June 29, 2022

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Statins and aspirin should be taken for lifetime after cerebral infarction?

Statins and aspirin should be taken for lifetime after cerebral infarction?


Statins and aspirin should be taken for lifetime after cerebral infarction?   Someone asked the doctor that he had suffered from cerebral infarction, but he had no sequelae. Now he is taking statins and aspirin. Should these two drugs be taken for life and cannot be stopped for a lifetime? The doctor told him that these two drugs are the “cornerstone” drugs to prevent the recurrence of cerebral infarction. The pathogenic factors of cerebral infarction cannot be completely cured, and the average recurrence rate is 40%. Therefore, people who have suffered from cerebral infarction must pay attention to prevention and continue to take medication.

Statins and aspirin should be taken for lifetime after cerebral infarction?

 


1. Pathogenic factors of cerebral infarction

Cerebral infarction refers to the blockage of the arteries in the brain, causing local blood supply to the brain to be interrupted. The tolerance of brain nerve cells to ischemia and hypoxia is very low. As long as the ischemia exceeds 6 minutes, the brain nerve cells will die. No medical method can regenerate the dead brain nerve cells, and the functions of this part of the brain cells will be lost, causing great harm to the human body, with a very high rate of disability and death.

One of the main causes of cerebral infarction is atherosclerosis caused by hypertension, diabetes, hyperlipidemia, smoking and other factors that cause damage to the arterial intima. If atherosclerosis occurs in the carotid artery, cerebral artery, etc., when the hardened plaque ruptures, it will induce platelet aggregation to form thrombus.

 


2. Why should I take statins and aspirin

The lipid core of atherosclerosis is formed by the foam cells that cholesterol enters the arterial intima and is swallowed by macrophages. With the current medical level, there is no way to remove the foam cells unless the arterial intima is cut open. Therefore, once atherosclerosis occurs, it cannot be cured. However, the progress of atherosclerotic plaques is not fast. It often takes decades for plaques to form from the beginning to cause severe stenosis and block blood vessels.

The main risk of plaque lies in its instability, which is easy to rupture. Because the surface of the plaque is not a normal arterial intima, but is covered with a “fiber cap”. In the event of arterial spasm, blood pressure fluctuations, blood flow and other factors, the fiber cap may rupture. When the fibrous cap is ruptured, exposing the contents of the plaque, it will activate platelet aggregation and form a thrombus, which may cause blockage of blood vessels.

 

Therefore, to prevent cerebral infarction, it is necessary to “reinforce” the plaque so that it is not easy to rupture. The effect of statins, in addition to lowering the level of cholesterol in the blood and halting the progression of plaques, can also increase the lipid core density of plaques, reduce the volume, and improve the metabolism of arterial intimal cells. Inflammation, anti-oxidation, etc., transform unstable plaques into stable plaques and “reinforce” the plaques.

Using statins, it takes a long time to “reinforce” the plaque. However, the pathological basis of patients with cerebral infarction has been formed. In order to prevent the recurrence of cerebral infarction, a “double insurance” must be added, which is an antiplatelet drug represented by aspirin. Aspirin can inhibit the activity of platelets, so that when the plaque ruptures, it can inhibit the aggregation of platelets and avoid the formation of thrombus.

 


3. Why take medicine for life

As  the doctor said, once atherosclerosis occurs, it cannot be cured. The effect of statins can inhibit the progression of atherosclerotic plaques and can partially reverse the plaques. However, it takes time for a drug to work. In clinical trials, it usually takes more than 2 to 4 years to take the drug for a significant reversal effect. Moreover, with the prolongation of the medication time, the protective effect on the cardiovascular and cerebrovascular will be stronger, so statins need to be taken continuously for a long time.

Aspirin is a “passive defense” that only works when the plaque ruptures. But we don’t know when the plaque will break. This is a random event. Therefore, aspirin needs to be taken every day to inhibit the new platelets in our body every day, to ensure that all platelets are effectively inhibited in the event of an accident and will not aggregate to produce thrombus.

 

Some people worry about the side effects of the medicine, so they are reluctant to take the medicine. What the doctor wants to say is that although drugs have certain side effects, they can be prevented and treated. A medical expert once said that he is willing to take aspirin at the risk of side effects, because the stomach bleeding caused by the side effects of aspirin can be cured, but a cerebral infarction will cause a lifetime of pain.

Although drug treatment itself has the risk of adverse reactions, it is a lower risk and can replace the high risk of disease. Want to complete the treatment without taking any risk, the current medical level is not up to the requirement. So as long as the benefits of medication outweigh the risks, medication should be adhered to.

 

Sum up:

cerebral infarction has a high recurrence rate, so people who have had a cerebral infarction must pay attention to prevention. Statins and aspirin are the “cornerstone” drugs to prevent recurrence of cerebral infarction. As long as there are no contraindications to medication or untolerable adverse reactions, the medication must be adhered to and not stopped. Regarding drug selection and specific usage, it must be carried out under the guidance of a doctor. If you find any problems during medication, please consult your doctor or pharmacist in time. 

 

 

 

 

(source:internet, reference only)


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