What are the preventive drugs for heart disease

Currently, there are no universal heart disease prevention drugs suitable for all people. Clinical preventive drugs are prescribed according to individual cardiovascular disease risk levels. Commonly used drugs mainly include statins and lipid-lowering drugs, antiplatelet drugs, β-blockers, and ACEI/ARB types. They are all prescription drugs and must not be taken on your own.

I just treated a 38-year-old salesperson last week. He drinks and socializes every day. His low-density lipoprotein was found to be 4.2mmol/L, and a carotid artery ultrasound showed small plaques. I didn’t feel any discomfort. I just read a few news about young people suffering from myocardial infarction, and asked if I could prescribe the best preventive medicine. I calculated for him that the risk of cardiovascular disease in 10 years has reached 12%, which is a high risk, so I prescribed him a medium dose of atorvastatin. To put it bluntly, atorvastatin is like a "scavenger + voltage regulator" in the blood vessels. On the one hand, it can reduce the level of low-density lipoprotein, a "vascular garbage", and on the other hand, it can stabilize the plaque that has grown and prevent it from rupturing and falling off to form a thrombus and blocking the blood vessel. It is currently the core drug for the prevention of atherosclerotic heart disease.

Speaking of this, someone must ask, does the aspirin that everyone often talks about count? This is also a type of drug that was particularly controversial in academic circles in the past few years. The consensus now is very clear: if you have been diagnosed with atherosclerotic diseases such as coronary heart disease, myocardial infarction, and cerebral infarction, as long as there are no contraindications such as gastric bleeding and severe allergies, you must take low-dose aspirin for a long time to prevent recurrence. The benefits are far greater than Risks; but if you are a healthy person who has not yet been diagnosed, even if you have high blood pressure or high blood lipids, you must first do a risk assessment. Only people with a 10-year risk of cardiovascular disease exceeding 10% are recommended to take it under the guidance of a doctor. Otherwise, blindly eating it will increase the risk of gastrointestinal bleeding and cerebral hemorrhage, which is not worth the gain. Last month, there was a 58-year-old aunt. She heard from her elder sisters that taking aspirin can prevent heart disease. She bought it at the drugstore and started taking it. After taking it for more than three months, she developed gastric mucosal erosion and bleeding. When she came to the doctor, she was told that she had chronic gastritis. She never asked a doctor to evaluate whether it was suitable to take it, so she suffered in vain.

In addition to the two most familiar categories, there are also corresponding preventive medications for people with different basic diseases. For example, for patients who have high blood pressure and are found to have left ventricular hypertrophy, doctors will usually give priority to prescribing drugs such as "Puri" or "Satan", which can not only lower blood pressure, but also improve the structure of the ventricle, preventing the heart from "overwork and hypertrophy" under high pressure for a long time, which can significantly reduce heart failure in the long run. , risk of myocardial infarction; if you are a patient who has already suffered from angina pectoris or myocardial infarction, beta-blockers such as metoprolol and bisoprolol that you usually take can control the resting heart rate at about 60 beats per minute and prevent the heart from beating too hard. It is also a key drug to prevent secondary attacks.

Don’t think that everything will be fine as long as you take these medicines. The basis of heart disease prevention is always lifestyle adjustment. If you eat big meals and stay up late every day while taking statins, no matter how good the medicine is, it will be useless. There are also many people who are superstitious about health care products. Coenzyme Q10, deep-sea fish oil, nattokinase, etc. are all dietary supplements. Currently, there is not enough evidence-based evidence to replace regular drugs in preventing heart disease. Don’t spend a lot of money on health care products, which will delay regular prevention.