At the recent annual meeting of the European Society of Cardiology, the research teams at Harvard University and Oxford University reported the results of two large clinical trials:
For middle-aged and elderly people with moderate cardiovascular risk and diabetes, there is little benefit in using aspirin to prevent cardiovascular disease!
His papers were published in The Lancet and the New England Journal of Medicine.
I. Still taking aspirin?
A professor at Dartmouth College in the United States once said this sentence: “If I am going to be on a desert island, if I choose to carry a certain drug with me, then my first choice may be aspirin.”
It can be seen that aspirin has an important position in many medicines.
However, as soon as the above news came out, many patients who were taking aspirin began to panic. This medicine, which is often used again, should continue to take it?
According to the Health News report, Xu Juntang, the chief physician of the Department of Cardiology of Peking University People’s Hospital, previously stated that it is uncontroversial that aspirin is used for secondary prevention of atherosclerotic cardiovascular disease. The benefits or benefits of aspirin in primary prevention of atherosclerotic cardiovascular disease have been controversial in recent years.
Primary prevention: including prevention of risk factors (such as obesity, hypertension, hyperlipidemia, diabetes), prevention of the occurrence, development and subsequent development of atherosclerotic cardiovascular disease (coronary heart disease, cerebrovascular disease and lower extremity arterial disease) A vascular event that has occurred.
Secondary prevention: Prevention of disease progression to cardiovascular events and prevention of recurrent cardiovascular events through effective interventions.
Aspirin alone in secondary prevention can reduce myocardial infarction, cerebral infarction, and cardiovascular death by 22%. Aspirin is an essential medicine for protecting the mind, protecting the brain and saving lives. Without special circumstances and with the permission of the doctor, the patient must not stop using aspirin. The result of stopping the drug can not only lead to myocardial necrosis (myocardial infarction), cerebral infarction, but also people may not be killed. .
Xu Juntang believes that aspirin is still the basic drug for secondary prevention of atherosclerotic cardiovascular disease and primary prevention of high-risk patients. Aspirin is not outdated, and the “myth” of aspirin will continue.
2. How effective is aspirin?
If there is a magical medicine in the world, it must be aspirin.
Aspirin, also known as acetylsalicylic acid, is a long-established antipyretic analgesic that was born on March 6, 1899. Unlike most western medicines today, its molecular structure is very simple and its synthesis cost is extremely low.
According to reports, the annual consumption of aspirin in the world has remained at around 50,000 tons in recent years, equivalent to 150 billion tablets of aspirin per year. A long-established old drug can have such an amazing amount of use, which proves that aspirin has a pivotal position in the pharmaceutical industry.
It can not only be used to treat colds, fever, headache, toothache, joint pain, rheumatism, but also has an inhibitory effect on platelet aggregation. It is also effective to prevent myocardial infarction by taking aspirin reasonably. Therefore, aspirin is called “universal medicine” by many people.
However, the role of aspirin is much more than that.
Part of the use of aspirin:
1. Analgesic effect
It is mainly a peripheral analgesic by inhibiting the synthesis of prostaglandins and other substances that can make the pain sense sensitive to mechanical or chemical stimuli (such as bradykinin, histamine). But the possibility of central analgesia cannot be ruled out. It is effective for chronic dull pain and is not effective for acute sharp pain and severe pain.
2. Antipyretic effect
It can reduce the body temperature of fever patients, but has no effect on normal body temperature. It may cause peripheral vasodilation by acting on the hypothalamic temperature regulation center, increase blood flow of the skin, sweating, and increase heat dissipation. The effect may be related to the inhibition of the synthesis of prostaglandins in the hypothalamus.
3. Anti-inflammatory, anti-rheumatic
Its anti-inflammatory mechanism is still unclear, probably due to its action on inflammatory tissues, and it has an anti-inflammatory effect by inhibiting the synthesis of prostaglandins or other substances that cause inflammatory reactions such as histamine. About its anti-rheumatic, it is mainly because it has antipyretic and analgesic and anti-inflammatory effects.
4. Anti-platelet aggregation
Aspirin acts as an anti-platelet aggregation by inhibiting platelet-prostaglandin epoxidase and preventing the production of thromboxane A2.
5. For Kawasaki disease
Aspirin is used in children with Kawasaki disease to reduce inflammation and prevent the formation of intravascular thrombosis.
6. For diabetes
Aspirin may promote endogenous insulin secretion and hepatic glycogen synthesis, inhibit intestinal absorption of sugar and promote tissue uptake of sugar to lower blood sugar.
7. For Alzheimer’s disease
According to the study, the risk of senile dementia and cognitive impairment is significantly lower in elderly people who regularly take aspirin. Low-dose aspirin can reduce the progression of Alzheimer’s disease. This is because aspirin has the effect of enhancing cerebral blood flow and preventing blood clotting.
8. Anti-cancer effect
Earlier, some media reported that scientists at the Gastroenterologists Conference in Barcelona, Spain, said that continuous taking small doses of aspirin can reduce the risk of cancer in the liver, stomach and most organs related to digestion and metabolism.
According to the doctor who conducted the experiment, aspirin can increase the efficiency of immunotherapy several times, and can also independently fight leukemia, rectal cancer and other tumors, and can increase the chance of survival after chemotherapy by 15-20%.
9. Male contraception
There are 13 kinds of PG in human semen, the total amount of 300mg/ml is conducive to the operation and conception of sperm. Aspirin can reduce the concentration of PG in semen, leading to more abnormal sperm in semen, which can reduce the probability of conception. .
10. Reduce ototoxic antibiotics for hearing damage
Animal studies have shown that the use of aminoglycoside antibiotics in combination with aspirin reduces hearing loss. After entering the human body, aminoglycoside antibiotics combine with iron in the body to form free radicals, which can damage hair cells. Once the hair cells are damaged, the inner ear loses the ability to detect sound, resulting in permanent hearing loss. Aspirin is broken down into salicylates, which prevent the formation of free radicals and reduce the incidence of deafness caused by antibiotics.
11. Treatment of biliary mites
After oral absorption, it is excreted from the bile, causing the biliary environment to change, and the mites are anabolic and withdraw from the biliary tract.
12. For pre-eclampsia
Placental tissue and platelets in patients with pre-eclampsia significantly increased TXA2 compared with normal pregnant women, while placenta, umbilical cord PGI2 and urinary excretion of PGI2 metabolites decreased, and normal PGI2/TXA2 balance was destroyed. Therefore, this balance is restored with a small dose of APC, which is expected to prevent or treat the disease.
13. Female infertility and habitual abortion
Aspirin can inhibit PG synthesis and can be used to treat habitual abortion and infertility due to increased PG, because increased PG in the body can promote the strengthening of tubal peristalsis, destroy the synchronization of fertilized eggs and endometrium, and increase uterine contractility. The secretion of progesterone from the corpus luteum of the ovary is reduced to affect the implantation of the fertilized egg.
14. Senile cataract
British Medical News, Vol. 244, No. 23, at the meeting of the American Academy of Ophthalmology in Chicago, Gottler, a professor of ophthalmology at Yale University School of Medicine, found that aspirin may have some delay in the development of senile cataract. effect. It can delay the formation of this disease for 10 years, and can reduce 45% or more patients from surgery. The clinical application of its exact inhibition mechanism needs further study. Studies have shown that the increase of plasma tryptophan content in cataract patients leads to increased aldose reducing sugar activity in crystals, while aspirin can not only inhibit aldose reductase activity, but also reduce plasma tryptophan content, so it is believed that aspirin can at least slow down The occurrence of cataracts.
15. Help repair tooth decay
Previously, researchers from Queen’s University in the United Kingdom found that aspirin can effectively reverse the effects of tooth decay, which may reduce the need for people to fill their teeth.
Studies have found that low doses of aspirin can significantly increase the mineralization of the teeth and enhance the expression of genes that form dentin, which usually destroys the structure of the hard teeth in the teeth. The researchers point out that the anti-inflammatory and pain relief of aspirin The effect may be titled as a solution to help control neuralgia and inflammation caused by individual tooth decay, while also promoting natural tooth repair.
16. Promote the role of anticancer agents
Previously, a new study by the University of Queensland in Clinical Cancer Research showed that the addition of aspirin to some existing anticancer drugs can increase the effectiveness of anti-tumor treatment.
Helmut Schaider, author of the article, said: “We found that adding aspirin to the cancer inhibitor drug Sorafenib enhances its effectiveness in lung cancer and melanoma mouse models with RAS mutations.”
At the same time, the researchers believe that the addition of aspirin may also prevent tumor recurrence. Joint research on aspirin and other anticancer drugs is already underway.
Of course, any kind of medicine can’t avoid the side effects. Aspirin also faces this problem while exerting its extensive therapeutic effects, including acid reflux, poor appetite, abdominal distension, abdominal pain, upper gastrointestinal bleeding, and even increased uric acid, drug dermatitis, allergic asthma, and inhibition of coagulation. Symptoms such as decreased sexual function.
Therefore, even if it is a magical medicine, don’t eat it indiscriminately. You must follow the doctor’s advice.
With more and more research on the use of aspirin in the medical community, we have reason to believe that aspirin is not outdated, and the “myth” of aspirin will continue.