11/28/2012

When should the use of aspirin in patients with hypertension?

1 blood pressure control stability

Aspirin for control of blood pressure in hypertensive patients with stable. Usually <150/90 mmHg as blood pressure stability criteria.

A British study observed 5499 position for 45 ~69 years old man, were taking aspirin or placebo. The results show that, blood pressure below 130mmHg male coronary heart disease morbidity is reduced by 45%. But the blood pressure is higher than 145mmHg group did not significantly reduce the risk of coronary heart disease. Blood pressure below 130mmHg in the aspirin group stroke is the placebo group 41%, and high blood pressure in 145mmHg than in the placebo group suffered a stroke in 42%. The results show that: blood pressure higher than 145 mm Hg patients, aspirin can not bring much benefit, even more serious risk of cerebral hemorrhage.

2 time of taking medicine

Usually that aspirin should be taken after lunch. But also somebody thinks that high quality of enteric coated aspirin can be taken on an empty stomach, is beneficial to improve the bioavailability of.

However, in the breakfast or dinner after taking, there exists some controversy. Platelet inhibition effect, breakfast or dinner service was no big impact, this point from aspirin mechanism is easy to understand. Although some people think that 18 to 24 is the new generation of platelets in the primary period of time, bedtime aspirin can better inhibit these neonatal platelets, recommend the night of aspirin.

The focus of controversy is breakfast or dinner after taking effect on blood pressure. A study of Spain were observed in 328 cases of untreated patients with mild hypertension, were randomly divided into non-drug health diet, at 100 mg to 100 mg aspirin, aspirin therapy group three. Observation of 3 months. 48 hour ambulatory blood pressure results, improve the life style groups blood pressure was significantly decreased ( mmHg less than 0.2 ). Morning blood pressure mildly elevated 2.6/1.6 mmHg ( p=0.002 ). While the bedtime group blood pressure decreased significantly in 6.8/4.6 mmHg ( P<0.001 ). Note bedtime aspirin lowers blood pressure and antihypertensive drug acts. Bedtime aspirin reduces nocturnal renin - angiotensin - aldosterone system ( RAAS ) activity fluctuations, thus eliminating nitric oxide produced by night valley. In contrast, some studies suggest that, in the early morning of aspirin can also increase blood pressure.

Therefore, let patients taking aspirin is currently the physician's main task, without too much emphasis on the morning or evening.

In two, daily medication a few times

Aspirin is by inhibiting platelet activation and to prevent thromboembolic events. This inhibitory effect on platelet is lifelong nature, can not be restored, because platelet without nuclei, enzyme cannot regenerate. But human platelet life span of 7 to 10 days, but every day about 1/10 platelet is new, its function can not be aspirin inhibition. Therefore taking a daily aspirin 1 times, can inhibit 85%-90% in vivo platelet function, and the prevention of thrombotic cerebrovascular disease play a role. Therefore, taking an aspirin every day.

Three, what form better

The best choice of enteric coated tablets. Enteric solvent because it is not in the stomach acid dissolution, can make the aspirin induced gastrointestinal side effects occur rate reduced by about 60%. Non enteric-coated tablets ( such as ordinary aspirin or effervescent tablets ) in the stomach is dissolved, the gastric mucosa has a stimulating effect, is suitable only in acute period first supplement.

Hypertensive patients how to choose, how to use aspirin to be associated with physicians communicate according to individual condition and after. If physical discomfort, should be immediately to the hospital for treatment, so as not to delay treatment.



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