminotransferase, Aspartate aminotransferase is mainly elevated, if the elevation reaches three times the normal value, it is necessary to immediately stop the drug, and dynamic monitoring of aminotransferase, if necessary, hepatoprotective treatment; (3) statin can cause muscle damage, during the use of drugs, if there is muscle pain, tenderness or muscle weakness, it should be highly suspected that the possibility of myopathy, and immediately retest the creatine kinase, if the elevation reaches 10 times the normal value, immediately discontinue the drug to avoid rhabdomyolysis; (4) during the use of statin may occur ) During the use of statin may appear abnormal blood sugar, mainly fasting blood sugar, glycated hemoglobin elevation, so, during the use of statin pay attention to the monitoring of fasting blood sugar and glycated hemoglobin; (5) statin is mainly to reduce cholesterol, low-density lipoproteins, to stabilize the soft plaques, to prevent them from rupture, and at the same time, it can prevent the generation of new plaques, can not be arbitrarily discontinued, and need to be taken for a long period of time, or else it will lose the cardiovascular protection effect It should be taken for a long time, otherwise it will lose its protective effect on cardiovascular.

The use of aspirin need to pay attention to: (1) aspirin antiplatelet effective dose of 75-300mg. commonly used clinical dose of 75-100mg, the dose range, both anti-platelet aggregation, but also to reduce the incidence of adverse reactions, it can not be unauthorized increase or decrease in dosage; (2) asthma, aspirin allergy, bleeding, gastrointestinal ulcers, severe cardiac, hepatic and renal insufficiency, etc., patients are prohibited from aspirin, otherwise it will aggravate the condition. Otherwise, it will aggravate the condition; (3) aspirin common dosage form after meals, enteric solvent fasting, can not be confused, otherwise it will aggravate gastric mucosal damage, and enteric solvent type can only be swallowed as a whole, can not be broken or chewed; (4) aspirin can inhibit the excretion of uric acid, triggering gout, but its cardiovascular protection is much greater than the effect of uric acid, patients with hyperuricemia can not be discontinued without authorization, and, when necessary, change to clopidogrel, clopidogrel does not affect uric acid, and the effect is much greater than that of uric acid. Clopidogrel, clopidogrel does not affect uric acid metabolism; (5) because aspirin anti-platelet aggregation, so there can be a risk of bleeding, bleeding can occur anywhere, such as cerebral hemorrhage, gastrointestinal tract hemorrhage, bleeding of the skin and mucous membranes, the need for close monitoring of the drug during the period of use, and if necessary, discontinue the drug for observation.

Thanks for reading!

I. What can aspirin and statin be used for?

Aspirin is an anti-platelet aggregation drug, while statins are a class of drugs used to lower lipids and stabilize plaque! Aspirin and statin, taken together, are often used in atherosclerotic diseases such as cardiovascular disease that have been diagnosed! to be used to minimize events such as acute cardiovascular disease! So, aspirin and statins are used to prevent the development of atherosclerotic disease!

Second, what do I need to pay attention to when taking both?

Since it is clear that aspirin and statin are used to prevent acute events of atherosclerotic disease, and already diagnosed cardiovascular and other diseases! So it is very important to take your medication on time to maintain good compliance! The next step is to prevent the respective side effects of both drugs! For example, aspirin side effects bleeding, aspirin asthma, gastrointestinal reactions and so on! And statin's side effects are mainly liver impairment, myalgia, rhabdomyolysis, and so on!

C. How long do both need to be taken orally?

The use of antiplatelet aggregating drugs and statins in patients who have been diagnosed with atherosclerotic diseases such as cardiovascular and cerebrovascular disease is required for a long period of time! Long term here means, in most cases, if there are no contraindications or other complications, until finally they cannot be taken orally! So, if the need to take both orally has been diagnosed, then you just need to stick to them!

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The most important thing to watch out for during oral aspirin intake is bleeding. But what should you watch out for during oral statin intake? Many people may not know. However, this question is indeed asked by many patients and friends every day in the clinic. In fact, I personally think that the most important thing you should pay attention to when taking statin is the question of how to review. Everyone is concerned about this issue and the level of concern is very high. Today, Dr. Zhang will talk to you about this issue.

Generally speaking, for patients who are taking statin lipid-lowering drugs, they need to monitor their blood lipids and some other indicators that need attention especially closely. We generally recommend that patients taking a statin for the first time should have their lipids, transaminases and creatine kinase rechecked within the 6th week of medication. If the blood lipids have reached the standard by this time, and no adverse drug reaction is found, then it can become 6-12 months to review. For those patients whose lipids are not up to standard, but have no adverse drug reactions, they can subsequently be reviewed every 3 months. If after another 3 months-6 months of treatment, the lipids are still substandard, the dose and type of lipid-lowering medication should be adjusted or combined with ezetimibe taken orally at the same time. Whenever medication is adjusted, it should be reviewed within 6 weeks of treatment.

If a patient has an adverse drug reaction, it depends on the specific case, the treatment plan for milder cases is different from the more severe cases, the best thing to do at this time is to find a medical professional for further consultation to decide how to treat the next step, some people need to adjust the medication, some need to stop the medication, the treatment is different, listen to the doctor.

Statins are commonly used in the clinic to regulate blood lipids, belonging to the hydroxymethylglutaryl coenzyme A reductase inhibitors, common drugs include simvastatin, atorvastatin, resuvastatin, etc. Hydroxymethylglutaryl coenzyme A reductase is the rate-limiting enzyme for cholesterol synthesis, statin can inhibit the synthesis of hepatic cholesterol by selectively and competitively binding with this enzyme, and play the role of lipotropic effect, and it can significantly reduce the level of total blood serum cholesterol, LDL cholesterol and ApoB. It can significantly reduce the levels of serum total cholesterol, low-density lipoprotein cholesterol and apolipoprotein B. It can also reduce the level of triglycerides and mildly increase the level of high-density lipoprotein cholesterol. In addition, statins also have anti-inflammatory, antioxidant, stabilizing and narrowing atherosclerotic plaques, etc. Currently, they are mainly used in the treatment of hypercholesterolemia and mixed hyperlipidemia in the clinic, and long-term use of them can significantly reduce the risk of myocardial infarction and stroke and other cardiovascular events.

Long-term use of statins requires attention:

• Liver function should be tested before treatment and in the 3rd month after the start of treatment, if the elevation of serum aminotransferases exceeds 3 times the upper limit of the normal range, the dosage of the drug should be reduced or the drug should be discontinued under the guidance of a doctor, and should be used with caution by those who have the habit of excessive alcohol consumption and a history of liver disease, in order to avoid causing serious liver damage.
• For people who are older than 70 years old, hypothyroidism, renal impairment, alcohol abuse, and family history of muscle disease, taking statins can increase the risk of rhabdomyolysis; therefore, statins should be used with caution in the above groups. In the course of drug use, once unexplained muscle weakness, pain or spasm occurs, accompanied by general malaise or fever, the drug should be stopped immediately and seek medical attention.
• Long-term use of statins can lead to elevated blood glucose, especially fasting blood glucose and glycosylated hemoglobin. For high-risk groups such as those with elevated fasting blood glucose, overweight, high blood pressure and hypertriglyceridemia, care should be taken to monitor the indicators of blood glucose, blood lipids, and blood pressure, and to maintain a healthy body weight during the course of medication.

Aspirin has been used in clinical applications for a hundred years now, because of its good antipyretic, analgesic and anti-inflammatory effects, in the past, mostly used for post-cold fever, relief of headache, toothache, muscle pain, neuralgia and other chronic pain. It was later found that small-dose aspirin can also inhibit platelet thromboxane A2 synthesis, prevent platelet adhesion, release and aggregation, with the role of thrombosis prevention, for hypertension, high blood cholesterol, obesity, diabetes mellitus, smoking history, family history of coronary heart disease, age greater than 50 years of age and other cardiovascular diseases in high-risk groups, the long-term use of small-dose aspirin can reduce the occurrence of myocardial infarction and stroke and the risk of recurrence.

Long-term aspirin use requires caution:

• Gastrointestinal damage: aspirin can directly stimulate the gastrointestinal mucosa, destroying the mucosal phospholipid layer barrier, resulting in gastric mucosal damage, but also through the inhibition of prostaglandin synthesis, weakening the protective effect of prostaglandin E on the gastrointestinal mucosa, resulting in gastrointestinal mucosal damage, long-term use of nausea, vomiting, abdominal pain, diarrhea, dyspepsia, and even gastric and duodenal ulcers, hemorrhage, perforation, and other adverse effects of the use of Aspirin enteric preparation, can effectively reduce the direct stimulation of aspirin on the gastrointestinal mucosa, but still can not avoid the mechanism of action of aspirin inhibition of prostaglandin E synthesis, therefore, in the first 6 months after starting to use aspirin can be used in conjunction with the use of omeprazole, rabeprazole, and other proton pump inhibitors, to protect the gastric mucosa, to prevent mucosal damage, especially the elderly and patients with gastrointestinal diseases.

• Dosing time: Aspirin enteric-coated preparations should be taken half an hour to an hour before meals, both to reduce the direct stimulation of aspirin on the gastrointestinal mucosa, but also to help aspirin absorption in the intestinal tract.
• Bleeding: Aspirin can inhibit platelet aggregation, long-term use can increase the bleeding tendency, in the process of using the drug in the event of nosebleeds, bleeding gums, black stools, subcutaneous bleeding, etc., should immediately stop the drug to seek medical attention.
• Acute asthma attack: aspirin in the body metabolism process can produce allergic mediators leukotriene, induced bronchospasm, resulting in bronchial asthma attack, therefore, a history of bronchial asthma should be careful with aspirin.
• Acute gouty attack: aspirin is mainly excreted through the kidneys, small doses of aspirin can compete with uric acid for excretion channels, leading to obstruction of uric acid excretion and causing acute gouty attacks, therefore, patients with gout or hyperuricemia taking aspirin for a long period of time should be regularly monitored for blood uric acid.
• Kidney injury: aspirin inhibits prostaglandin synthesis, prostaglandin has the effect of dilating renal blood vessels and increasing renal blood flow, aspirin can weaken the protection of prostaglandin on the kidneys, especially in patients with renal injury, aspirin can aggravate the condition, or even induce acute renal failure, therefore, people with renal damage should be regularly monitored for renal function when long-term use of drugs.

Thanks for the invite.

Statins and aspirin in the prevention and treatment of cardiovascular and cerebrovascular diseases occupies a very important position, for the need for long-term use of these two drugs for patients, should be in the doctor's comprehensive assessment of the condition of the use of the first need to make it clear that not all people are suitable for the use of these two drugs, the two drugs need to adhere to the medication once used, can not be eaten to stop, adjustment or discontinuation of the use of must be carried out under the guidance of a professional physician, and also need to monitor the side effects and regular review in order to long-term stable control of the condition to reduce the complications. At the same time, the use of the process also need to monitor the side effects of drugs, and regular review, in order to stabilize the long-term control of the disease and reduce the occurrence of complications.

Statins are commonly used in the clinic to regulate blood lipids, can reduce dyslipidemia patients to reduce blood lipid levels, in addition statins have a very important role, can be used in patients with atherosclerosis to stabilize the plaque, to reduce the plaque cracking or shedding. Statins are generally recommended to be taken at night (mainly simvastatin, and other generation of drugs), but for long acting drugs such as Rosuvastatin, they can also be taken at a fixed time of the day, and whether or not to eat and the time of taking the drug does not have a great impact on the efficacy of the drug.

Aspirin has a clear anti-platelet aggregation effect and is suitable for those who have ischemic cardiovascular and cerebrovascular diseases (e.g. coronary heart disease, stroke, TIA) or cardiovascular and cerebrovascular surgeries (e.g. stenting interventions, post-occlusion, post radiofrequency ablation, etc.) or those who do not have ischemic cardiovascular and cerebrovascular diseases but have a risk of occurrence of more than 10% in the next ten years (e.g. age greater than 50 years old, obesity, diabetes mellitus, hypertension, etc.). Its effective dose is 75 to 100 mg per day, the optimal time to take the drug varies depending on the dosage form, ordinary aspirin should be taken after meals to reduce the stimulation of the gastric mucosa; and enteric-coated aspirin is recommended to be taken on an empty stomach, and the optimal time to take the drug is more than three hours before bedtime from dinner, or before breakfast.

The side effects of statins are: ① muscle damage: muscle pain, tenderness, pain, weakness, muscle enzyme elevation can be detected; ② liver function damage: mainly seen in the elevation of liver enzymes, usually transient, common ALT elevation; ③ blood glucose abnormality: fasting blood glucose elevation, elevated glycated hemoglobin and so on. Therefore, long-term use of statin drugs need to pay attention to the presence of muscle pain, dry mouth and drinking, and regular checks of liver enzymes, muscle enzymes and fasting blood sugar, it is recommended that every three months. The common side effects of aspirin include gastrointestinal discomfort, bleeding (skin mucous membranes, gastrointestinal tract, etc., and in severe cases there is a risk of cerebral hemorrhage), allergy, liver and kidney damage, and in severe cases, central nervous system damage and Reye's Syndrome, which should likewise be monitored and regularly reviewed.

Thanks for reading and good health to all. This article was originally written by General Practice Sweeper on Today's Headlines & Wukong Q&A, Copyright © All Rights Reserved.

First ask yourself do I really want to take these two drugs?

This statin is used to prevent and control the arterial wall of the heart and brain plaque, stabilize the plaque has formed to prevent it from too fast tensile prevent those "crazy tensile" of the instability of the soft plaque rupture leads to platelet flow through the rough rupture is activated to expose the fibrin receptor, which can be connected to activated platelets to form a thrombus, and, gradually to the The lumen of the blood vessel is completely blocked leading to myocardial or brain tissue infarction. Instead of high blood viscosity forming a thrombus, or plaque rupture lipids flow out to block the blood vessel.

Poorly controlled or undetected hypertension, hyperlipidemia, especially high cholesterol or high LDL, diabetes mellitus is most likely to cause (blood pressure, lipotoxicity, glucotoxicity) damage to the arterial intima after an overly strong inflammatory response invites a large number of phagocytosis macrophages, monocytes, leukocytes to enter the subintima, and LDL cholesterol LDL is too high will also be invaded by the damage to the subintima and oxidized. So the phagocytosis function of the cell insatiable phagocytosis of oxidized LDL to form the volume of hypertrophic foam cell accumulation of plaque core lipid, the stronger the inflammatory response, the higher the level of LDL plaque grows bigger and bigger on the formation of unstable soft plaque, and the statin is to inhibit the LDL is too high to play a preventive role in preventing, controlling and stabilizing the plaque.

But not regardless of vascular ultrasound, CT coronary angiogram finding of plaque in the carotid or coronary arteries doctors will almost always prescribe you to take statins for a long period of time, and my answer to that is NO!

1. No Lun what age if not suggestive of multiple soft plaques, although there is arterial stenosis but not more than 70% and no symptoms, first control your blood pressure, preferably once a year dynamic blood pressure which is the gold standard for assessing high blood pressure and the treatment and control of whether it is good or not. Next is blood glucose, especially glycosylated hemoglobin, which represents the average value of your blood glucose for three months and is the gold standard for assessing whether diabetes is well controlled. Next is whether your LDL is below 2.6-3.0 mmoI/L with good blood pressure and glucose control. It is not necessary to use statins to fulfill these criteria, but it is necessary to follow up once a year to see if there is any change in plaque and stenosis.

2. People who have had a heart attack, cerebral thrombosis, or endovascular stent implantation surgery, then these two drugs should not be stopped. The LDL of these people should be controlled below 1.8 mmoI/L. With these two drugs other parts of the cardiovascular and cerebral vessels due to plaque produced ischemic symptoms and thrombotic events will certainly be greatly reduced.

3. There have been typical exertional angina or unstable angina but there must be two senior cardiovascular doctors to confirm the diagnosis, because the patient complained of a variety of chest tightness, chest pain, chest pressure, etc. arbitrarily put angina hat too many doctors. In addition ischemic cerebral infarction with a history of myocardial infarction or cerebral thrombosis, with the exception of lacunar cerebral infarction and cerebral embolism caused by atrial fibrillation embolus dislodgement, should be taking statins and aspirin, even though there has not been an intervention.

4. Middle-aged and elderly people who have many years of hypertension, hypercholesterolemia, diabetes, smoking and have a family history of cardiovascular and cerebrovascular diseases, usually three high control is not good, the treatment is not standardized, regardless of the vascular ultrasound, CT imaging found that there are a number of soft plaques, especially the personality of the impatient, impulsive, easy to lose control of the emotions of the patient is very prone to coronary artery spasm resulting in soft plaque rupture, the above groups of people should also be taking statin and aspirin in order to prevent thrombotic events that may occur at any time.

What to look for:

1.taking statins to reach the standard should not be too large a dose, if you are taking a variety of antihypertensive drugs other treatment of heart disease, especially antiarrhythmic some of the drugs are not selected through the liver enzyme CYP450 in the most congested 3A4 channel so as not to produce drug competition caused by the statin blood concentration is too high and the payoffs, especially atorvastatin, simvastatin and lipids Kang (lovastatin). If you can't reach the standard with one statin, you can add a tablet of ezetimibe to lower your LDL by 55% or more to reach the standard.

2. The first two weeks after taking statin drugs for the first time to pay attention to the presence of muscle weakness and myalgia, although the incidence is very low for fear of drug interactions caused by statin blood concentration is too high and produce muscle damage, liver damage. Especially taking anti-arrhythmic ethylamine iodobutone, anti-hypertensive calcium conjugate antagonist, fruits in the grapefruit, grapes, try not to and long-term use of Lipitor, shu descending fat, blood fat Kang at the same time, once the occurrence of muscular symptoms immediately consult a doctor to check the myocardial enzymes to prevent a large number of rhabdomyolysis occurring in acute renal failure.

4. statin caused liver damage is rare, liver enzymes tens of thousands of people check the median properly enlarged (Shanghai average value is 19, put 40), individual differences, especially in China overweight and obese number of people more than 50%, fatty liver caused by transaminase mildly elevated more, some of them although in the 40 below the increase of 10-20 after the use of medication is completely possible, alcoholics fatty liver proportion of its high, so taking statin patients try not to drink Therefore, patients taking statin try not to drink white wine. In addition, the Chinese people hepatitis B and C infection rate is very high SGPT/SGOT hidden elevation or a lot of people on the high side, nevertheless, before and after the use of statin drugs once a month to check the liver enzyme control is still necessary.

5. The effect of taking aspirin is only an antiplatelet activation effect at the moment of plaque rupture, remembering that it is only the prevention of that moment that is really useful, and therefore has a preventive effect on those who may rupture unstable soft plaques at any time. Damage to the gastric mucosa from this drug should not be ignored, even more so in those with a bleeding tendency, and of course be aware of the rare allergic reactions, induced asthma, etc. and allergic rhinitis. Sometime aspirin has, 20-40% resistance (i.e., it no longer has an antiplatelet effect), and may be taken in vain.

2018.12.13