"Aspirin" to prevent strokes could it cause strokes?

[이코노믹리뷰=황진중 기자] It is not well known that the world's population takes about 600 billion doses a year, which is effective in preventing strokes, but it can cause strokes rather than mistakenly.

The side effects of aspirin are: headache, vitamin C deficiency, gastrointestinal bleeding, reduced platelet and leukocyte count, and increased bleeding time due to impaired function. The United States Food and Drug Administration (FDA) has advised consulting medical personnel before taking it.

Stroke is a disease characterized by the obstruction or bursting of the blood vessels supplying the brain with brain damage, leading to brain damage and physical disability. According to the World Health Organization (WHO), cerebrovascular disease is the second leading cause of death in the world in 2016 and the third leading cause of death in Korea since 2007.

Since last May, Korea has promulgated the "Law on the Prevention and Management of Cardiovascular Diseases" and implemented the first comprehensive cardiovascular disease management plan (2018-2022) aimed at reduce the incidence of diseases and set up a fast professional medical system. And steps are being taken for that.

Prevention of this important stroke, help with low dose aspirin?

The risk factors for stroke are divided into risk factors that can not be corrected and into risk factors that can be modified. The first are age, bad and family history. These include hypertension, smoking, diabetes, heart disease and hyperlipidemia.

According to the Ministry of Health and Welfare guidelines for the prevention and management of cardiovascular disease, smoking and alcohol consumption should be stopped by consuming a few drinks a day or less. It is good to eat foods in a consistent way and eat lots of vegetables and fish. Do at least 30 minutes of exercise a day to maintain proper weight and waist circumference and, most importantly, take the habit of taking regular habits to measure blood pressure, blood glucose, cholesterol and blood pressure. Hypertension, diabetes and hyperlipidemia.

"The acetyl group of aspirin binds to the platelet membrane and irreversibly inhibits the enzyme cyclooxygenase (COX), thereby reducing the formation of thromboxane A2 (TXA2) and preventing platelet aggregation" Aspirin is effective in preventing the recurrence of obstructive arterial diseases such as myocardial infarction, cerebral infarction and peripheral vascular disease. "

"A low-dose aspirin is helpful in preventing strokes," Bayer said. "A meta-badysis of 10 clinical trials involving patients with transient ischemic stroke or ischemic stroke presented with low-dose aspirin in patients with transient ischemic stroke or stroke. risk of ischemic stroke has been reduced by 17%. "

▲ Aspirin Protect 100 mg tablets. Source = Bayer Korea

However, people who do not have a history of heart attack or stroke should be cautious when taking it. The US Food and Drug Administration (FDA) said last November that "Aspirin is effective for the second prevention of cardiovascular disease, but that consuming it every day is not the right way for everyone. world, "he said. "He said.

Previously, the US Food and Drug Administration had rejected Bayer's request to allow label etiquette stating that the product was effective against cardiovascular disease.

According to the US Food and Drug Administration (FDA), aspirin does not support its first-line preventive role in people with no history of heart attack, stroke, or cardiovascular disease. For these people, aspirin can cause bleeding of the brain and intestines.

Johan Sundstrom, professor at the University of Uppsala in Sweden, has published a study suggesting that taking a low-dose aspirin in September of last year would result in a 37% increase risk of myocardial infarction or stroke within three years of weaning. . He explained that aspirin seems to be effective for these patients.

"There is evidence that the risk of thrombosis increases rapidly if we stop taking aspirin," said Nieca Goldberg, spokesperson for the American Heart Association at the time of the study, " it is a rebound effect ". The US AHA recommends taking low-dose aspirin daily for people at high risk for cardiovascular disease and those who have ever had one. Aspirin is effective at preventing this disease, but it also has side effects. This can be called the paradox of aspirin.

Kim Chi Kyung, professor of neurology at the Guro Hospital of Korea University, said, "One of the main treatments for stroke is prevention." It is advisable to people who have previously suffered a stroke take a second dose of low-dose aspirin and adopt healthy eating habits. If you are a high-risk stroke, you should consider making a decision in consultation with a specialist. "

Significant stroke of Golden Time, perception of early symptoms about 52.7% nationwide

The stroke can be divided into cerebral infarction and cerebral hemorrhage. Cerebral infarction is a condition in which cerebral blood vessels are blocked and brain cells die because they can not receive blood or oxygen. The cerebral hemorrhage is caused by the bursting of the blood vessels and damages the blood from the brain.

A transient ischemic attack may occur before the onset of the stroke, which means that blood does not flow into severely narrowed cerebral blood vessels, then flows again, or that cerebral blood vessels are blocked by clots. blood (blood clots) then reopened.

The symptoms of stroke are brief and improve in minutes or hours. This symptom is a strong warning for future strokes, but it goes away as if nothing had happened, so most people ignore it and often miss a treatment.

Perceptions of the first symptoms of a stroke in Seoul. Source = Statistical Office

Although treatment waiting time is the most important factor in stroke, according to National Census Bureau statistics, the percentage of early symptoms of stroke in the country as a whole was than half of the 52.7%. In Seoul, Gangnam-gu posted the highest score of 63.4% and Seongdong-gu the lowest score of 20.1%.

The Department of Health and Welfare is working to prevent disease by educating patients about symptoms and reducing the mortality rate by about 1% by 2022 by increasing the rate of cerebral palsy. vascular and socio-economic costs, which represent 24.3%. We plan to increase the early recognition rate by about 10%.

Dizziness, headaches, etc. The first symptoms must be checked … Missing Golden Time has lost 90% of the treatment possibilities

Dysmenorrhea, speech disorders (aphasia), speech disorders (speech disorders), ataxia, visual acuity, visual disturbances, dysphagia, dementia, dizziness and headaches are the first symptoms of stroke.

The first symptoms of stroke. Source = Ministry of Health and Social Welfare

Professor Kim said: "The rate of recognition of early symptoms of a stroke varies slightly depending on the medical accessibility and individual perception in each region, but the same goes for that it is necessary to act quickly in case of stroke. "We must know the first symptoms and go to the hospital within 2 hours of the start and treat it within 6 hours at the latest. Otherwise, 90% of the treatment possibilities will be lost. "

Professor Kim said, "Once the dead brain cells can no longer be saved, we should go to the hospital as soon as possible to identify the cause of the stroke and start the treatment. result."