Heart disease prevention knowledge brochure

More than 90% of heart attacks can be prevented by controlling controllable risk factors. There is no need to blindly take health products or expensive supplements. Controlling weight, blood pressure, blood lipids, blood sugar, and quitting smoking and alcohol are the most cost-effective prevention solutions.

This is not said casually. It is a conclusion clearly stated in the WHO 2023 Cardiovascular Disease Report. I have been doing free clinics in community cardiology departments for 8 years. I have seen too many patients who could have escaped disaster and stepped on various cognitive pitfalls. I just met a 32-year-old Internet programmer last week. He was eating fried chicken and drinking energy drinks while he stayed up late to modify code. His chest pain was so intense that he broke into a cold sweat before he came to check. His coronary artery had been blocked by 30%. He also clutched the physical examination report and said that his electrocardiogram last year was all normal. How could he have a heart problem?

Many people's understanding of heart disease is still that it's a disease of the elderly and "only fat people get it." This is really not the case. Last month I saw a 58-year-old aunt who has been a vegetarian all her life. She weighs less than 90 pounds and her triglycerides are still twice as high. When I asked her, I found out that she eats two fried dough sticks for breakfast every day and drinks a cup of milk tea with pearls and milk caps in the afternoon. Those trans fats hidden in shortening and non-dairy fat are more harmful to blood vessels than fat. When it comes to diet, there are two mainstream recommendations. One is the Mediterranean diet that everyone has heard of a lot, and the other is the DASH diet for people with high blood pressure. You really don’t need to use rigid recipes to force yourself to eat olive oil and quinoa that you don’t like. I also like to eat Chongqing hot pot. I order half a plate of green leafy vegetables every time, add less sesame sauce and more garlic for dipping. After so many years of eating, my blood fat has not exceeded the standard. Only habits that can be adhered to for a long time are useful.

Oh, by the way, the most asked question is "should we take aspirin daily to prevent heart disease?" This has been really controversial in the past two years. In the past few years, European and American guidelines recommended low-risk groups to take low-dose aspirin. The guidelines just updated in 2024 have changed: only high-risk groups who have been diagnosed with coronary heart disease, or have high blood pressure + diabetes + smoking history, need to take it under the guidance of a doctor. Ordinary healthy people eating indiscriminately can easily induce gastrointestinal bleeding, which is completely outweighing the gain. Some people also ask whether drinking red wine can protect blood vessels. A small European sample study said that the resveratrol in red wine is good for the vascular endothelium. However, a large sample study published by The Lancet last year clearly stated that as long as alcohol is consumed, it will increase the risk of blood vessel damage. The benefits of resveratrol are not worth the harm of alcohol. If you really want to eat, it is better to eat two more fresh grapes.

Don’t always think that to prevent heart disease, you have to apply for a fitness card and run five kilometers. For people who usually feel tired from sitting in the office and even going downstairs to get takeout every day, suddenly running a half-marathon on the weekend, the risk of myocardial infarction is three times higher than usual. If you really don’t have the energy to exercise, get off the bus two stops before get off work every day and walk for 20 minutes. Don’t slump in a chair and check your phone during lunch break. Stand and move for 10 minutes. The cumulative effect will not be bad. Last month, a young man came and asked, saying that he was working out every day and his body fat rate was 12%. Why was he still found to have myocardial ischemia? When I asked, I found out that he stayed up until two o'clock every day before going to bed, and smoked a pack of cigarettes a day when he was stressed. Don't think that exercising can offset the damage caused by staying up late and smoking. The damage to blood vessels is superimposed, and there is no such thing as "offsetting".

Many people just look at the normal electrocardiogram for annual physical examination and rest assured. It is really unnecessary. If there is a direct family member who suffered from myocardial infarction or cerebral infarction before the age of 50, it is best to have blood lipids and carotid artery ultrasound checked every year after the age of 30, focusing on low-density lipoprotein indicators. This can detect vascular problems earlier than electrocardiogram. I met a 35-year-old man last year. His electrocardiogram had been normal for three consecutive years. During the carotid artery ultrasound, there were already soft plaques. After taking a statin for half a year, the plaques were stabilized. If it takes another three to five years, it would be a serious problem if it blocks the coronary arteries.

There is another point that people tend to overlook: emotions really have a greater impact on the heart than you think. Not long ago, there was a 42-year-old eldest sister who had no underlying medical conditions. When she was arguing with her children, she suddenly suffered chest pains that made her unable to breathe. She was sent to the emergency room to be diagnosed as stress cardiomyopathy, which is what we often call "having a heart attack from anger." It's really not an exaggeration. People who are chronically anxious, stressed, and aggressive have always had high levels of cortisol in their bodies, which can cause more damage to the vascular endothelium than high blood lipids.

To put it bluntly, preventing heart disease is really not a high-tech thing. You don’t have to remember so many complicated indicators, and you don’t have to force yourself to live an ascetic life. Don’t overeat every meal, don’t stay up until two o’clock and scroll through your phone. Stop smoking if you can, drink as little alcohol as you can, don’t always compete with yourself when things happen, take half an hour to draw blood every year to check your blood pressure and blood lipids, most people can avoid it. Oh, and one last thing to mention, if you suddenly experience pain behind your sternum, pain in your shoulders, back, and tooth, and you can't breathe, don't hold on and wait for relief. Call 120 immediately. The time you save will be life-saving.