Heart disease prevention methods

Control controllable risks and screen for hidden problems early. There is no need to believe in the "miraculous blood vessel clearing medicine" promoted by those selling health care products, and there is no need to force yourself to implement a health regimen that is too demanding to adhere to. If you can implement these 8 words, more than 90% of premature heart disease can be avoided.

I was particularly impressed by Uncle Zhang, whom I met at a community free clinic last week. He had been taking medicine for high blood pressure for five years, and his systolic blood pressure had been hovering around 160. When I asked him, I found out that he had to drink 2 taels of white wine every day. He also said that "drinking to activate blood circulation is more effective than antihypertensive medicine." As a result, I went to the emergency room last month for acute myocardial infarction and had a stent inserted. Now when I see her, I regret not listening to her advice earlier. Don't think this is an isolated case. Clinically, 80% of patients with premature myocardial infarction clearly have basic problems such as high blood pressure, hyperlipidemia, and high blood sugar, but they either don't take it seriously, or they follow folk remedies and refuse to control them in a standardized way. To be honest here, there is no unified standard for the control targets of basic indicators: it is enough for ordinary people to control LDL below 3.4mmol/L and stabilize blood pressure within 130/80mmHg. For high-risk groups who already have plaques or have a family history, LDL must be reduced to 1.8 or even lower to be safe. Don’t use the general standards on the Internet to apply to your situation.

When it comes to diet, there are actually quite a lot of controversies. When low-carb diets became popular in the past two years, many people ate meat instead of staple food, saying that this would lower blood lipids and prevent heart disease. Later, they said that the Mediterranean diet is the gold standard. At present, the American Heart Association does recommend a Mediterranean diet, eating more deep-sea fish, whole grains, fresh fruits and vegetables, and less trans fatty acids and processed red meat. However, recent studies have shown that low-carb diets are more effective in controlling blood lipids for people with high cardiovascular risk associated with type 2 diabetes. There is really no need to worry about which is the "optimal diet". My advice to patients has always been: the way you can stick to it for a lifetime is the one that is best for you. For example, if you really don't like salads, it would be better to add two less spoons of oil when frying vegetables every day, rather than forcing yourself to eat salads for half a year and then eating hot pot in revenge. Oh, by the way, a little trivia. Many people don’t know that long-term constipation and straining to defecate are also high-risk factors for myocardial infarction. The year before last, I treated a 62-year-old man who was constipated and had chest pains after squatting for 20 minutes. He was taken to the emergency room for 80% blockage. So eat more dietary fiber and don’t strain to hold it in. It’s really not a trivial matter.

Don’t listen to those fitness bloggers who say that you must run 5 kilometers every day and have your heart rate above 130 to be considered exercise. I met a 72-year-old aunt who had bad knees and couldn't run. She walked around the community for 40 minutes after dinner every day and picked up her grandson who was attending cram school. She persisted for 8 years. Last year, the coronary plaque shrank a little during a review. Of course, it would be better if you could occasionally add strength training by lifting mineral water bottles. You don’t have to waste money by going to the gym to apply for a card. Even if you usually climb two extra flights of stairs or walk more when doing housework, the cumulative amount of activity will be better for your heart than your sudden 10-kilometer run on the weekend.

When it comes to the issue of tobacco and alcohol, we have been quarreling for many years. There are always elders who say, "I have been drinking one or two drinks a day for my whole life, and my health is very good." "Drinking a small amount of alcohol activates blood circulation and removes blood stasis." The latest "Lancet" research does show that even a small amount of drinking can increase the risk of cardiovascular disease. However, some traditional medical opinions believe that people with weak and cold constitutions drink a small amount of warm rice wine and red wine, which can indeed help improve peripheral circulation. There is no need to go to extremes. People who do not drink alcohol should not drink alcohol. If an elderly person has been drinking for decades, there is no need to completely quit drinking. Slowly reducing the amount to drinking once or twice a week will be enough. On the contrary, the stress response of sudden withdrawal is even worse for the body. There is nothing controversial about smoking. Whether it is first-hand, second-hand or third-hand smoke, the damage to the endothelium of blood vessels is certain. Last year, I met a 32-year-old girl who did not smoke but her husband smoked at home every day. The physical examination showed that the coronary calcification was more serious than that of many 40-year-old smokers. This is really not a trivial matter of "my smoking does not affect others."

Speaking of this, I suddenly thought of the question about health products that many people ask: Can coenzyme Q10 and deep-sea fish oil prevent heart disease? The current evidence-based evidence is that if you usually eat a balanced diet and are not deficient in nutrients, you don’t need to eat it at all. If you really want to eat it, ask a doctor first, and don’t buy it blindly. I have seen too many people who took Sanwu fish oil and damaged their liver function, and the gain outweighed the loss. There is also the recent trend of "patting the elbow socket to clear blood vessels". It is purely an IQ tax. If the plaque can be patted away, why do you need a cardiologist?

In fact, many people think that heart disease is a disease of the elderly. The youngest patient with myocardial infarction received last year was 27 years old. He was an Internet programmer. He stayed up all night for three consecutive days to revise projects. He had chest tightness all morning and thought he was tired. He carried it until he got off work and fainted in the elevator. When he was taken to get an angiogram, it was already 70% blocked. Don’t think that you can have a surgery if you are young. Even if you are not feeling uncomfortable if you are over 30 years old, you should have a blood lipid check and an electrocardiogram every year. If you have a family history, you can also get a coronary CT. It is much better to detect problems early than to put in a stent if there is a blockage.

Oh, and there is a little trick I often tell patients: you can put a small nut box in your pocket and eat two almonds or walnuts when you have nothing to do. It is better than eating potato chips and biscuits when you are fishing. About 10 nuts each time is enough. Don’t eat too much and it will increase blood lipids. Don’t hold your urine for a long time either. I’ve actually met an uncle whose blood pressure soared and caused angina pectoris after holding his urine for a long time. It’s all trivial things, but if you hold it in too much, it can lead to big problems.

In fact, the prevention of heart disease is never a difficult task that requires you to stick to it. To put it bluntly, you just need to pay more attention to your body, don’t make things up, don’t force yourself when you feel uncomfortable, and talk to your doctor regularly, which is better than anything else. After all, your body is your own, and methods that are comfortable and sustainable are the ones that are truly useful.