Heart disease prevention knowledge

After excluding unchangeable risk factors such as genetics and age, through a combination of lifestyle adjustments, chronic disease control, and targeted screening, the risk of early-onset heart disease (onset before the age of 55 for men and before 65 for women) can be reduced by at least 80%. There is no need to regard heart disease as an "unpreventable disease of the elderly."

Don’t believe it. Last year, I met a 32-year-old programmer from a gaming company at the cardiology clinic. His physical examination showed that his low-density lipoprotein was 4.9mmol/L, which was almost double the upper limit of normal. I told him repeatedly that he needed to take medicine to control it. He stayed up late and drank less iced Coke. He waved his hand and said that he was young and didn't feel good. He turned around and went back to work on the project for three consecutive days. On the fourth day, he had chest pain and called 120 and sent him to the emergency department. An angiogram showed that 90% of the anterior descending artery was blocked, and he was saved after a stent was installed.

When many people hear about preventing heart disease, they think they need to boil vegetables every meal and give up meat and sugar, which is completely unnecessary. I often tell people who come for consultation that it is more practical to first put away the pickle bottles and bibimbap sauce at home - the light soy sauce and soybean paste we usually use contain almost 1.5g of salt for every 10g. Add two spoons to a stir-fry, and add some processed meat or takeout. The daily salt intake directly exceeds the 5g upper limit recommended by the WHO. Instead, it is better to eat braised pork ribs occasionally to satisfy your cravings, and just control the total intake. By the way, I have to mention Coenzyme Q10, which is the most frequently asked question. The current official recommendation of the American Heart Association is that only people diagnosed with cardiomyopathy or those who have muscle soreness as a side effect of taking statins need to take additional supplements. Healthy people usually eat some red meat, nuts, and deep-sea fish, and the intake is completely sufficient. ； However, this year’s new guidelines from the European Society of Cardiology also mention that sub-healthy people who have long-term high workloads and often stay up late can take 100-200mg in small doses every day as a supplement. However, this is just a supplement, and it definitely cannot replace the effect of staying up late and drinking one less cup of milk tea.

Some people also ask whether it is necessary to walk 10,000 steps a day to protect the heart? There used to be a 62-year-old aunt who walked 20,000 steps a day after listening to an online health class. Not only did she have fluid in her knees after walking for half a month, but she also registered premature beats due to overexertion. The current consensus among academic circles is that as long as you get 150 minutes of moderate-intensity exercise every week, it will be enough. What is moderate-intensity? It means that you can talk to people normally when you move, but you can't sing loudly. Walking two stops to and from get off work, climbing three flights of stairs, and taking a walk for half an hour after a meal can be divided into 10 minutes each time. It is effective. There is no need to force yourself with steps. Interestingly, a niche sports medicine study last year suggested that high-intensity interval training for about 10 minutes 2-3 times a week can improve cardiopulmonary function better than walking for an hour continuously. However, this conclusion has not yet been adopted by mainstream guidelines, and people with high blood pressure and arrhythmia are not recommended to try it casually.

What is more important than diet and exercise is actually controlling existing chronic diseases. I have seen too many people who are diagnosed with high blood pressure and diabetes and ignore them. They think they don’t need to take medicine if they don’t have symptoms. They wait until they have squeezing pain in the chest or radiating pain in the back before they come to the hospital. Most of the blood vessels have been blocked. There is no need to be overly anxious and run to the hospital when nothing is wrong. For people under 40 years old and with no family history of heart disease, it is enough to check their blood pressure, blood lipids, and electrocardiogram every two years. ； People with a family history, or those with high blood pressure, may need a heart ultrasound once a year. There is also a controversial point here: some domestic institutions currently recommend that healthy people undergo coronary CT every year to check for vascular stenosis, but the American guidelines clearly state that it is not recommended for the general population. After all, the radiation dose of a coronary CT is almost equivalent to taking dozens of chest X-rays. On the contrary, it may bring unnecessary risks. It is not too late to do it if you really have chest tightness or chest pain.

To be honest, I have been practicing cardiology for almost 10 years and have seen too many heart attacks that could have been avoided. Most of them were caused by youth and carelessness, or by listening to messy health rumors. Prevention of heart disease has never been something that requires a lot of money and effort. You don’t need to buy a health device worth thousands of dollars, and you don’t need to take imported health products every day. Just find a life rhythm that you can stick to for a long time - you don’t need to go hungry every day to lose fat, you don’t need to walk to make up for the number of steps and your legs hurt. Smoking two fewer cigarettes, staying up less late at night, and measuring your blood pressure regularly are more effective than anything else. If you are really unsure of your risks, go to the cardiology department of a regular hospital, register a regular number, and chat with the doctor for 10 minutes. It is much more reliable than watching short health videos for three days.