What medicines should be taken to prevent heart disease?

First of all, let’s be clear - there is no “panacea” for heart disease prevention that is suitable for everyone. Whether and what you need to eat depends entirely on your cardiovascular risk level. People with low health risks do not need to take medicine, and lifestyle intervention is enough. Only people with medium to high risk or even extremely high risk need targeted medication after a doctor’s evaluation. Indiscriminate eating will cause additional damage.

Last week, I met Lao Zhang, a 42-year-old programmer at a free cardiovascular clinic at a community health service center. He has a BMI of 28 and occasionally stays up late. His blood pressure and blood lipids are at the critical value but not exceeding the standard. He has no history of smoking or family history of premature cardiovascular disease. He asked the doctor to prescribe aspirin and said "take it in advance to prevent myocardial infarction." The doctor directly advised him back: You are now in a low-risk group. Taking aspirin may increase the risk of gastric mucosal bleeding and cerebral hemorrhage. It is completely unnecessary.

Don’t think this is an exception. Many people now have very deep misunderstandings about the use of preventive drugs for heart disease, especially the primary prevention of aspirin. In fact, the views of the academic community have been updated in recent years. In the early years, some moderate-risk groups were recommended to take small doses. Now the latest domestic and foreign guidelines have narrowed the appropriate dosage. For the scope of use, only people whose 10-year risk of ASCVD (atherosclerotic cardiovascular disease) is estimated to exceed 10% and who do not have high-risk factors such as peptic tract ulcers or bleeding history will consider using it in small doses. If the risk of bleeding is high, it may not be prescribed even if the risk meets the standard. In fact, cardiovascular disease is like the water supply pipe at home. The essence of preventive medicine is to help you maintain the condition of the pipe. If the pipe itself is still very smooth, with no scale or signs of hardening, if you insist on pouring detergent indiscriminately, it will easily corrode the pipe wall and cause problems.

Speaking of this, some people may ask, if I have underlying diseases, what can I eat to prevent heart disease? In fact, there are not so many bells and whistles. Controlling the indicators of basic diseases first is the best prevention. For example, if you already have high blood pressure, don't think about looking for "special medicine to prevent heart disease". First, take antihypertensive medicine steadily. Whether it is Dipine, Sartan or Prilim, long-term control of blood pressure below 130/80mmHg is the best for the heart. For protection, my neighbor Uncle Wang has high blood pressure and refuses to take medicine regularly. He always feels that "the medicine is a third part of the poison". Last winter, he had a heart attack and was sent to the emergency department. He had a stent inserted. Now he takes medicine according to the doctor's instructions every day. I regret that if I had known to take good antihypertensive medicine, I would not have suffered this problem. If you have abnormal blood lipids, especially those with excessive low-density lipoprotein cholesterol, statins are the core preventive medication. Don’t always focus on the rumors that statins damage the liver spread on the Internet. Most people will not have any problems if they take a regular dose. Regular liver function checks are enough. Previously, the department met a 50-year-old patient. Three years after I was diagnosed with hyperlipidemia, I stopped taking statins for a week because I felt weak. I ate the "blood vessel clearing" health supplements purchased online every day. Last year, my physical examination revealed that my coronary arteries were 40% clogged. Later, I took statins regularly and controlled my diet. A year later, the low density dropped to 1.8mmol/L, and the plaques were stabilized a lot.

If people who have been diagnosed with coronary heart disease, have had a stent removed, or have had a myocardial infarction fall into the category of secondary prevention, aspirin and statins are basic medications, and some of them need to be taken in combination with clopidogrel or ticagrelor for a period of time. Do not stop taking the medication privately at this time, otherwise the risk of plaque rupture and thrombosis will be much higher.

Oh, by the way, don’t believe those health care drugs that claim to be “purely natural and have no side effects to prevent heart disease.” Deep-sea fish oil, coenzyme Q10, nattokinase, etc. are at most dietary supplements and cannot replace regular drugs. If you are really afraid of heart disease, quit smoking first, drink less alcohol, and walk for half an hour three or four days a week. It will be much more useful than spending thousands on health care products.