Aspirin was first widely used in clinical practice as a painkiller, but later it was discovered that aspirin could inhibit platelet aggregation and prevent thrombosis. Now it has become a very common antithrombotic drug and an essential drug for patients with coronary heart disease and stroke. But aspirin is not without side effects, it can cause gastrointestinal bleeding and brain bleeding, and indiscriminate use of aspirin can be harmful. So we need to understand whether aspirin should be taken and how to take it? 1, who must use aspirin? People who have had angiography to confirm the diagnosis of coronary heart disease, myocardial infarction, stroke, peripheral vascular disease, stent and heart bypass surgery have been diagnosed with cardiovascular disease, if there is no contraindication should take aspirin. Here we need to emphasize that we are referring to coronary heart disease diagnosed by cardiovascular specialists, not because there are premature beats, atrial fibrillation, dizziness and weakness, etc. buckle up to the cardiovascular disease. 2, people over 40 years old without cardiovascular disease also need to take aspirin? There is a misconception that people over the age of 45 take aspirin to prevent heart disease. This aspect is indeed controversial. Studies have found that in people without cardiovascular disease, taking aspirin daily does not reduce deaths by only 5 myocardial infarctions per 10,000 people per year, but increases serious gastrointestinal bleeding and intracranial hemorrhage by 3. The net benefit is not significant. Recommendations vary between national and regional guidelines due to differences in ethnicity and diet, etc. However, it is important to remember that aspirin is a drug that can cause serious side effects such as bleeding. Not all people over 40 years of age need to take aspirin and there are strict indications for its use. The need for aspirin needs to be determined based on a risk versus benefit assessment. 3. How long do I need to take aspirin? All patients who meet the indications for taking aspirin and who do not have side effects such as gastrointestinal bleeding or asthma attacks while taking it need to take it for a long time as long as they can tolerate it. 4.How to take aspirin? In the past, many people thought that aspirin was damaging to the stomach and should be taken after meals, but this is not the case in reality. At present, the aspirin sold in China is basically aspirin enteric tablets. Enteric tablets are designed to avoid aspirin being absorbed in the stomach. The enteric coating is not broken down in the acidic environment of the stomach, and the aspirin is only released to work in the alkaline environment of the intestine. This design greatly reduces the damage to the stomach and changes the way aspirin is taken – from after a meal to on an empty stomach. This is because the acidic environment of the stomach may be altered after a person eats, and the enteric coating of aspirin enteric soluble tablets may disintegrate earlier, so taking it after a meal may instead damage the gastric mucosa. It takes at least 2-3 hours for aspirin enteral tablets to enter the intestine in the fasting state. And it also takes about 3 hours for the stomach to empty after a meal, so that there is no good point in time to meet this requirement either before breakfast, and between three meals, while bedtime is generally more than 3 hours before dinner, which can be considered fasting, and the gastric pH should be sufficient to ensure acidity. It is possible to ensure that aspirin enter the intestinal tract as much as possible to exert its medicinal effect. In addition, it should be noted that aspirin enteric tablets should not be broken or bitten to take, otherwise the intestinal coating will lose its effect, which will increase the gastrointestinal adverse reactions. 5, who can not take aspirin? Aspirin is a medicine there must be contraindications, if you can have a history of aspirin allergy, aspirin asthma, ongoing episodes of gastrointestinal bleeding and peptic ulcers that require treatment, as well as intracranial hemorrhage in the past 6 weeks and other conditions do not take aspirin. 6.Can aspirin be stopped? Inhibition of platelets by aspirin to exert antithrombotic effects can also lead to bleeding. When patients taking aspirin undergo surgery, it will be more difficult to stop bleeding. Surgeons often ask to stop aspirin, but in patients who have had a stent, stopping aspirin increases the risk of stent thrombosis, which is often fatal when it occurs. Therefore, it is important to seek the advice of a cardiovascular surgeon when discontinuing antiplatelet drugs such as aspirin and clopidogrel.