Heart disease prevention knowledge

Current clinical data confirms that more than 90% of cardiovascular events such as coronary heart disease and acute myocardial infarction can be avoided through active intervention. The core logic of heart disease prevention is very clear - giving priority to controlling variable risk factors such as smoking, unreasonable diet, and lack of exercise, combined with targeted regular early screening, even if there are immutable risks such as family history and age, the probability of disease can be reduced by more than 60%.

Last week, I met a 32-year-old Internet practitioner in the clinic. He worked hard for 12 days in a row to get the project online. He consumed three cups of ice cream every day and ate takeaways heavy in oil and salt. If the company’s physical examination had not revealed that his low-density lipoprotein was twice the normal value, he would have felt that he was young and strong and had nothing to do with heart disease. Many people's impression of heart disease prevention is still limited to "prevention and treatment of geriatric diseases." To be honest, I see more than a dozen cases of acute myocardial infarction in people around 30 years old every year. The youngest is only 28 years old. He stayed up for 3 days in a row playing games and broke into a cold sweat due to chest pain. An angiogram showed that 90% of the blood vessels were blocked.

When it comes to eating, many people’s first reaction is “It’s okay if I’m a vegetarian, right?” Not really sure. I met an aunt before who had been a vegetarian for five years. She fried vegetarian vegetables with a lot of oil every time, and also loved to eat melon seeds and shortbread. Last year, it was found that her coronary artery was 40% blocked. There are actually slight differences in academic views on diet to protect the heart. European and American guidelines place more emphasis on the intake of whole grains and unsaturated fatty acids, and even recommend that healthy people drink red wine in moderation. However, domestic clinicians generally recommend controlling the intake of invisible salts and invisible sugars first. For example, a bottle of sugar in the bottled lactic acid bacteria drink you like is equivalent to 8 sugar cubes, and the sauce sold downstairs has 2 grams of salt in one spoonful. These small details that you don’t care about add up to plaque in your blood vessels.

There is another question that people ask a lot: Should I take aspirin every day to prevent heart disease? There is currently no unified answer in the industry. The American College of Cardiology’s 2019 guidelines recommend that people with a 10-year risk of cardiovascular disease greater than 10% can take low-dose aspirin for prevention. ； However, many cardiologists in China will be more cautious. After all, aspirin carries the risk of gastric bleeding and cerebral hemorrhage. If you have gastric ulcer or poor coagulation function, taking it will not be worth the gain. Don’t take it without a doctor’s evaluation.

There is also a lot of controversy in the area of ​​exercise. Some people say that you must run 5 kilometers a day to be effective, while others say that you only need to walk 6,000 steps a day. In fact, there is really no standard answer. If you are young and have no underlying diseases, running 3 kilometers and playing soccer two or three times a week will indeed significantly improve your cardiopulmonary function. ； But if you have high blood pressure and poor joints, take a 20-minute walk after meals, do housework, and take two extra steps to pick up the kids. This kind of fragmented low-intensity activity is no worse than high-intensity exercise over a long period of time in protecting your heart. I have seen too many people apply for a fitness card and go there twice and then lie in ashes. On the contrary, it is not as practical as climbing three flights of stairs every day.

By the way, don’t be too anxious about early screening. Many people go for coronary CT when they feel a little chest tightness. In fact, it is completely unnecessary. If you have no family history, no high blood pressure, and no smoking, a routine physical examination of blood pressure, blood lipids, and electrocardiogram every year before the age of 40 is enough. ； If a direct relative has coronary heart disease before the age of 55, or if you have high blood pressure or diabetes yourself, then a carotid artery ultrasound examination every year after the age of 30, and a coronary CT every two to three years are enough. After all, doing too much may lead to radiation risks.

I often forget to move when I’m busy with clinics, so I set an alarm clock on my phone for 3 p.m. When the time comes, I stand up, pour a glass of water, walk twice in the corridor, and climb two flights of stairs. I save more than half an hour of activity in a day. I really don’t have to spare an hour or two to go to the gym. A habit that I can stick to is useful.

In fact, the prevention of heart disease is really not that flashy. You don’t need to buy those heart-protecting teas and Coenzyme Q10 health care products that are highly publicized. You can stay up less late, drink two less cups of milk tea, and take time to walk two more steps. It will be more effective than any other health care product. If you are really unsure about a question, go directly to the cardiology department of a regular hospital and ask the doctor. Don’t search on Baidu yourself and get more panicked, which may lead to problems in the end.