What are heart disease preventive drugs?

There is no universal "heart disease prevention drug" that is suitable for all people. All drugs used to prevent heart disease need to first assess the individual's cardiovascular risk and then be prescribed by a doctor. There is no drug that can 100% prevent heart disease for everyone.

Aspirin, which everyone has heard the most about, has actually been controversial in terms of its preventive indications in recent years. The guidelines in previous years also recommended that medium-risk groups should take small doses. In recent years, as more clinical data have come out, the scope of application has been narrowed down to only 10 years of hard work. Only people with a risk of tube event ≥10% and a low risk of bleeding are recommended to take long-term low-dose aspirin for prevention. If the gastric mucosa is fragile or the risk is very low, taking medicine indiscriminately may induce gastrointestinal bleeding or even cerebral hemorrhage, which is not worth the gain. Last week I met a 51-year-old brother in the outpatient clinic. I heard from neighbors in the community that taking aspirin can prevent myocardial infarction. I bought it at the drugstore and took it for more than three months. Recently, he had black stools for a week before coming to the doctor. After a check, he had multiple bleeding spots on the gastric mucosa. He does not have high blood pressure, diabetes, does not smoke, and is not obese. He is not at the level where he needs to take aspirin to prevent it. He just took medicine blindly and got into trouble.

In addition to aspirin, statins are also commonly used preventive drugs for high-risk groups. Their main function is to reduce high-density lipoprotein cholesterol and stabilize atherosclerotic plaques that have grown in blood vessels. This is equivalent to wrapping a protective layer on these easily broken "vascular time bombs". Preventing plaque rupture and thrombus blocking blood vessels will naturally reduce the risk of myocardial infarction and sudden death. Of course, not everyone needs to take it. Only people with excessive blood lipids or clear plaques in their blood vessels need to take it as directed by a doctor. If healthy people have normal blood lipids, there is no need to take it.

There are also preventive drugs for specific groups of people that are more targeted. For example, patients with atrial fibrillation all year round, whose heart beats wildly, can easily develop mural thrombus in the atrium. The thrombus will fall off and run along the blood vessels, causing blockage. In this case, doctors may prescribe anticoagulants such as rivaroxaban and dabigatran. These are exclusive preventive drugs for them. Others who take them casually will be at risk of major bleeding.

As for so-called "heart-protecting health products" such as coenzyme Q10 and deep-sea fish oil, which are very popular on the market, there is currently no unified conclusion in the academic community. Some studies believe that they can have a certain auxiliary and improving effect on patients who have already suffered from heart failure and myocarditis, but there is no evidence that healthy people can prevent heart disease if they take them. Buying them as preventive drugs is basically paying an IQ tax.

To be honest, for the vast majority of healthy people with regular schedules and no underlying diseases, the best preventive medicine for heart disease is not the bottles and jars sold in pharmacies. Instead, it is to smoke less cigarettes, drink less cup of full-sugar milk tea, and go out for a half-hour walk three or four days a week.