A complete list of preventive measures for heart disease

The optimal prevention logic for heart disease currently recognized by the medical community is "layered intervention" - ordinary people adhere to the 7 core controllable items of lifestyle. High-risk groups with high blood pressure/diabetes/family history can avoid more than 80% of the risk of sudden heart disease by adding 1-2 targeted screenings per year. There is no need to follow the trend and take expensive supplements such as Coenzyme Q10 and deep-sea fish oil, and there is no need to deliberately do high-intensity exercise that exceeds the body's load.

The last time I went to the outpatient clinic with Director Zhang of the Department of Cardiology, I met a 29-year-old Internet product manager. Last year, there was nothing wrong with the routine physical examination. Last week, he stayed up for three nights to revise the version and was sent to him with chest pain. The angiography showed that the coronary artery was 70% blocked. When asked, he drank all the takeaways that were heavy in salt and oil, and drank Coke as water for almost 5 years. The coronary blood vessels are actually like the tap water pipes at home. Over the years, grease and salt have accumulated on them, and the rust and scale are so thick that only 70% of them are blocked before they will have obvious symptoms of chest tightness and chest pain. Many people don't feel anything at ordinary times, and it is an emergency when they develop. In fact, there has been a lot of controversy about diet. When the low-carb diet trend became popular two years ago, many people said that it is not necessary to control fat but only refined sugar. From the perspective of evidence-based medicine, it is appropriate for ordinary people to control their daily salt intake to 5 grams (about the amount of a beer cap) and saturated fat to account for no more than 10% of total calories. The safest thing is that if you don’t have underlying metabolic diseases, it’s okay to occasionally eat hot pot that’s heavy in oil and salt. There’s no need to overdo it. However, people with a family history of premature heart disease should really not blindly follow the ketogenic diet. We have previously treated a girl who relied on ketogenic diet to lose weight for 3 months, and her blood lipids tripled, causing angina pectoris.

Many people’s misunderstanding about exercise is that running marathons and training with heavy weights are necessary to be effective. Many cardiac rehabilitation patients I have come into contact with previously had problems caused by years of inactivity and sudden intense exercise. The 150 minutes of moderate-intensity exercise recommended by mainstream guidelines per week is actually very low. It means that you can talk normally but cannot hum while walking briskly. This includes getting off the car two stops early from get off work and walking home, or spending two hours walking in the park with your family on weekends. In recent years, some studies have shown that 75 minutes of high-intensity exercise per week has about the same heart-protecting effect as 150 minutes of moderate-intensity exercise, but the premise is that you do not have underlying problems such as high blood pressure or valvular disease. If you usually get out of breath when climbing three floors, don't rush into HIIT or half marathon, as this may lead to accidents.

The conclusion on tobacco and alcohol is actually relatively clear. It is recommended for all ages to quit smoking. No matter how many years you have smoked, how many cigarettes you smoke every day, or even if you only smoke secondhand smoke all year round, the rate of damage to the vascular endothelium will increase by 2-3 times. Wine is more controversial. There has been a saying among the people that "a small amount of red wine softens blood vessels." The latest Lancet study shows that abstaining from alcohol is the best for the heart. It can actually be considered based on the situation: if you do not have atrial fibrillation or high blood pressure, it is okay to drink one or two drinks at friends gatherings occasionally. But if you have an old problem of panic, or there is a history of atrial fibrillation in your family, you really should not drink alcohol. I have seen too many patients who were sent to the emergency room for acute atrial fibrillation after drinking half a glass of white wine.

If you already have high blood pressure, diabetes, or have a direct family member who had a myocardial infarction before the age of 55, then lifestyle alone is not enough, and you need to add the buff of early screening. There used to be a 42-year-old business owner who had a routine physical examination at work every year. The electrocardiogram and chest X-ray were all normal. Later, because he often stayed up late and worked overtime, he became panicked and had a coronary CT scan. It was found that the blood vessel had been blocked by 50%. He took medicine early and intervened, so it did not develop into a myocardial infarction. Many people think that routine physical examinations are useless. In fact, it is not. For ordinary people, a physical examination plus four blood lipids and carotid artery ultrasound are enough. If high-risk groups have chest tightness, left shoulder pain, toothache but no oral problems can be found, an exercise treadmill or coronary CT will be enough. There is no need to perform expensive whole-body PET-CT several times a year, which is a waste of money.

There are two other risk points that are particularly easy to ignore, one is emotion and the other is sleep. Not long ago, an aunt had a fight with her daughter-in-law, and she fell to the ground with chest pain. She was sent to be checked out for stress cardiomyopathy, commonly known as "broken heart syndrome." People who are chronically anxious, stressed, and prone to rage have a risk of heart attack that is more than twice that of ordinary people. This is really not a scare. Many people think that snoring means sleeping soundly. In fact, if you snore and suddenly stop for a few seconds, and wake up with a dry mouth, it is most likely sleep apnea. This condition will cause you to be deprived of oxygen during sleep, and the risk of heart disease is 2-3 times higher than that of ordinary people. If you have this problem, go to a respiratory doctor as soon as possible. It will be more effective than any number of heart-protecting supplements you take.

In fact, to put it bluntly, heart disease prevention really doesn’t have that many bells and whistles. Don’t listen to those who sell health care products on the Internet. Magic medicines for clearing blood vessels and quantum heart protection devices are all IQ taxes. Doing small daily things well is better than anything else. If you really experience chest tightness or pain that lasts for more than ten minutes, or is even accompanied by nausea and left shoulder pain, don’t force yourself to do it, call 120 and go to the cardiology department. In many cases, if you get to the hospital half an hour earlier, the result will be completely different.