What are heart disease preventive drugs?

First of all, it must be clear that there is no "universal heart disease prevention drug" that is suitable for everyone. The relevant drugs currently used in clinical practice are prescribed for high-risk groups by doctors after assessing the individual risk of disease. They are used to reduce the probability of serious heart disease events such as myocardial infarction and sudden death. Ordinary people taking them without indications may actually harm their health.

A while ago, I saw a 42-year-old programmer who had smoked for 20 years, had low-density lipoprotein that was twice the normal value, was overweight, and had a family history of premature coronary heart disease. The doctor assessed that his risk of myocardial infarction in the next 10 years exceeded 10%, and prescribed him rosuvastatin and 100 mg of aspirin, which are the most typical preventive drugs for heart disease.

The main function of statins is to reduce density lipoprotein cholesterol. You can think of this cholesterol as "grease" in blood vessels. If it accumulates too much, it will form plaques and block the coronary arteries that supply blood to the heart. If the plaques are broken, they will cause myocardial infarction. Statins can not only remove the "grease", but also "weld" unstable plaques to reduce the risk of rupture. However, the controversy about statins has not stopped. Many people think that statins damage the liver and muscles. Indeed, less than 1% of people who take them will have adverse reactions such as increased transaminases and muscle soreness. Therefore, they must not be bought and eaten casually. People who need to take medicine should also regularly review their liver function and muscle enzymes. If there are problems, they can adjust the medicine in time and there will be no major problems.

Aspirin is even more controversial. Its function is to inhibit platelet aggregation, which is equivalent to making the blood less likely to clot. Even if the plaque is broken, it will not be easy to quickly form a thrombus and block the blood vessel. But now academic circles have long discouraged low-risk people from regularly taking aspirin to prevent heart disease. For example, if you are just a little fat, have normal blood pressure and blood lipids, and have no family history, the risk of bleeding (such as gastric bleeding and cerebral hemorrhage) from taking aspirin is much higher than the preventive benefits it can bring. I met a 60-year-old aunt before. I heard from an old sister that taking aspirin can prevent myocardial infarction. I bought it for half a year, and ended up hospitalized for stomach bleeding. The gain outweighed the loss.

In addition to these two things that everyone often hears, in fact, many drugs that control basic diseases are also preventive drugs for heart disease, such as antihypertensive drugs that people with high blood pressure take for a long time, and hypoglycemic drugs that patients with diabetes take. After all, high blood pressure and high blood sugar are "slow knives" that slowly corrode blood vessels. Controlling these indicators within a safe range is to reduce the burden on the heart and reduce the risk of disease.

Don’t think that you can sit back and relax after taking preventive medicine. I have seen too many people taking statins, eating hot pot and barbecue, staying up late and smoking every day, but still cannot control their blood lipids, and still suffer from myocardial infarction. In the final analysis, regular work and rest, smoking cessation and alcohol limit, balanced diet, moderate exercise and other lifestyle adjustments are the most cost-effective "preventive medicines", which are more reliable than any prescription medicine.