Study Of Low-dose Aspirin On Attenuating The Progression Of The Atherosclerotic Plaque Of Patients With Hypertension

Backgroud: The beneficial effects of aspirin on the primary and second prevention in cardiovascular and cerebrovascuar disease are verified by lots of clinical trials, and these effects are thought to be the results of its anti-platelet effect, but its effects on attenuating atheroclerosis are not clear, the optimal dosage is still not clear either.Objective: To evaluate the effects of low-dose of aspirin,which correspond to 100mg/d in its clinical use,on the progression of atherosclerotic plaque in carotid artery.Methods:120 patients with hypertension and atherosclerotic plaque in carotid artery were randomized divided into 4 groups: control group,aspirin group, atorvastatin group and the combination group,30 patients in each group respectively.All groups were given the treatment of hypotensive drugs,including CCB,ACEI,beta-blocker,to make the BP lower than 140/90mmHg.The patients in aspirin group received aspirin 100mg once a day beside the hypotensive drugs;the atorvastatin group received atorvastatin 20mg once a day;and the combination group received combination therapy with both aspirin and atorvastatin.The main follow-up time was 18 months.All the enrolled patients were detected the biochemical indicator in the blood serum, the diastolic function of brachial artery, carotid artery intra-media thickness(IMT),and the plaque score at the first and last follow up.Result: Compared to the first follow-up,the CRP, carotid artery IMT and the plaque score of the control group were significantly higher,while the EDD and EID were significantly lower(P<0.05) in the last follow-up;The CRP of the aspirin group was significantly lower,while the EDD and EID were significantly higher(P < 0.05),but there were no significant differences in carotid artery IMT and plaque score(P=0.166,P=0.487).In the atorvastatin group and the combination group,there were no significant differences in plaque score(P=0.081,P=0.068),but the other index had significantly changed.Compared to the control group,the CRP and the carotid artery IMT and the plaque score were significantly lower,while the EDD and the EID increased obviously.The carotid artery IMT and the plaque score of the atorvastatin group and the combination group became even lower than the aspirin group(P<0.05); The carotid artery IMT of the combination group was significantly lower than the atorvastatin group,but there were no significant differences in plaque score between the atorvastatin group and the combination group(P=0.730).Conclusion:1,Low does aspirin can inhibit the inflammatory reaction in the patient of artherosclerosis;2,Low does aspirin can ease the injury of the endothelial cell and the vascular smooth muscle,and protect the function of them;3,Low dose aspirin can attenuating the progression of carotid artery IMT and the plaque score;4,Aspirin combining with atorvastatin can make batter effect on anti-artherosclerosis than the sigle usage of aspirin or atorvastatin.