What medicines should be taken to prevent heart disease

First of all, it must be clear that there is no "panacea for preventing heart disease" that is suitable for everyone. The vast majority of healthy people with low risk of cardiovascular disease do not need to take medicine at all. Only people with high-risk factors or those who already have underlying cardiovascular-related diseases need targeted medication after a doctor's evaluation.

I met a 32-year-old young man from an Internet company in the clinic last week. He is 175cm tall and weighs almost 180cm. He stays up until two or three o'clock every day. Some time ago, a colleague in the same department suffered a heart attack and was hospitalized. He was so frightened that he came over and asked for aspirin without any examination, saying that he needed to prevent heart disease in advance. I calculated for him that the risk of cardiovascular disease in 10 years was only 3%, and his blood lipids and blood pressure were at the normal threshold. I directly advised him to stop eating late at night when he went back, and to go out for a half-hour walk three or four days a week without taking any medicine.

Of course, this does not mean that all situations do not require medication for prevention. If you have been diagnosed with chronic diseases such as high blood pressure, hyperlipidemia, and diabetes, or have had a myocardial infarction or missed a stent, then taking the corresponding medication as prescribed by the doctor is the most reliable preventive method. For example, if patients with high blood pressure keep their blood pressure below 130/80mmHg for a long time, whether they use dipinephrine or sartan antihypertensive drugs, they are essentially reducing the continuous damage to the blood vessel wall, which can naturally reduce the incidence of coronary heart disease and heart failure. If the low-density lipoprotein is excessive all year round and cannot be reduced after adjusting diet and exercise for 3 months, taking statins as prescribed by the doctor to stabilize the plaques and prevent them from rupturing is a real prevention of myocardial infarction.

Speaking of which, I have to mention aspirin, which many people have misunderstandings about. In the past few years, it was generally believed that middle-aged and elderly people could prevent heart disease by taking aspirin. In recent years, major global guidelines have adjusted their recommendations. This is also a controversial point in the cardiovascular field: some scholars believe that it can be used as long as there are high-risk factors, while others place more emphasis on the assessment of bleeding risks. The current mainstream consensus in the industry is that only people with a 10-year risk of cardiovascular disease exceeding 10% and no history of gastric ulcers or bleeding are recommended to take a small dose for primary prevention. If you have gastric erosion, or are prone to gum bleeding or blood in the stool, taking aspirin indiscriminately may induce massive gastrointestinal bleeding or even cerebral hemorrhage. Failure to prevent it may lead to other diseases first.

Many people also ask whether Internet-famous health products such as Coenzyme Q10 and deep-sea fish oil can prevent heart disease. To be honest, these are dietary supplements. If you already have heart failure or myocarditis, Coenzyme Q10 can help improve symptoms, but it really has no clear preventive effect for healthy people, and it cannot replace regular drug intervention. Just like you usually take vitamin tablets every day, there is no substitute for eating fresh vegetables to supplement nutrition, right?

In fact, the core of heart disease prevention is never to think about what medicine to take first. If you smoke two packs of cigarettes every day, drink white wine every day, and stay up until three in the morning, no matter how many medicines you take, you will not be able to block blood vessels and cause problems. If you really want to worry about your heart, go to the hospital for a formal cardiovascular risk assessment. It is much more reliable than buying health care products randomly and taking medicine randomly.