The latest comprehensive list of heart disease prevention methods

Healthy people should give priority to lifestyle adjustments, and people with underlying diseases such as hypertension, hyperlipidemia, and diabetes should focus on controlling risk indicators. High-risk groups with family history and vascular plaques should follow the doctor's advice and cooperate with medications/interventional interventions. There is no "universal heart-protecting prescription" that is suitable for everyone. Methods that match their own conditions are useful.

Last month, I met a 32-year-old Internet programmer in the outpatient clinic. His annual physical examination showed that his low-density lipoprotein was 3.9mmol/L, and a single soft plaque had appeared in his carotid artery. I searched a lot of "heart-protecting tips" on the Internet, ate nattokinase, drank black coffee every day, and stayed up late to run 5 kilometers every day after working overtime. When I came to the doctor, I had occasional chest tightness. When I did an exercise treadmill test, the signal of myocardial ischemia was already obvious. Are you saying he didn't take precautions? I did it, but I did it all wrong, which put more burden on my heart.

When it comes to lifestyle adjustments, many people's first reaction is to "eat a vegetarian diet, exercise, and sleep for eight hours." In fact, there are many controversial points here. Take vegetarianism as an example. A paper published in Nature Cardiovascular Research last year showed that a long-term balanced plant-based diet can indeed reduce the risk of cardiovascular disease by about 15%. However, we have encountered many people who have adhered to a vegan diet for more than 3 years in clinical practice. Because they did not pay attention to supplementing vitamin B12, their homocysteine ​​levels are 2-3 times higher than ordinary people, and they have become a high-risk group for myocardial infarction. If you really want to adjust your diet, you don’t have to force yourself to eat boiled vegetables every day. The latest guidelines recommend more relaxed recommendations: eat enough vegetables and half a pound of fruits every day, no more than 500g of red meat per week, and try to avoid trans fats (such as non-dairy creamer in milk tea and bread made with shortening) as much as possible. You can already get basic heart protection points.

Speaking of exercise, I met a marathon enthusiast before. He was 40 years old and his full marathon time was within 3 and a half hours. It stands to reason that the amount of exercise is enough, right? As a result, last year's physical examination revealed myocardial strain. After questioning, I found out that he was used to running 10 kilometers after get off work at 1 a.m. every day. During the run, he also drank two cans of energy drinks to replenish energy. It was equivalent to being forced to wake up and work overtime after his heart had been tired for a day. The latest guidelines have long made it clear that a total of 150 minutes of moderate-intensity exercise per week (that is, an intensity that allows you to talk normally but not sing during fast walking or jogging) is enough. Excessive and overdrafting exercise will increase the risk of myocardial damage. There is really no need to compete with your own pace and exercise duration.

Don’t underestimate the impact of sleep on the heart. Many people think that as long as they sleep for 8 hours, they will be fine, but this is not the case. Last year, during a screening in our community, we met a 52-year-old Uncle Zhang. His blood lipids and blood pressure were normal. However, he snored loudly every day and always felt headaches and panic when he woke up in the morning. A sleep monitor revealed that he had severe obstructive sleep apnea. He had more than 80 apnea a night, which is equivalent to having his heart repeatedly awakened dozens of times every time he slept. People with this condition have a risk of heart attack that is more than three times that of ordinary people. Later, he followed the doctor's advice and wore a home ventilator. After only half a month, he no longer suffered from panic attacks. In addition, studies have shown that people who sleep more than 9 hours a day have similar cardiovascular risks to people who sleep less than 6 hours a day. Too much sleep and too little sleep are not good.

If you have been diagnosed with basic diseases such as high blood pressure, hyperlipidemia, and diabetes, lifestyle adjustments alone are not enough. This part is actually more controversial. Take blood lipid control as an example. In the past few years, everyone shouted "the lower the low-density lipoprotein, the better." However, in the past two years, more and more clinical studies have suggested that for the elderly over 75 years old, or patients with severe carotid artery stenosis, there is no need to reduce the low-density lipoprotein to below 1.8mmol/L. Reducing it too low may increase the risk of cerebral hemorrhage. Specific control goals must be determined by your doctor based on your situation, and do not take medicine blindly according to online standards. As for blood pressure control, not everyone must adhere to the 120/80mmHg standard. For those over 80 years old, it is safer to control blood pressure within 140/90mmHg.

If you have a family history of early-onset heart disease (your parents were diagnosed with coronary heart disease before the age of 55), or have been found to have coronary plaque or carotid artery plaque, you are a high-risk group. Don't insist on not taking medicine. I have previously followed up two patients who had coronary stents, one was 48 years old. After the stent, he strictly stopped smoking, took statins and aspirin on time every day, and paid attention to his diet. Now after 11 years, he has had a follow-up angiography, and there is no problem with the blood vessels at all. ； The other, 52 years old, felt better after the stent, but continued to smoke and drink every day, and did not take medicine. Two years later, the blood vessel stenosis reappeared, and the stent had to be inserted again. There are also PCSK9 inhibitors that many people ask about, which are what everyone calls "hyperlipidemic injections." For patients with familial hypercholesterolemia, even if they are only in their twenties or thirties, as long as their blood lipids cannot be lowered, they must be used as needed, otherwise it will be too late to intervene after the blood vessels are blocked.

Finally, let’s talk about the most frequently asked questions about the heart-protecting health products, such as coenzyme Q10, deep-sea fish oil, and nattokinase. Are they IQ taxes? It cannot be killed with one stroke. Coenzyme Q10 is indeed useful for people who already have cardiomyopathy, or who have muscle soreness side effects from taking statins, but the daily intake of ordinary healthy people is enough, and there is no need to spend extra money to supplement it. Deep-sea fish oil currently only has high-purity prescription-grade fish oil (the Omega3 content is over 90%), which has a clear blood-lipid-lowering effect on people with high triglycerides. The health-care fish oil sold on the market for tens of dollars a bottle has less than 30% Omega3 content, and is basically useless if eaten. Not to mention nattokinase. Currently, there are no high-quality clinical studies that can prove that it has the effect of protecting the heart or dissolving plaques. Don’t waste your money.

In fact, after so many years of practicing cardiovascular clinical practice, my biggest feeling is that there are really no fancy tricks to prevent heart disease. You don’t have to believe the rumors on the Internet that “eating an onion can open blood vessels”, and you don’t have to force yourself to live like an ascetic. Checking your blood lipids, blood pressure, and electrocardiogram every year, staying up less late at night, and smoking less than two cigarettes are more effective than expensive health care products. If you really feel unwell, don't search for the disease yourself. See a doctor from a regular hospital, which is better than anything else.