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"We treat risk factors such as high blood pressure, diabetes, and high cholesterol much better," said Kevin Campbell, a cardiologist at the University of North Carolina, who said: is not directly concerned by the new directives adopted.
This is an important message, which denies the many years of experience that aspirin is a useful tool for preventing primary diseases.
Doctors may consider aspirin in some elderly patients only if it is difficult to lower cholesterol or control hyperglycemia and increase the risk of internal bleeding – as outlined in the new US guidelines. for scientists. The European Society of Cardiologists also called for the use of special treatments to reduce clotting, such as aspirin, regardless of the age of patients.
"When prescribing aspirin, doctors should be cautious if they are given to people who have not yet been diagnosed with cardiovascular disease," said Roger Blumenthal, cardiologist. at Johns Hopkins University, one of the authors of the new guidelines. lifestyle, control blood pressure and cholesterol instead of aspirin.
The critical approach, born in the Atlantic, of the usefulness of aspirin for clearing blood did not come about by chance. Cardiologist at Santara Clinic of Vilnius University Milda Kovaitė recalls that the debate on this subject did not last for many years.
Although aspirin is not banned, it is no longer offered as an anti-infarction protection because of the risk of internal bleeding. Until such a conclusion is reached, a number of large scale studies have been conducted.
In the latest study, ARRIVE, presented at the European Society of Cardiology Munich in 2018, was attended by 12,000 patients taking aspirin. It turned out that the use of aspirin to prevent the onset of the first cardiovascular disease had no significant benefit, but a much higher risk of bleeding was identified. There was no difference in the risk of death, stroke or myocardial infarction in patients who took or did not take aspirin.
In another study, ASCEND was included in diabetic patients. The data showed that aspirin in this group reduces the risk of cardiovascular disease, but also increases the risk of major bleeding.
"If a person has not had a heart attack or stroke, aspirin does not seem to be needed as an extra measure to use for primary prevention," Kovitė said.
– What hopes did aspirin relate to?
– This drug reduces platelet adhesion and coagulation in the arteries. For a long time, it was thought that aspirin in primary prevention reduced the number of primary patients with stroke or stroke.
The medical literature has already published articles on the benefits of aspirin. The ARRIVE study dispelled doubts about aspirin because it appeared that the use of this drug increased the risk of bleeding from the gastrointestinal tract.
So, by inviting aspirin to take a tablet every day, we not only help people avoid heart attacks or strokes, but we run the risk of bleeding.
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Modern medical devices already allow high blood pressure, an increase in cholesterol levels. We also advise patients to change their lifestyle, get rid of their harmful habits, lose weight and increase their physical activity. Studies have shown that aspirin is not needed to eliminate these risk factors.
By cons, if the patient has a history of infarction, stroke or peripheral arterial disease, if his blood flow is impaired, secondary prevention of aspirin is necessary. You have to give life to prevent a heart attack or a stroke. In this case, aspirin is a protective shield.
In primary prevention, we can not write non-medical measures that regulate hypertension, bad cholesterol and overweight. But from this list, we can boldly exclude aspirin.
– What can cardiologists advise? Are herbal preparations and supplements only fashionable? Can they protect against cardiovascular disease?
– Natural means have been and are needed at all times, no one says that they are not necessary. Vegetable materials such as nathinase, extracted from fermented soybeans, are safe. Scientific studies have shown that this enzyme is useful for blood circulation: it prevents the formation of clots throughout the vascular system, destroys existing blood clots, lowers blood pressure, improves blood circulation and blood viscosity.
A scientifically tested combination of nano-kinase and hydroxytirosol (a potent antioxidant of olive oil) could enrich the diets of physically inactive, obese people, using contraceptives with high blood glucose or type 2 diabetes who take drugs to lower cholesterol (statins) because they play an important role in controlling blood flow.
Blood thrombosis is also helpful in the treatment of vascular thrombosis, especially in people with varicose veins or having a tendency to inherit venous thrombosis.
– Patients fall into your hands for a variety of reasons. How many of them perceive that a heart attack or stroke is not a mountain?
– It sometimes happens that a person is even offended by hearing tips aimed at reducing excess weight, exercising, giving up bad habits, she is indignant that someone interferes in her personal life and advises him to eat and rest.
Our problem is that information does not become knowledge, and knowledge is a habit.
I had a patient who had a stroke at the age of 33 and the only risk factor was smoking. The patient was surprised to find himself in the hospital for a stroke: "What? Is that what happened here?"
Our problem is that information does not become knowledge, and knowledge is a habit. As if we knew what we are at risk, we do not do anything, we think that a heart attack or stroke will reach us.
– At what age should people be worried about the blood circulation?
– People of working age are suffering from cardiovascular disease. Therefore, men aged 40 and women aged 50 must know blood pressure, cholesterol and blood sugar. That should not be the case – I'm not in a polyclinic because I feel good. We do not know many risk factors until we conduct research.
– In Lithuania, treatment methods do not differ much from those of Western clinics and the incidence of cardiovascular disease does not decrease at all. What is missing?
– In Lithuania, more than half of people die of cardiovascular disease. Our statistics are sad. They differ greatly from the economically developed western countries, as well as from the United States, where cardiovascular mortality is almost twice as high as ours. There is no doubt that the United States has been actively supported by prevention.
The bad situation in Lithuania is due to bad cholesterol. People with heart attacks should have cholesterol levels below 1.8 mmol / l in men. However, in Lithuania, only less than one-tenth of patients reach this rate, so we are in last place in Europe.
This shows that our consciousness is weak.
Screening for cardiovascular disease has shown that in Lithuania about 90% of the total number of people with cardiovascular disease. people tested increased cholesterol.
We have modern treatments and prophylaxis should be followed before the start of treatment. In the West, cholesterol levels are controlled much earlier and we are still far behind.
Screening for cardiovascular disease has shown that in Lithuania about 90% of the total number of people with cardiovascular disease. people tested increased cholesterol. Some people think that if almost all people of a certain age have such a high cholesterol level, is it worth it to adjust? However, this approach to cholesterol is naive and not based on scientific facts.
– Is it possible to control cholesterol without drugs? How natural products helps save blood vessels?
– People with high cholesterol should understand that they are at a higher risk of circulatory problems. Therefore, it is important not only to lower cholesterol, but also to control blood flow.
Some patients with low or moderate cardiovascular risk may be able to properly control their cholesterol-free drug, with natural combinations of complex actions, such as the neurotoxin enzyme (for the control of blood circulation) and monacolin K ( for the control of fermented rice by red yeast – cholesterol).
– Why did Lithuanians have fewer cardiovascular diseases 100 years ago? What can we learn from them?
"I do not know if people were less likely to have cardiovascular disease a hundred years ago, but their lifestyle was different: they did not sit in front of a computer or television, but worked hard physically, we do not suffer from physical stress, stress, nervous tension, we live in a much more polluted environment than our ancestors.
They also ate other foods – natural, no preservatives, sweeteners, flavor enhancers, they did not know what semi-finished products, sauces with high sugar content. Therefore, we can not align with our ancestors by eating traditions.
If a man plows the soil all day long, he needs very well cooked food, namely ginger, and we consume much less energy. We became sedentary. It is therefore worthwhile to abandon rich foods of animal origin. They should be replaced by blood vessels and heart friendly products.
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