Lecture on heart disease prevention

The core of ordinary people's prevention of heart disease is never to wait for chest tightness or chest pain before going for a check-up, but to plug the metabolic abnormalities and habitual loopholes that are easily overlooked in daily life in advance. There is no 100% universal "prevention formula". All methods must be adjusted based on your own family history and physical foundation. Don't copy other people's experiences online.

Last week, I met a 42-year-old Internet company architect at a community free clinic. His blood lipid profile has been elevated for three years. He didn't even look at the arrow on the physical examination report, saying that he had no other discomfort except being fat. As a result, he stayed up all night the day before to change his plan. The next day, he was so tight that he couldn't breathe and went for a checkup. His coronary artery was 30% blocked. Fortunately, he came early and didn't need a stent. He could control it by taking medicine, but he will no longer be able to stay up late and drink ice-cold Coke.

Many people's impression of heart disease is that it's a disease of the elderly and "only fat people get it." That's not true. Last month, I admitted a 28-year-old girl to the outpatient clinic. She is 1.68 meters tall and weighs 92 pounds. She has been on a diet for almost two years to wear a small skirt. She basically only eats boiled vegetables. The results showed that her homocysteine ​​level has soared to 22 μmol/L, her high-density lipoprotein is less than 1 mmol/L, and her cardiovascular risk is higher than that of many overweight people.

Speaking of this, many people asked me, should I take some coenzyme Q10 to protect my heart? There are indeed different opinions on this in the industry. The consensus of the European and American Society of Preventive Medicine is that healthy people can supplement the required coenzyme Q10 by eating some meat and nuts every day. Taking extra health products is an IQ tax. ； But many of our frontline clinical doctors believe that if you stay up late for a long time or are taking statin-type lipid-lowering drugs, many people will have problems with fatigue and high myocardial oxygen consumption. Appropriate supplementation can indeed relieve uncomfortable symptoms. It depends on your own situation. There is no need to deify it or beat it to death with a stick.

By the way, there is another little thing that many people ignore, which is oral problems. I once had an old patient who suffered from recurring periodontitis for almost 5 years. He always thought he was angry and ignored it. He had a myocardial infarction last year and had a stent inserted. Later, when he checked the cause, he found that his C-reactive protein had been on the high side, which means unstable blood vessel plaques caused by long-term chronic inflammation. So don’t always think that toothache and oral ulcers are trivial. It’s best to check for inflammation indicators if you have recurring inflammation. It won’t cost you dozens of dollars.

As for exercise, many people think that to protect their heart, they have to run five kilometers a day and practice high-intensity intervals. This also depends on the person. The view in the fitness circle is definitely that doing more high-intensity exercise can improve cardiopulmonary function, which is good for long-term health. ； However, our cardiovascular doctors generally recommend that for people who have high blood pressure, premature beats, or who rarely move at all, doing high-intensity exercise can easily increase the load on the heart and even induce plaque shedding. It is better to go downstairs for half an hour after dinner every day, or do Baduanjin or Tai Chi. This kind of moderate-intensity exercise can be done five times a week, and the effect is not bad at all.

I have been doing cardiovascular clinics for almost 12 years. I would like to give you the most practical advice. During the annual physical examination, don’t just look at the upward arrow in the blood lipid column. Look at the LDL value yourself. If any of your immediate relatives have coronary heart disease or myocardial infarction before the age of 55, even if your LDL is within the reference range, as long as it exceeds 2.6mmol/L, it is best to see a doctor in the cardiovascular department to see if you want to intervene in advance. This small detail can really help you avoid a lot of risks.

Don't take it too seriously in daily life. Remember to wear a scarf to protect your neck when you go out in winter. Last winter, I admitted three elderly people to the emergency room for morning exercises in one night. They didn't wear scarves. The cold wind sucked in the blood vessels and directly spasmed, which caused myocardial infarction. And don’t just slump on the sofa and check your phone as soon as you get home. Sitting there for three or four hours is more harmful to your heart than eating hot pot fried chicken once in a while.

I have talked so much today, either to make you start to feel anxious after reading it and to feel like there is something wrong with you, or to remind everyone that the heart is a very "honest" organ. By the time you feel pain, the problem has often been there for a long time. It's better to be more careful than anything else. There are really uncertain indicators. Don't scare yourself by searching Baidu. Go to the hospital and ask a doctor. It won't take much time, so don't worry.