The 2019 Chinese Expert Consensus on the Use of Aspirin in the Primary Prevention of Cardiovascular Disease states that adults over the age of 70 should not routinely take small doses of aspirin (75-100 mg orally daily) for the primary prevention of atherosclerotic cardiovascular disease. There are several concepts involved here that we must understand otherwise it is easy to take aspirin out of context and misunderstand its role. 1. What exactly is aspirin and what is its role? Aspirin does have an irreplaceable role in the prevention and treatment of atherosclerotic cardiovascular diseases, and can inhibit the aggregation of platelets and prevent thrombosis. Abnormal platelet aggregation is the key starting step of thrombosis and the framework basis of thrombosis. All people at high risk of ischemic cardiovascular disease and disease, as long as there are no relevant contraindications, are recommended to take aspirin for antiplatelet therapy, which can effectively prevent the formation of thrombosis. 2.What does primary prevention mean Primary prevention of cardiovascular disease refers to preventive measures taken when cardiovascular disease has not yet occurred or is in the subclinical stage, to prevent cardiovascular events and reduce group morbidity by controlling or reducing cardiovascular disease risk factors. Aspirin does not significantly reduce mortality when used for primary prevention of atherosclerotic cardiovascular disease. The main benefit is a significant reduction in myocardial infarction, transient ischemic attack, and cerebral infarction; the main risk is a significant increase in bleeding events, including gastrointestinal bleeding and intracranial hemorrhage. Therefore, the use of aspirin for primary prevention is meaningful only when the benefits significantly outweigh the risks. 3, people over 70 years old for disease treatment and secondary prevention then can not stop using aspirin If you have a history of coronary heart disease, cerebral infarction, atherosclerosis, etc., and are currently taking aspirin because of these diseases, then you must insist on taking it, even if you are over 70 years old, you can not take aspirin. The primary prevention for people over 70 years old is for those who are healthy and do not have atherosclerosis, and the percentage of such people is very low, estimated to be no more than 10%. Therefore, do not understand the wrong private discontinuation of drugs, otherwise it is easy to re-occur ischemic cardiovascular events. 4.What are the main adverse effects of aspirin? 1). Gastrointestinal reactions: nausea and vomiting are the most common. Long-term use is likely to cause damage to the gastric mucosa, causing gastric ulcers and gastric bleeding. Therefore, it is recommended to test the fecal occult blood test and gastroscopy regularly, and to take drugs to enhance the barrier function of gastric mucosa. 2). Aggravated bleeding: Due to its anti-platelet aggregation effect, it can also cause coagulation dysfunction and is therefore contraindicated in severe liver disease, bleeding tendencies such as hemophilia, and pregnant women. For patients who need surgery, aspirin should be stopped one week before surgery. 3). Allergic reactions: It varies from person to person. A small number of atopic patients may show rash and asthma, which can be relieved by using hormone. 5. How to prevent the damage of aspirin to the gastrointestinal tract? If you have symptoms of gastrointestinal discomfort, such as stomach pain, nausea and vomiting, indigestion, etc., you should actively conduct relevant examinations and evaluate whether aspirin may have caused stomach damage. For these high-risk groups who are over 70 years old, have a history of peptic ulcers or bleeding, are positive for H. pylori, or are concurrently using hormonal medications, prophylactic use of drugs that inhibit gastric acid secretion can be effective in preventing bleeding. Untitled 11.png 6.How to prevent cardiovascular diseases at the first level for people over 70 years old? (1) Eat a reasonable diet; (2) It is not recommended to start drinking alcohol or drink frequently for the sake of preventing heart disease. (3) reduce sodium intake, salt control at 3-5g per day; increase potassium intake, potassium salt ≥ 4.7g per day. (4) regular exercise: adhere to at least 30min of relaxing aerobic exercise every day; (5) weight control: overweight and obese people to lose 5% to 10% of body weight in 6-12 months, BMI maintained at 18.5-23.9kg/m2, waist circumference control in men ≤ 90cm, women ≤ 85cm. (6) Quit smoking and avoid passive smoking.