What medicines should be taken to prevent heart disease?

There is no magical medicine for preventing heart disease that is suitable for everyone. Whether and what medicine should be used depends entirely on the individual's cardiovascular risk stratification. Taking medicine randomly without high-risk factors may lead to problems such as liver and kidney damage and gastrointestinal bleeding.

Last week, I met a 40-year-old private company owner in the outpatient clinic. His weight and blood lipids were normal, and he had no family history. He just heard from his business partner that taking aspirin can prevent myocardial infarction. He took it online for half a year. Recently, he had unbearable stomach pain and came for a checkup. The gastroscopy showed multiple erosions in the gastric mucosa. It was caused by eating aspirin indiscriminately. It is completely unnecessary.

If you have been diagnosed with coronary heart disease, cerebral infarction, or have had a stent or bridge bypassed, and are among the extremely high-risk groups for cardiovascular disease, then taking statins, antiplatelet drugs, and antihypertensive and antihyperglycemic drugs as prescribed by your doctor are the best preventive drugs. Don’t always listen to the online sayings that "statins damage the liver" and "antihypertensive drugs are dependent on them." "Just stop taking statins privately. I have seen too many patients whose blood vessels restenosis within half a year of stopping statin privately. It's really not worth the loss. As long as the indicators are reviewed regularly, most people tolerate these drugs very well. If there are any adverse reactions, they can adjust the plan in time. It is far better than emergency treatment if the blood vessels are blocked."

There is actually a lot of controversy in the academic community about drug prevention for healthy people. For example, the most familiar aspirin is no longer recommended for ordinary people without high-risk factors to take it regularly to prevent heart disease. Only people who have been evaluated by doctors and believe that the risk of blood clots is much greater than the risk of bleeding will be recommended to take it in small doses. There are also GLP-1 drugs that have become popular in the past two years. Although the latest research has confirmed that it has clear cardiovascular benefits, it is currently only recommended for people with diabetes who have cardiovascular disease or are at high risk. It has not yet reached the level of regular use for healthy people to prevent heart disease. Don't follow the trend and prescribe so-called "preventive magic tools."

To be honest, rather than worrying about which medicine to take for prevention, most people should first change their bad habits in life, which is more effective than taking any tonic or preventive medicine. I have a 52-year-old patient who was diagnosed with 30% mild coronary artery stenosis two years ago. In addition to taking low-dose statins as prescribed by the doctor, he quit smoking after 30 years of smoking. He walks around the neighborhood for 40 minutes every day after dinner and basically avoids high-fat and high-salt dishes. Last week, a coronary CT scan showed that not only has the stenosis not progressed, but the blood vessel plaques have also stabilized a lot. His condition is much better than when he just took medicine and drank heavily.

If you are really worried about the risk of heart disease and want to intervene in advance, it is better to go to the cardiology department for a comprehensive risk assessment first, and let the doctor comprehensively judge whether you need to take medicine based on your blood pressure, blood lipids, blood sugar, family history, and living habits. Don’t just search for some popular science and buy medicines indiscriminately. After all, medicines are divided into three parts, and medicines that are suitable for others may become "harmful medicines" in your case.