Heart disease prevention knowledge

There is no universal "universal formula" for heart disease prevention. The most effective plan is essentially a combination of "stratified management and control based on individual risk levels + long-term lifestyle fine-tuning + regular targeted screening." There is no possibility that risks can be avoided 100% by relying on a certain type of food or exercise.

Last week I met a 34-year-old young man at the outpatient clinic. His body fat rate is 15%. He goes to the gym five times a week. His chest muscles are stronger than the storage box at the nurse station in our department. When he came in with the coronary CT report, his face was white - the anterior descending artery had been blocked by 40%. He couldn't figure it out himself. He said that I played iron every day and didn't even touch Coca-Cola. How could my blood vessels become blocked? After further questioning, I found out that he had to eat more than half a pound of red meat in order to gain muscle. His father had a heart attack at the age of 38 and needed a stent. He was a clear high-risk group for familial hypercholesterolemia. He never took it seriously and always thought, "I love exercising so I won't get heart disease."

To be honest, this is where many people misunderstand the prevention of heart disease. They always rely on a certain "good habit" to save the day, either by hoarding coenzyme Q10 or walking 20,000 steps a day. In fact, these are extremes. Take Coenzyme Q10, which is the most frequently asked question, as an example. There is currently no unified conclusion in the academic community: the 2023 Prevention Guidelines of the European and American Society of Cardiology clearly states that regular supplementation of Coenzyme Q10 for healthy people has no clear benefit in reducing the risk of heart disease, and is no different than taking a placebo. ； However, our clinical experience has shown that patients over 65 years old who have weak metabolic capacity, or who have muscle soreness as a side effect of long-term statin consumption, or who are recovering from myocarditis, can indeed relieve the symptoms of chest tightness and fatigue by taking a small dose of 100 mg per day.

When I was working late at night, I would never listen to the nonsense on the Internet about "running in the morning to increase metabolism" after work. When I got home, I would sleep for 4 hours, and when I woke up, I would cook a bowl of vegetable noodles with an egg. It was 10 times better than going out to exercise. Speaking of staying up late, it is quite interesting. One group of scholars who do rhythm research believes that as long as a fixed sleep cycle can be maintained, even if you stay up and stay up at night every day, as long as you sleep for 7 hours, it will have little impact on cardiovascular disease. ； But our clinical experience is that people who often suffer from jet lag and have random sleep cycles are more than three times more likely to have blood lipid disorders than people who have a fixed schedule. If you don't have a job that requires shift work, try not to stay up after 2 o'clock. If you really need to stay up late occasionally, don't force yourself to go to work the next day. Two hours of sleep is better than anything else.

Many people do electrocardiograms every year for physical examinations. If the results are normal, they think everything is fine, but this is not the case. If you have high blood pressure, diabetes, or a direct relative has had a myocardial infarction before the age of 55, it is best to have a coronary CTA and blood lipid high-sensitivity C-reactive protein test every two years after the age of 30. This is much more sensitive than an ordinary electrocardiogram. Last year, my cousin's electrocardiogram during the physical examination at work was normal. I forced him to do a CT scan. It turned out that the blood vessels were 50% blocked. I took medicine and adjusted it in time, and now there is nothing wrong.

There is also the all-vegetarian diet that has been very popular in the past two years to prevent heart disease. It is said that eating a vegetarian diet for three years can cure coronary heart disease. As a result, the blogger himself was hospitalized due to hypoalbuminemia. There is no consensus on this matter in the academic community. Some studies say that a long-term vegetarian diet can reduce the risk of cardiovascular disease by 18%. There are also follow-up studies that say that vegans have generally high homocysteine ​​levels due to B12 deficiency, and their risk of cerebral infarction and myocardial infarction is increased by 12%. In fact, there is really no need to go to extremes. Eat less processed meat, drink two cups less sugary milk tea, and eat deep-sea fish twice a week. It is more reliable than any harsh vegan diet.

I have been practicing cardiology for almost 6 years. I have seen old people who smoked two packs of cigarettes a day and lived to be over 90. I have also seen young men who had a heart attack at the age of 30 while maintaining health and taking various supplements every day. Prevention of heart disease is not a 100% certain event. There is no need to worry about getting sick every day. Eat half-full meals, don’t stay up late, and don’t carry it if you feel uncomfortable. It is much more useful than hoarding a cupboard of health care products.