What medicines should be taken to prevent blood clots due to high blood pressure?

There is no universal anti-thrombotic drug suitable for all patients with hypertension. The vast majority of people who only suffer from high blood pressure, no other underlying diseases, and no clear unstable plaques in their blood vessels, as long as their blood pressure is controlled stably and below 130/80mmHg for a long time, do not need to take additional anti-thrombotic drugs. Only hypertensive patients who have been assessed by a doctor as being at high risk of cardiovascular and cerebrovascular diseases need to take corresponding antiplatelet and lipid-lowering drugs as directed by the doctor.

Not long ago, I met a 56-year-old aunt at a community free clinic. She has been suffering from high blood pressure for three years. She usually takes medicine to control her blood pressure. When she was doing square dancing, she heard from an old sister that taking aspirin can prevent strokes. She secretly bought aspirin and took it for three months. Recently, her gums started to bleed when she brushed her teeth, and she kept getting bruises all over her body. She came to me in a panic and asked me if my high blood pressure had gotten worse. I checked her physical examination report and found that she had no history of diabetes or coronary heart disease, and the carotid artery color ultrasound was also clean. There was no indication for medication at all. Within two weeks of asking her to stop taking the medication, all the bleeding disappeared.

In fact, academic circles do have different views on the indications for antiplatelet drugs in patients with hypertension. Some European and American guidelines believe that as long as the 10-year risk of cardiovascular disease exceeds 10%, low-dose aspirin can be considered to prevent thrombosis. However, most clinicians in China will be more cautious. After all, aspirin itself has a risk of bleeding. If you have gastric ulcers, Helicobacter pylori infection, or people who often take painkillers or like to drink alcohol, taking it rashly may cause problems with digestive tract or subcutaneous bleeding. The benefits of preventing thrombosis are not worth the risk of bleeding, and the gain is not worth the loss.

If medication is really needed after a doctor’s evaluation, the most commonly used one is low-dose aspirin enteric-coated tablets. If you have intolerances such as acid reflux or bleeding gums after taking aspirin, you can also switch to clopidogrel. In addition, many people tend to ignore statins. When many patients get the medicine, they read that the instructions are for lowering blood lipids. If their blood lipids are at normal values, they want to stop taking the medicine privately. In fact, for hypertensive patients with unstable plaques, the core function of statins is to wrap the easily ruptured "soft plaques" in blood vessels into stable "hard plaques" to prevent plaque rupture from triggering thrombosis. This effect is much more important than simply lowering blood lipids.

Having said that, don’t always focus on the medicine. I have seen many patients taking medicine to prevent blood clots while drinking heavily and smoking two packs of cigarettes a day. Their blood pressure fluctuates up and down like a roller coaster. In this case, taking more medicines is useless. It is better to adjust your work, rest and diet first and keep your blood pressure within the standard line. This is the best way to prevent blood clots.