Heart disease prevention and treatment

The prevention and treatment of heart disease can never be achieved by taking sky-high-priced Coenzyme Q10 and running marathons. The core logic is to "control the daily load of blood vessels and myocardium within safe thresholds, and at the same time intercept reversible disease-causing signals as early as possible" - this is the most practical principle I have summarized after 12 years of clinical experience in cardiology and seeing tens of thousands of patients.

I just received a job from a 32-year-old Internet operator a while ago. His blood lipids during the annual physical examination were in the borderline elevated range. I felt that I was young and had a good foundation, so I followed the trend and ran a half-marathon at night. When I ran, my chest was so tight that I still had to hold on to the finish line. When I was sent to the emergency room, it was already an acute myocardial infarction. Fortunately, the stent was inserted in time, so there were no serious sequelae. When it comes to the issue of exercise to protect the heart, two groups of people are quarreling on the Internet right now. One group says, "Exercise is the best medicine to protect the heart. The more you move, the stronger your heart will be." The other group says, "Patients with heart disease cannot move at all. If they move, they are prone to accidents." In fact, both views are too extreme. If people with underlying coronary plaques suddenly do high-intensity exercise, it may indeed cause plaque rupture and induce myocardial infarction. However, if they lie completely still, blood lipids will be deposited on the blood vessel wall faster, which will accelerate plaque growth. Ordinary people just need to find the right intensity. For example, when exercising, they can still speak complete sentences normally and are not so out of breath that they can't even speak. This level is safe for the heart, and there is no need to force yourself to hit the pace or distance.

There was an aunt in her 60s who was in the clinic before. She said that she had completely given up red meat and only ate vegetables and white rice every day. Why was her cholesterol still soaring? After careful questioning, I found out that she had to eat two fried poached eggs every morning, and had to drink a can of commercially available "sugar-free eight-treasure porridge" as a snack in the afternoon. The hidden oil and added sugar in it together were more harmful to blood vessels than eating two taels of braised pork. Regarding the relationship between diet and heart disease, the academic community has been revising its views over the years. In the past, everyone believed that saturated fat was the number one culprit. Now, more and more studies have proven that trans fat and added sugar are really strongly related to the onset of heart disease. There is no need to completely cut out red meat. It is perfectly fine to eat a palm-sized piece of lean pork and lean beef every day. What you need to avoid are trans fats such as creamer in milk tea, margarine in shortening bread, and cooking oil that has been fried repeatedly. There are also a lot of rock sugar in braised dishes and invisible sugar hidden in salad dressing. These are the driving forces behind the increase in blood lipids and the growth of plaque on blood vessel walls.

Oh, by the way, there is another causative factor that many people don’t take seriously – snoring. Last month, there was a 40-year-old male patient. His blood pressure had been high for five or six years and he couldn't control it even with medication. He often woke up in the early morning with chest tightness. Finally, he was found to have severe sleep apnea, which is the kind where he snores and suddenly stops breathing while sleeping, and he can't breathe for a long time. If you are deprived of oxygen dozens of times a night, your heart will be beating overtime all night long. Over time, the risk of myocardial infarction and heart failure is 2 to 3 times higher than that of ordinary people. Don't think that snoring means sleeping soundly. If this is the case, go to the respiratory department for sleep monitoring, which is more useful than how many heart-protecting health products you take.

Many people ask me whether Coenzyme Q10 is an IQ tax. I can say this objectively: healthy people usually eat a balanced diet and eat meat, eggs, and nuts. There is no need to take extra supplements.； But if you are taking statins, or have myocarditis or myocardial strain, appropriate supplementation can indeed relieve the muscle soreness caused by statins and help improve myocardial energy metabolism. But don’t expect it to open blood vessels and cure coronary heart disease. It is just an auxiliary supplement, which cannot replace drugs or healthy living habits.

If coronary plaques have been detected or even coronary heart disease has been diagnosed, there is no need to be too anxious. I have seen many patients lie at home every day after being diagnosed, not daring to move, taking pills one after another, and looking for home remedies everywhere. Instead, they gained 20 pounds in half a year, and their blood lipids became higher. In fact, whether you need to take medicine or not and whether you can exercise vary from person to person: if there are only mild plaques and no symptoms of chest tightness and chest pain, most people can adjust their lifestyle for 3 months first and there is no need to rush to take medicine. ； But if the stenosis of the coronary arteries has exceeded 50%, or if you often feel chest pain when you move, you really cannot stop taking statins and aspirin casually. I have seen too many people who stopped taking medicine and took health supplements after listening to rumors, and ended up with myocardial infarction. It is really a pity.

After all, the heart is actually a very "honest" organ. Don't stay up late every day to make it keep spinning. Don't spike your blood pressure and make it contract violently when you get angry. Don't stuff it with junk every day. It will rarely attack you unexpectedly. If you really have chest tightness and pain after activity, or inexplicable toothache, left shoulder pain, or stomach pain, and it subsides after resting for ten minutes or so, don't force yourself to do it. Go to the hospital as soon as possible and get an electrocardiogram. It's better than anything else.