To prevent the occurrence of various ischemic cardiovascular and cerebrovascular diseases, many middle-aged and elderly people clinically need to take aspirin (ASA) for a long time. At present, it is recognized that low-dose aspirin (ASA) (75-325 mg/d) has anti-platelet aggregation effect and can play a role in preventing various ischemic cardiovascular and cerebrovascular diseases. However, with the widespread use of low-dose ASA in clinical practice, and the long-term use of ASA, and even lifelong application, ASA adverse reactions are also more common, and long-term use of aspirin should be taken seriously. The 4 hazards of aspirin 1, the damage to the mucosa of the gastrointestinal tract is worthy of attention. the mechanism of ASA damage to the mucosa of the gastrointestinal tract mainly has two aspects: local and systemic effects. ①Local damage. The systemic effect is most likely to lead to peptic ulcer of stomach, bleeding and perforation; meanwhile, long-term application of low-dose ASA can also cause damage to esophagus, small intestine and colorectum, resulting in ulcer, bleeding, intestinal lumen narrowing and perforation. Symptoms of bleeding include vomiting bright red blood (upper gastrointestinal bleeding), dark red vomiting (upper gastrointestinal bleeding slowed or stopped), and black stools (intestinal bleeding). These symptoms should be seen by a doctor immediately. 2. Long-term use of aspirin can also cause subcutaneous bleeding, which is characterized by bruised skin or bleeding spots, or even bleeding gums or nose bleeding, and is especially common in older women. Because of its anticoagulant effect, aspirin can increase the risk of surgical bleeding. These should attract wide attention. 3, long-term use of aspirin can also cause poisoning, causing patients to suffer from headache, dizziness, nausea, vomiting, ringing in the ears, hearing and vision loss and other symptoms. 4, pregnant women taking aspirin within 3 months of pregnancy can lead to abnormal fetal development, after long-term use, can lead to delayed delivery and the risk of bleeding, so it should be prohibited 2-3 weeks before delivery. 8 notes on taking aspirin 1. Take the appropriate dose and choose the right time to take the medication. After a comprehensive analysis of a large amount of data, the dose of ASA for preventive applications, 50 to 100 mg per day (mostly recommended 75 mg per day) is the most appropriate for long-term use. This can achieve the best preventive effect and minimize the toxic effects of the drug. Should aspirin be taken in the morning or in the evening? This issue is still controversial, and there is disagreement as to whether the drug should be taken at night or in the morning. Some people believe that taking aspirin at night is more effective based on the fact that platelets are more active between 2:00 p.m. and 10:00 a.m., which is also a time of high incidence of cardiovascular disease; some studies have found that taking it in the morning with higher levels of prostacyclin in the blood at night is more effective in preventing cardiovascular attacks at night, and suggest that it should be taken in the morning. In fact, it does not matter at which time of day you take the drug, as long as you keep taking aspirin for a long time you will get a sustained platelet inhibition effect. In terms of efficacy, the current consensus among experts is that the effect of long-term aspirin use is continuous, and there is little difference between morning and evening, the key is to persist. 2, avoid combining with other antithrombotic drugs or peptic ulcer-causing drugs. Aspirin will also interact with non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen and naproxen, blood-thinning drugs such as warfarin, and anti-platelet drugs such as clopidogrel (Polivir) or ticlopidine (Valtrex), which should be taken in strict accordance with medical advice. 3, the elderly gastric mucosa to the damage of factors to reduce the ability to adapt to more likely to cause gastric mucosal injury. 4. To prevent complications of gastrointestinal bleeding caused by ASA, drugs to prevent gastric mucosal damage can be taken at the same time, and preventive acid-suppressing drugs and gastric mucosal protective agents can be used together. 5. Choose the appropriate ASA dosage form. At present, in clinical practice, for the long-term use of low-dose ASA to prevent ischemic cardiovascular disease, enteric-coated or slow-release ASA is applied, which can reduce the local direct damage to the gastric mucosa. 6, pay attention to the medical history of the person taking the drug. The current consensus is that those who have a history of peptic ulcers or bleeding in the past, especially those who have a similar history when taking non-carrier anti-inflammatory drugs (NSAID) or aspirin (ASA) in the past, these patients are at high risk of gastrointestinal bleeding when taking ASA and should be used with caution and prohibited. 7.Check before and during taking the drug. It is best to check blood before taking the drug, such as red blood cells, platelets, and clotting time, and if the patient has epigastric discomfort during the period, the drug should be checked promptly or discontinued. 8.How to take aspirin for patients who have had stents? In clinical practice, we often encounter patients who have had stents for coronary artery disease taking dual antiplatelet drugs for 12 months and then stop taking aspirin and take clopidogrel. This is incorrect, and current studies confirm that clopidogrel is not a substitute for aspirin for secondary prevention. The correct approach is to discontinue clopidogrel and take aspirin alone after 12 months of taking the dual antiplatelet drug aspirin and clopidogrel. If a patient cannot tolerate aspirin or is allergic to aspirin, clopidogrel can be substituted for aspirin. The Journal of the American College of Cardiology published a new study involving 68,000 patients that found more than 1 in 10 patients were taking aspirin improperly. 1. Have you been evaluated by a medical professional for the risk of taking aspirin? If you have not been evaluated by a medical professional, you should not take aspirin regularly. The risk of heart disease or stroke depends on many factors, both known and unknown. If a doctor does not assess the risk of heart disease and stroke, aspirin may not be appropriate to prevent heart disease and stroke. Of course, if it is discontinued, it should not be done arbitrarily, but also after professional evaluation. 2.History of aspirin use, did you hide it? When you go to the doctor for other diseases, you should tell your doctor. Because it has interactions with other medications and more commonly if you are going to undergo other procedures during this time, you should be aware of the additional risks of the procedure. Because aspirin has an anticoagulant effect, it can make surgery more risky for bleeding. For a flat surgery, the doctor will advise the patient to stop taking aspirin at least 5 days prior to the surgery, examination or extraction. In case of emergency surgery, re-evaluate the surgery when necessary. 3. Aspirin is not a panacea. Together with penicillin and Valium, aspirin is considered one of the three classic masterpieces in the history of medicine. The role of aspirin in the field of disease and health is great, including antipyretic, pain relief and anti-cancer, so its role is sometimes exaggerated. But aspirin is not a panacea, not a cure-all drug. Maintaining a healthy lifestyle is more important than taking aspirin when it comes to heart disease and stroke prevention, rather than simply taking aspirin and then resting easy and being free from cardiovascular disease. Some people also use it as a lipid-lowering drug, mistaking it for a statin. 4, aspirin is one of the three bedside lifesavers? Is it really that amazing? The Internet rumor is that aspirin is one of the three life-saving bedside treasures, and all people who suspect a heart attack need to take aspirin immediately to save their lives. Is it really that amazing? During a myocardial infarction, aspirin can quickly inhibit platelet aggregation and has a role in slowing down the progression of the disease. In the case of emergency myocardial infarction, taking aspirin can reduce the mortality rate by 20-30%. European guidelines for chest pain recommend that patients with suspected myocardial infarction should immediately call for emergency care while taking aspirin. However, lay people lack the knowledge to identify heart disease, and taking aspirin in case of digestive tract disease or aortic coarctation is harmful instead. It is recommended to call emergency first when a heart attack is suspected, and take the medication under the guidance of emergency professionals. In case of emergency, the dose should not be too small and should be 300 mg. It should be chewed up and taken as quickly as possible to absorb the effect of the drug. 5, combined with other drugs, be cautious. When used with other drugs, it will increase additional risks: (1) aspirin and vitamin B1 together will increase the gastrointestinal reactions of patients; (2) aspirin and anticoagulants in the combination of double coumarin, easy to cause patients bleeding; (3) with hypoglycemic drug D860, easy to cause patients hypoglycemic reactions; (4) with adrenal corticosteroids, easy to induce ulcers; (5) with methotrexate, can enhance its toxicity; (6) with diuretics (6) with diuretics may cause salicylic acid poisoning in patients.