A complete list of heart disease prevention methods

The core logic of heart disease prevention has never been achieved by eating Coenzyme Q10 or drinking a certain health tea. The essence is three things - stabilizing the four basic indicators of blood pressure, blood sugar, blood lipids, and weight within a safe range, cutting off smoking, staying up late, and long-term high pressure, which are clearly harmful habits to the heart. After the age of 30, do a basic heart screening once a year, and advance to the age of 25 if you have a family history. All the various prevention methods you can find on the market are essentially an extension of these three things. You don’t need to be dazzled by anxiety-mongering content.

Don’t believe it, I just saw a 28-year-old programmer from an Internet company last week. After working on a project for three days, his chest was so tight that he couldn’t breathe. When he came in, his hands were cold. An angiogram showed that his coronary arteries were 40% blocked. His previous physical examination showed that his blood pressure fluctuated around 140/90mmHg for three consecutive years. He never took it seriously because he was young. He also thought that smoking three cigarettes a day to stay awake was normal. To put it bluntly, he was ignoring all the core things.

When it comes to controlling targets, many people’s first reaction is to avoid eating this or touching that. In fact, there are quite a lot of controversies about diet in academic circles: one group believes that a vegan diet can effectively lower blood lipids and reduce the risk of cardiovascular disease. There are colleagues around me who have been vegan for 5 years, and their blood lipids are indeed stable.； The other group believes that there is no need to go to extremes. As long as ordinary people keep their low-density lipoprotein cholesterol within 2.6mmol/L, eat braised pork and braised beef two or three times a week, and control it to about 100g each time, it will not put any burden on the heart at all. The current mainstream evidence-based conclusions are also more inclined to the latter. After all, forcing yourself to eat boiled vegetables every day will make you feel depressed. On the contrary, it will increase the risk of cardiovascular disease due to long-term emotional stress, which is not worth the loss.

In addition to food, exercise is also the most frequently asked question. A while ago, a 62-year-old patient came to me for a review. He said that he had heard someone say that walking 10,000 steps a day can protect his heart. He forced himself to walk more than 20,000 steps a day. As a result, his knees broke and he dared not move for half a year. He gained 12 pounds in weight and his blood lipids were much higher than before. In fact, you really don’t need to make up the number of steps. 30 minutes of moderate-intensity exercise three times a week is enough. You can square dance, skateboard with your grandson, or even climb a low mountain on the weekend. It’s easy to judge the intensity. You can chat with people normally during exercise, but you can’t hum a complete song. This level is just right, it won’t be too tiring, and it can also have an exercise effect. Oh, by the way, I really need to talk about smoking. Don’t believe the nonsense that “smoking less will be fine.” As long as tobacco is ingested, regardless of the amount, it will damage the endothelium of blood vessels. I once had a 70-year-old female patient who had never smoked in her life. Her husband smoked for more than 40 years. Her carotid artery plaque was worse than that of many men who have smoked for 20 or 30 years. Of course, there is no need to break the habit just because you can't quit at once. Many clinicians now recommend a step-by-step approach to quitting smoking, slowly reducing from 20 cigarettes a day to 10 or 5 cigarettes. Even if you only smoke 1 cigarette a day in the end, the benefits will be much greater than smoking 20 cigarettes.

Many people think that they don’t need to have a heart checkup if they don’t have symptoms. This is actually a big misunderstanding. However, regarding the selection of early screening items, different doctors have different recommendations: some doctors recommend that people with family history and hypertension should have a coronary CTA every year after the age of 40 to detect early stenosis and intervene early. ； The other group believes that coronary CTA contains radiation and does not need to be done every year if there are no obvious symptoms. Routine electrocardiogram, cardiac ultrasound, and blood lipid and blood glucose testing are enough. The current consensus is also relatively compromise: if you usually don’t have chest tightness, chest pain, or palpitation after activity, these three items of routine physical examination are enough. ； If you feel a tightness in your chest every time you climb the third floor or take two quick steps and feel better after resting for three to five minutes, then don't delay and go to the hospital for further examination.

Finally, let me talk about the health care products that everyone is most concerned about, such as coenzyme Q10, deep-sea fish oil, and nattokinase. Too many people ask. The current research conclusion is very clear: people who have been diagnosed with heart disease take coenzyme Q10 to help improve myocardial energy metabolism. People with excessive triglycerides can indeed lower triglycerides by taking medical-grade high-purity fish oil. However, there is currently no clear evidence-based evidence that healthy people can prevent heart disease if they eat these. Of course, if you have too much money, you can eat it if you want, but don’t think that you can stay up late, smoke, and eat and drink as much as you want. It’s really useless.

I have been in the cardiovascular department for almost 15 years, and I have seen too many patients with myocardial infarction that could have been avoided. They all turned small problems into big troubles with the mentality of "I am young and fine" and "don't worry about this small problem". But don’t be too anxious. If you occasionally stay up late at night and have a hot pot with heavy oil and salt at a party with friends, you won’t get a heart attack immediately. You are afraid that long-term indulgence will slowly block the blood vessels. After all, your heart has been beating every minute since the day you were born, and it has never been lazy. Only if you pay more attention to it will it accompany you for a longer distance.