Aurelia There is no "magic pill" for preventing heart disease that is suitable for everyone. The vast majority of low-risk people who have no underlying diseases and have acceptable lifestyle habits do not need to take medicine to prevent heart disease. Only people who have been assessed by doctors as being at high or extremely high risk for heart disease need to take corresponding medicines as directed by the doctor.
Last week, I met two people of similar age in the outpatient clinic. A 43-year-old brother who drives a long-distance truck has been suffering from high blood pressure for 5 years without taking any medicine. His BMI is almost 30 and he smokes at least a pack a day for 20 years. Coronary CT scan showed that he has two mild to moderate stenoses in the blood vessels. He is a clear high-risk group for coronary heart disease. I prescribed him long-acting antihypertensive drugs, statins, plus a small dose of aspirin, and repeatedly told him to take it on time and to come for a review every three months. Another 39-year-old young man who works in operations found that his low-density lipoprotein was slightly elevated by 0.2mmol/L during his physical examination, his blood pressure and blood sugar were normal, and he had no family history of premature heart disease. I directly asked him to replace his daily cup of full-sugar milk tea with sugar-free one, and to run 3 kilometers in the evening three or four days a week. He would just come back for a re-examination in half a year, and he didn’t even prescribe half a pill.
In the past few years, many people used low-dose aspirin as a "daily preventive medicine" and would take one pill every day without any problem. In recent years, the academic consensus has actually been adjusted. Last year, two follow-up studies in top journals showed that low-risk people with no clear cardiovascular history took aspirin, and the benefits of preventing heart disease were almost negligible. On the contrary, the risk of gastrointestinal bleeding and cerebral hemorrhage increased by about 30%. At present, our clinical practice only recommends eating it to people who have been diagnosed with atherosclerotic cardiovascular disease, or whose risk of cardiovascular disease has been assessed to exceed 10% within 10 years. Ordinary people really should not buy it and eat it blindly.
Many people don’t know that if you have basic diseases such as high blood pressure, diabetes, and hyperlipidemia, drugs that can control the indicators within the normal range are the best preventive drugs for heart disease. After all, 80% of coronary heart diseases are caused by poor long-term control of these basic diseases, which slowly damage and block blood vessels. Controlling the source is much more effective than specifically looking for "heart-protecting drugs".
Speaking of which, this matter is just like the maintenance of sewer pipes at home. You should not pour oil or food residue into the pool at ordinary times, and check every now and then to see if there are any signs of blockage. It will save you much more worry than waiting for the pipe to be clogged and the water leaks downstairs before calling a master to clear it. The same is true for heart disease prevention. The core prevention measures for low-risk groups are always to smoke less and drink less, don’t stay up until midnight every day, eat less salt and less greasy food, and take some time to move every week. If you do these well, they will be more effective than eating too many health supplements.
As for coenzyme Q10, deep-sea fish oil, and nattokinase that are often asked about, they are all dietary supplements and cannot replace drugs. If the doctor has rated you as high-risk, but you ignore the prescribed statins and antihypertensive drugs and instead take hundreds of dollars a bottle of fish oil every day, it is simply wasting money and delaying things. Of course, that’s not to say that these are completely useless. For example, some patients experience muscle soreness as a side effect after taking statins. Following the doctor’s advice and supplementing with coenzyme Q10 can indeed relieve the pain, but for ordinary healthy people who want to take these to prevent heart disease, there is really no need to spend that money.
If you are really not sure whether you should take medicine, don’t just search for it online for a long time and just buy it yourself. Go to the cardiology department of the hospital to do a simple risk assessment, draw blood, and do an electrocardiogram. The doctor will judge whether you need to take medicine before taking it. After all, taking the right medicine will protect the heart, but taking the wrong medicine will put a burden on the body.
