Moss Currently, there is no "magic pill" for clinically used drugs for the prevention of heart disease. The core ones are selected based on atherosclerosis and thrombosis, the two core mechanisms of heart disease, as well as basic causes such as hypertension and diabetes. Commonly used drugs include statins, lipid-lowering drugs, antiplatelet drugs, and antihypertensive and hypoglycemic drugs adapted to different underlying diseases. There has never been a universal prevention model that applies to everyone.
In the past few years, many people followed the trend and stocked up on aspirin, thinking that taking one tablet a day can prevent myocardial infarction. In the past two years, patients with stomach bleeding and peptic ulcers have been admitted to the emergency department from time to time. In fact, the academic circles now have particularly strict regulations on the use of aspirin for primary prevention of people who have not yet suffered from heart disease. Only those who have more than three high-risk factors at the same time - -For example, only people with low risk of bleeding who smoke all year round, have a family history of myocardial infarction before the age of 55, have high blood lipids, blood pressure, and blood sugar, have clear stenotic plaques in the carotid arteries, and have no history of gastric ulcers or bleeding, will be recommended by the doctor after evaluation. If you like to drink alcohol and have a bad stomach, eating it will not be worth the gain.
In contrast, the evidence for statins is much stronger. Whether it is for people who have already suffered from coronary heart disease or myocardial infarction to prevent recurrence, or for high-risk people who have not yet developed the disease but have high blood lipids and have developed soft spots on their blood vessels, statins are the first choice as long as they are tolerated. Many people are afraid that statins will damage the liver and muscles. In fact, the incidence of adverse reactions is less than 1%. Regular review of indicators is enough. Compared with the risk of myocardial infarction due to blockage of blood vessels, the probability of this side effect can really be ignored. Last month, I met a 58-year-old uncle in the outpatient clinic. The low-density lipoprotein was found to be 4.2mmol/L and there were two vulnerable soft plaques of about 1mm in the carotid artery. He was afraid of the side effects of statins and refused to take them. So he spent a lot of money to buy the Internet celebrity "natural statin" health care products. After taking it for three months, he checked again. The low density had not dropped at all and the plaques had grown by 0.3mm. Finally, he took rosuvastatin. After half a year, the low density dropped to the target value of 1.8 and the plaques were stabilized.
Don’t think that antihypertensive and antidiabetic drugs only control blood pressure and blood sugar. Long-term control of blood pressure below 130/80mmHg and stable glycated hemoglobin within 7% can reduce the risk of coronary heart disease by at least 30%. For example, for people with high blood pressure and coronary stenosis, doctors prefer pruritanes, sartans or beta-blockers, which can improve cardiac remodeling and prevent heart failure, which is equivalent to treating disease and preventing two birds with one stone.
Many people ask me whether coenzyme Q10, deep-sea fish oil, and nattokinase can be used to prevent heart disease. To be honest, there is currently no clear evidence-based evidence to prove that these health products have a direct preventive effect on heart disease. At most, they can be regarded as auxiliary, such as People who occasionally experience muscle soreness after taking statins can take some Coenzyme Q10 to relieve the discomfort. There is no need to spend a lot of money to buy it specifically to prevent heart disease. If someone tells you that a certain health product can replace drugs to prevent heart disease, don’t think about it, it is 100% deceptive.
In the final analysis, medicine is always the last line of defense. If you eat a lot of food every day, stay up until two or three o'clock every day, and smoke continuously, even if you take all the preventive medicines, the blood vessels that should be blocked will still be blocked. Lifestyle adjustment is the cheapest and most effective preventive method. If you want to take medicine or what kind of medicine you should take, you must consult a doctor to assess the risks before making a decision. Don’t blindly follow the trend and buy medicine, which may lead to problems.
