Heart disease prevention guide

Blood lipids can reach the target, blood pressure and blood sugar can be stably controlled, and active/passive cardiovascular damage can be avoided. There is no need to take expensive health products or be overly anxious.

Last week, I met 47-year-old Uncle Zhang at a community free clinic. His physical examination revealed that his low-density lipoprotein (LDL-C) level was 3.8mmol/L. He searched Baidu for half a night and said that he was about to have a heart attack. He went to the emergency department before dawn. As a result, a coronary CT scan showed no plaque at all. The doctor only asked him to adjust his diet and exercise three times a week, without even prescribing a statin. It seems that many people are either too anxious or take it too seriously when it comes to heart disease prevention. In fact, there is no need to go to extremes.

Speaking of which, we have to mention blood lipid management, which is most easily ignored. This is also an area where there is still some controversy in the academic community. The traditional view is that saturated fat intake should be strictly limited, and red meat, butter, and animal offal should be consumed as little as possible ； However, a cohort study published in the New England Journal of Medicine last year also mentioned that as long as the total calories do not exceed the standard, the negative impact of saturated fat in the normal diet on cardiovascular disease is far less than previously publicized. Our clinical advice to ordinary people has always been very flexible: you don’t have to give up braised pork and braised pork sausage completely. It’s okay to eat it two or three times a week. The amount each time is no more than the size of your palm. But if your low-density lipoprotein has exceeded 3.4mm ol/L, you still need to properly control the intake of red meat and fried foods. If it exceeds 4.9mmol/L, don’t hesitate to ask a doctor to prescribe a statin. You won’t be able to reduce it by eating celery, drinking vinegar, etc. If you wait for the plaque to grow on the coronary arteries, it will be too late. Blood vessels are like the tap water pipes at home. It’s okay to pour some oil in them occasionally. If you pour some oil into them every day, scale will definitely accumulate. Once they are blocked, it will be difficult to unblock them.

Compared with the hidden nature of blood lipids, many people have already noticed the signs of abnormalities in blood pressure and blood sugar, but they just don't take it seriously. Two years ago, I treated a 29-year-old Internet operator who stayed up until 2 or 3 o'clock all the time. His blood pressure during physical examination was 145/95mmHg. He felt that there was nothing wrong with being young, and he even refused to take antihypertensive medicine. As a result, he suffered chest pains half a year later when he was working on a project. He already suffered from coronary artery spasm and slight myocardial damage, and it took him half a year before he could work normally. There are now different opinions on exercise to control blood pressure and blood sugar. It used to be said that moderate-intensity aerobic exercise must be done for 30 minutes a day to be effective. Now many studies have proven that climbing stairs and walking briskly every day for 30 minutes is not much different. There is really no need to force yourself to run 5 kilometers every day and eat boiled vegetables every day. How can ordinary people have so much time and energy? Get off the bus two stops before get off work and walk for 10 minutes, climb three flights of stairs when fishing, replace half of the white rice with corn or sweet potatoes when eating, and don’t drink more than 2 cups of milk tea a week. If you stick to these small things, they will be much more effective than if you apply for an annual pass and only go there twice.

There are also some cardiovascular injuries that are completely "acted" on your own initiative. If you avoid them, you can reduce the risk by half. For example, smoking, including second-hand smoke, is really not controversial. Every puff of cigarette will damage the vascular endothelium and increase the risk of plaque rupture. Don’t believe the nonsense that e-cigarettes are a healthy alternative to cigarettes. Last year, the World Health Organization clearly issued a document that e-cigarettes will also increase the incidence of cardiovascular diseases. It is purely an IQ tax. As for drinking, the controversy is even greater. In the past, it was said that drinking a small amount of red wine can soften blood vessels. Now, multiple studies in The Lancet have pointed out that there is no safe dose of alcohol, and that drinking it will cause cardiovascular damage. Our clinical advice is also very practical: if you don’t drink in the first place, don’t drink. If you really can’t avoid drinking, adult men should not drink more than 25g of alcohol a day, which is one or two white wine, a glass of red wine or a bottle of beer. For women, the amount should be half. Don’t drink too much.

Let me tell you something interesting. As a cardiologist, I occasionally eat hot pot and drink iced Coke with my friends, and sometimes work overtime until late at night. However, I check my blood lipids every three months, carry a portable blood pressure monitor in my bag all year round, and try to find time to walk 8,000 steps when I am on business trips. Heart disease prevention has never meant that you should live like an ascetic who cannot touch a little "junk food". Just find a balance that you can stick to. If you really find out that the indicators are abnormal, see a regular doctor. Don't frighten yourself by blindly searching Baidu, and don't take it seriously. It's as simple as that.