11/28/2012

How to make good use of aspirin in patients with hypertension

Hypertensive patients with aspirin to prevent thrombotic cardio-cerebrovascular disease, namely coronary heart disease events and ischemic stroke. China's " fifteen key " information display, systolic blood pressure of 140-159 mm Hg, 160-179 mm Hg, > 180 mm Hg in patients with essential hypertension, coronary heart disease events were normotensive 4 times, 10 times and 25 times.

1, why use of aspirin in patients with hypertension

HOT published in 1998 were studied in 18790 patients 50-80 years old hypertensive patients, daily aspirin 75 mg, a mean follow up of 3.8 years. It was found, in good control of blood pressure ( <90 mm Hg diastolic ) in patients with hypertension, compared with placebo, aspirin makes major cardiovascular events decreased in 15%, myocardial infarction, fall 36%. Further analysis showed that, creatinine increased ( >1.3 mg / dl ) of the patients and the patients with higher baseline blood pressure ( systolic blood pressure > 180 mm Hg or diastolic blood pressure > 107 mm Hg ) benefit more obvious.

Cerebral ischemic stroke, published in 2005 in the women's health study ( WHS ) results suggest that hypertensive patients with cerebral infarction aspirin, fall 27%. In 2002 of a collaborative group of more than 200000 people in 287 randomised clinical study conducted a meta-analysis. The results show, whether or not have hypertension, aspirin can cause serious cardiovascular events: the decrease of 1/4 nonfatal myocardial infarction reduces 1/3, nonfatal stroke reduction 1/4, cardiovascular mortality reduction 1/6.

Japan's JPAD research, incorporated age ≤ 85 years old with no history of 2539 patients with atherosclerosis in type 2 diabetic patients, the median follow-up of 4.4 years, use of low-dose aspirin ( 81 mg/d or 100 mg/d ) in the patients with fatal coronary or cerebrovascular event rate decrease. To 65 years of age or older patients, aspirin can significantly reduce the incidence of atherosclerosis. And the two group of hemorrhagic stroke and gastrointestinal hemorrhage there was no significant difference between the.

2010 Chinese hypertension prevention guide points out: aspirin in cardiovascular and cerebrovascular disease two level prevention effects of a large number of clinical research evidence to support, and has been widely recognized. Can effectively reduce the risk of serious cardiovascular events in 25%, including nonfatal myocardial infarction drop 1/3, non-fatal brain decreased 1/4, all vascular events decreased by 1/6. Due to aspirin can inhibit platelet aggregation, having antithrombotic effect, is the prevention of thrombotic cardio-cerebrovascular disease " cornerstone", therefore it is also important in hypertensive patients treated with drug.



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