Psychological adjustment combined with aspirin: a guideline for dual treatment and medication of coronary heart disease.

When patients experience psychological problems, the main treatment methods include:

1. Increase social interaction and cultivate hobbies. The most important aspect of treating mental illness is self-regulation. Finding ways to release emotions promotes mental health recovery. It is recommended to spend more time with family and friends, travel, avoid living alone, cultivate hobbies, and participate in group activities.

2. Medication can be used as an adjunct therapy for severe cases. Current research shows that sertraline and citalopram have no toxic side effects on the cardiovascular system and are therefore recommended as safe and effective medications for patients with coronary heart disease accompanied by anxiety and depression. Some traditional Chinese medicines, such as Qishen Yiqi Dripping Pills, can have a certain auxiliary effect in relieving mild depression or anxiety.

3. Aerobic exercise. Patients can engage in self-directed exercise at home, following the principles of gradual progression and exercising within their capabilities. The form of exercise can be determined according to the patient's preferences. If possible, patients should visit a hospital with a cardiac rehabilitation center to develop an exercise prescription and engage in regular aerobic exercise at a safe intensity.

Aspirin: Aspirin is currently the most commonly used and longest-used medication for treating coronary heart disease in the world. For many years, aspirin has been widely recognized in the treatment of cardiovascular diseases. Currently, my country has adopted low-dose aspirin (75-100 mg/day) for primary and secondary prevention of cardiovascular diseases, and this has been included in the "Guidelines for the Prevention of Cardiovascular Diseases in China."

1. What are the functions of aspirin? Aspirin is widely used in the prevention and treatment of cardiovascular diseases. Its most important function is to inhibit platelet aggregation and prevent thrombosis, commonly known as "preventing blood thickening." Because platelets play a crucial role in promoting atherosclerosis, luminal narrowing, blood coagulation, thrombosis, and their progressive development, inhibiting platelet aggregation can prevent thrombosis, reducing or avoiding the formation of blood clots in narrowed blood vessels that could block them.

2. Who Needs Long-Term Aspirin Use?

(1) Patients diagnosed with coronary heart disease or cerebral infarction, especially those who have undergone stent implantation or bypass surgery, need to take aspirin for life.

(2) Primary prevention with aspirin refers to patients who, although they do not have cardiovascular disease, have risk factors for cardiovascular disease and should take aspirin to prevent its occurrence.

In addition, patients with multiple risk factors such as advanced age, hypertension, diabetes, hyperlipidemia, and renal insufficiency are advised to consult a doctor for a thrombosis and bleeding risk assessment to determine whether they need long-term aspirin use to prevent cardiovascular disease.

3. Is Long-Term Aspirin Use Safe?

The main dangers of long-term aspirin use are twofold: one is direct damage to the gastrointestinal tract, such as leading to peptic ulcers; the other is increased bleeding risk. In reality, the probability of aspirin causing serious gastrointestinal damage is low, especially with enteric-coated aspirin, which significantly reduces the incidence of aspirin-induced ulcers. Studies have shown that, on average, 1 in 5,000 patients treated with aspirin experiences hematemesis, and 19 serious cardiovascular events are prevented annually among every 1,000 aspirin-treated patients. Therefore, for patients with indications, the benefits of aspirin far outweigh the risks, and one should not avoid it altogether.

4. Who should take aspirin with caution?

(1) People allergic to aspirin;

(2) Patients with a history of ulcers, blood disorders, or cerebral hemorrhage, as well as patients who have been taking analgesics long-term.

5. When is the best time to take aspirin?

Generally, 6-10 AM is a peak time for cardiovascular disease. To achieve the purpose of treating and preventing cardiovascular disease, it is usually recommended to take aspirin in the morning. Different aspirin formulations have different methods of administration.

(1) Enteric-coated tablets are recommended to be taken on an empty stomach. Taking enteric-coated aspirin tablets on an empty stomach in the morning is most effective. Enteric-coated aspirin is acid-resistant but alkali-resistant. If taken before meals, the drug is difficult to dissolve due to the strong acidic environment of the stomach on an empty stomach. If taken after meals, food alleviates the acidic environment of the stomach, increasing the pH of gastric juices, causing the drug to dissolve in the stomach and increasing the risk of gastric mucosal damage. Taking it on an empty stomach results in rapid gastric emptying, a shorter residence time of the drug in the stomach, and direct entry into the intestines, reducing damage to the gastric mucosa.

(2) Regular formulations are recommended to be taken after meals. Regular formulations of aspirin are recommended to be taken after meals to reduce direct damage to the gastrointestinal mucosa through food.

Note: Enteric-coated aspirin is recommended under all circumstances.