Red plates of blood – platelets – perform a vital function, almost instantly eliminating vascular damage and preventing the development of serious bleeding. However, sometimes the ability of these cells to quickly restore the integrity of the vascular wall serves as a disservice.
Tens of thousands of platelets circulating in the blood regulate an important system that “repairs” damage to the inner layer of the blood vessel wall – hemostasis. If it breaks, even a small scratch can be enough for extensive bleeding. Remember the last Russian tsarevich, who suffered from a hereditary blood clotting disorder that made even abrasions on the knees life-threatening.
Normally, the body is able to cope without outside help, even with rather serious bleeding, and all this is due to the work of the hemostasis system, in which one of the leading roles is assigned to platelets.
As soon as the vessel is damaged, conditions are created in it for the formation of a thrombus: first, the vessel reflexively narrows, which allows to reduce the blood flow rate, and then platelets rush to the place of the “accident”. They stick together to form what is called a white blood clot.
But the work to eliminate the damage does not end there: thanks to the complex blood coagulation system, which is triggered when the integrity of the vessel is violated, a network consisting of fibrin fibrin is formed. The fibrin network firmly “braids” the white thrombus, tightening the edges of the wound. This forms a red blood clot, which finally restores the integrity of the vessel.
After the danger is over, a system is put into operation, which dissolves the unnecessary thrombus. The vessel becomes strong, thin and elastic again, i.e. ensuring the unhindered movement of blood to the tissues. And everything would be fine if blood clots sometimes did not form where it is not necessary.
A thrombus is formed not only when a vessel is damaged, but also during infectious processes, vascular diseases and when the vessel wall changes
Vascular damage that triggers the formation of a blood clot may not only be due to trauma. A thrombus is formed during infectious processes, vascular diseases leading to their spasm, and, of course, with changes in the vascular wall associated with atherosclerosis.
This silent killer can progress without symptoms throughout a person’s life to serious, life-threatening cardiovascular disease, such as coronary artery disease , stroke, myocardial infarction, or peripheral arterial disease.
Deposits of cholesterol on the walls of arteries may not be felt for decades. A slight decrease in blood flow, which is associated with vasoconstriction due to the atherosclerotic plaques formed in them, does not threaten with serious consequences.
Moreover, the body can adapt to it, and then the vessels will expand, which will provide essentially normal blood flow. But the years go by, and the plaques, which are constantly washed with blood, experience a certain effect. If the stress reaches its limit, the plaque can rupture. And then a fast-acting tragedy develops.
The hemostatic system perceives the rupture of the plaque as a violation of the integrity of the vessel. Thousands of blood clots are sent to the crash site and try to “glue” the plaque. This is how atherothrombosis develops – an extremely dangerous condition in which the formed thrombus either partially or completely blocks the blood flow. Its manifestations depend on the vessels in which the plaque ruptured.
If a catastrophe happened in the vessels of the brain, a stroke or a transient ischemic attack (microstroke) develops, if the heart has a myocardial infarction, an attack of angina pectoris or sudden cardiac death, if intermittent claudication appears in the arteries of the lower extremities, and in severe cases, tissue necrosis and gangrene. To prevent such a scenario, drugs are designed that prevent the formation of a blood clot.
Time to take aspirin?
One of the most widely used anti-clotting drugs is the nonsteroidal anti-inflammatory drug (NSAID) acetylsalicylic acid, or aspirin. The drug reduces the severity of inflammation, relieves pain, and relieves fever. However, these properties are also typical for other representatives of the NSAID group.
But the ability to prevent the formation of blood clots by suppressing the production of substances involved in the coagulation cascade, favorably distinguishes acetylsalicylic acid in a number of other drugs. Moreover, this effect is manifested for at least 7 days after a single dose.
Acetylsalicylic acid is an affordable and effective opportunity to reduce the likelihood of myocardial infarction (including recurrent) or stroke in people with coronary heart disease or at high risk of cardiovascular accidents.
Acetylsalicylic acid reduces the risk of developing 1 :
myocardial infarction – by 30%;
stroke – by 25%;
mortality from cardiovascular accidents – by 17%.
The drug is also indicated for acute thrombophlebitis, rheumatoid arthritis, stenting, etc.
The cardiological effects of acetylsalicylic acid are manifested when it is taken in doses of 75 mg per day. The need for higher dosages is doubtful: according to studies, there is no information that the antiplatelet (anti-thrombotic) effect of the drug increases with increasing dose 2 .
Acetylsalicylic acid reduces the risk of developing
By the way, the tolerance of the drug in low doses is generally favorable. Such a side effect of taking the drug, such as bleeding, is quite rare (no more than 2% per year).
However, the effectiveness, availability and safety of low-dose acetylsalicylic acid as a cardiovascular risk-lowering drug does not mean that it should be taken by anyone looking to prevent heart attacks and strokes.
According to international recommendations, it is prescribed to patients with a high cardiovascular risk (10% or more) aged 50–69 years. The risk is calculated based on age, gender, cholesterol, smoking and other factors.
Taking acetylsalicylic acid without serious indications (such as, for example, a history of myocardial infarction) is not at all recommended for people under 50 and over 70 years of age, since the scales “benefit – harm” can lean towards adverse effects, and above all – increase the risk of bleeding.