A complete list of preventive measures for heart disease

More than 90% of heart attacks are preventable. The core logic is based on three things - control the three "vascular damaging molecules" of blood pressure, blood lipids, and blood sugar within a safe range, kick "death habits" such as staying up late, smoking, and heavy oil and salt off the survival list, and spend half a day every year for targeted screening to avoid most risks.

I was on duty in the emergency department last week and met a 32-year-old Internet product manager who had been working on a project for seven days in a row. When he came in with chest pain, his coronary artery was 80% blocked. I asked him if he knew he had high blood pressure. He said he did, but he thought he was young and didn’t take it seriously. He had never taken medicine. Do you think it's a pity? Our blood vessels are actually just like the tap water pipes at home. They work under constant pressure all year round and are never cleaned of scale. Sooner or later, they will either become clogged or explode. The current unified standard in the academic community is that normal blood pressure should be controlled below 130/80mmHg. Don’t use the old standard of 140/90 as a shield. Pressing the line is already a high-risk state. ； Low-density lipoprotein (LDL-C), the core indicator of blood lipids, should be lower than 3.4mmol/L for ordinary people. For those with a family history or arterial plaque, it must be lowered to 1.8 or even lower to be safe. Let’s be honest here, the controversy about statin lipid-lowering drugs has indeed always existed: one group believes that as long as blood lipids are high, one should take the drug as soon as possible to nip the risk before it starts. ； The other group believes that if it is only slightly higher and there are no other high-risk factors, you can first rely on diet and exercise adjustments for three months before making a decision to avoid unnecessary side effects of drugs. Judging from my many years of clinical experience, less than 1% of people who take statins will develop abnormal liver function. Regular reexamination can make timely adjustments. There is really no need to stop eating because of choking. The risk of stopping the medicine privately is much greater. Last month, an old man felt that his blood pressure had stabilized, so he secretly stopped his antihypertensive medicine. After drinking 20 ounces of wine at a New Year party, he was sent to the hospital with aortic dissection. It took him 6 hours to save his life.

Many people think that it is enough for me to take medicine on time every day, and then just eat hot pot with iced Coke, and stay up until two or three o'clock to watch short videos. This is equivalent to derusting the water pipes and pouring cement into them at the same time. It is completely useless. The opinions about diet are even more confusing. An old patient came to me before and said that he had read an article on the Internet saying that red meat causes cancer and blocks blood vessels. He had not touched a bite of pork or beef for half a year, and as a result, he became anemic and dizzy. In fact, the current attitude of the academic community towards red meat is not unified: the American Heart Association says that it is perfectly fine to eat lean red meat no more than 3 times a week, about 100g each time, and there is no need to give up completely. ； Instead, it is processed meats such as sausages, bacon, and cured meats. No matter who you are, it is recommended not to eat them if you can. There are also zero-calorie drinks that are very popular nowadays. Some studies say that sugar substitutes will disturb the intestinal flora and increase the risk of cardiovascular disease. Some studies say that as long as you don’t drink them every now and then, they will have little impact. My suggestion is to drink plain water as much as possible. If you are really greedy, it’s okay to drink it once in a while. Don’t be overly anxious and feel guilty after taking a sip. Oh, and there is drinking. Many people talk about "drinking a small amount of alcohol to soften blood vessels." Now the WHO has classified alcohol as a carcinogen. No matter how much you drink, it will cause damage to the body. However, some epidemiological studies show that drinking no more than 15g of alcohol per day. Essence (about one or two ounces of low-alcohol liquor), the negative impact on cardiovascular disease can be ignored, so this depends on personal choice: if you don't drink it, don't drink it. If you like to drink, it's okay to take a few sips less. Don't drink too much until you blush and feel dizzy. It really puts a burden on your heart.

As for exercise, there is really no need to force yourself to get a fitness card worth tens of thousands of yuan to run 5 kilometers every day. A study published in The Lancet last year said that if you accumulate 30 minutes of moderate-intensity exercise every day, such as climbing stairs, brisk walking, or even cleaning windows and mopping the floor, as long as your heart rate reaches (170-age), the effect is exactly the same as running for half an hour continuously. I have a 62-year-old patient who gets off the car and walks two stops early when picking up his grandson every day. He has persisted for three years and his blood lipids are healthier than many young people in their twenties. Of course, some experts in sports medicine have suggested that adding strength training twice a week to build muscle can better improve basal metabolism and have a stronger long-term protective effect on cardiovascular disease. This depends on individual circumstances. If you can do it, it is certainly better. If you can't do it, there is no psychological burden. It is better than sitting for a whole day. Oh, by the way, don’t exercise suddenly and strenuously. For people who never exercise normally, suddenly going to climb a mountain and run a half-marathon on the weekend may easily induce myocardial infarction. You should only exercise step by step.

Many people undergo routine physical examinations every year. If their electrocardiogram is normal, they think they have no heart problems. This is actually a big misunderstanding. Many early-stage coronary heart diseases cannot be detected by ordinary electrocardiography when there is no attack. For people with a family history of high blood pressure, diabetes, and heart disease, it is best to have a carotid artery ultrasound every year to see if there is any arterial plaque. This examination costs more than 100 yuan and is a golden indicator that can directly reflect the degree of systemic vascular hardening. ； If you occasionally have chest tightness or pain, you can do an exercise treadmill test and, if necessary, coronary CTA, which can basically screen out all early risks. I have a friend’s father whose annual physical examination and electrocardiogram were normal. Last year, he did a carotid artery ultrasound and found that there were multiple unstable plaques. Further tests revealed that the coronary artery was 60% blocked, and a stent was placed in time to prevent any problems.

There is another point that many people overlook: emotions. Long-term anxiety, stress, and sulking will cause serious damage to blood vessels. I used to have a class teacher at a key high school who couldn't eat or exercise regularly. He was under great pressure to lead a graduating class. He had to lie in bed for two or three hours every day before falling asleep. As a result, he was diagnosed with coronary artery spasm, which is also a type of heart disease. In severe cases, it can also induce myocardial infarction. So, if you have to fish, just fish. Don’t compete with yourself. It’s really not worth it.

After all, there are really no fancy tricks to prevent heart disease, and you don’t need to follow other people’s health lists. Some people are born to love sports, while others like to lie flat at home. As long as you avoid those core pitfalls, you can be as comfortable as you want - we live to live happily, not to set a lot of rules and regulations for ourselves and suffer, right?