Today is World Heart Day determined by the World Heart Alliance. On this special day, we will continue to popularize the relevant knowledge of cardiovascular medicines for everyone.
60-year-old Lao Zhao is a patient with coronary heart disease. After a strenuous exercise, he developed chest pain and . After going to the hospital for examination, the stenosis of the coronary artery of the heart has reached about 70%. According to the doctor's advice and Lao Zhao's personal wishes, he did not place a stent, but used conservative treatment to control the condition and reduce cardiovascular and cerebrovascular risks.
Faced with a lot of medicines prescribed by the doctor, Lao Zhao was in trouble. After taking it for a month, he felt that he had to take several medicines every day. It was really troublesome. He was also worried that taking these medicines for a long time would bring the risk of side effects. Since he did not feel discomfort after taking the medicine, Lao Zhao stopped the medicine by himself.
I don’t know when he heard that deep-sea fish oil can “treat” coronary heart disease, which can not only reduce blood lipids , improve plaques, but also improve blood viscosity and reduce blood clots. Lao Zhao felt that this was a natural health product and there was no need to worry about side effects when he took it for a long time, so he ate deep-sea fish oil. After eating it for half a year, Lao Zhao never had any serious chest pain symptoms again, so he thought that this fish oil was really a good thing and recommended it to his old friends everywhere.
But just last month, Lao Zhao, who insisted on eating fish oil to control coronary heart disease, suddenly suffered from severe chest tightness and chest pain at night a while ago. After taking nitroglycerin , it did not relieve it. His family quickly called 120 emergency number and sent him to the hospital to find an acute myocardial infarction. Although he finally recovered through emergency treatment, part of Lao Zhao's myocardium has suffered severe functional impairment due to severe ischemia during myocardial infarction, and the function of the entire heart has also been greatly reduced.
After learning about Lao Zhao's early medication situation and learning that he knew he had coronary heart disease, but did not follow the doctor's advice but insisted on taking fish oil, the doctor who treated him shook his head and sighed repeatedly. Such false and exaggerated publicity really harmed many people!
Can fish oil really control coronary heart disease?
Health products do not cure diseases, which is a truth that everyone must understand. Deep-sea fish oil is a health care product most of the time. Its main ingredients are eicosapentaenoic acid and docosahexaenoic acid , which is what we often call DHA and EPA. These two substances are a healthy unsaturated fatty acid, which has a certain health care effect on nourishing nerves, cell membranes, and promoting lipid metabolism. But it would be too exaggerated to say that it can strengthen the control of coronary heart disease or even replace drugs that control coronary heart disease.
Deep-sea fish oil has the benefit of DHA and EPA in patients with cardiovascular disease. In particular, EPA is beneficial to patients with cardiovascular disease. This type of unsaturated fatty acid can promote lipid excretion in the intestinal lipids and has a certain effect on reducing triglyceride in the blood. For important indicators for controlling the risk of coronary heart disease, the control of low-density lipoprotein cholesterol , deep-sea fish oil is powerless. In other aspects, the so-called improvement of blood viscosity and reducing thrombosis risk, there is no clear clinical evidence, it is just a presumption or false propaganda.
Even if it reduces triglyceride levels, not all deep-sea fish oil can do it. Research has found that only fish oil products containing high-purity DHA and EPA can play a role in reducing triglycerides. High-purity EPA derivative pharmaceutical preparations are products that clearly reduce triglycerides. Lao Zhao, who takes health-care fish oil, deep-sea fish oil will not bring much protection to his heart.
patients with coronary heart disease should protect their hearts. Please use these 4 drugs well.
From Lao Zhao's case, cardiovascular stenosis is 70%. Without unstable angina pectoris, there is no problem with choosing not to place a stent. However, for related drugs that control the risk of cardiovascular disease, it is a big mistake to stop taking the medicine after taking it for a month.For patients with stable coronary heart disease, no feeling and the frequency of chest pain attacks are not high, which is not an indication of stopping the drug. In addition to paying attention to maintaining a healthy lifestyle in all aspects in daily life, it is also necessary to actively control the risk of major cardiovascular and cerebrovascular events through reasonable use of medication.
For the disease risk control of patients with coronary heart disease, at least four types of drugs should be used for a long time and regular reviews should be carried out.
, medicine to control blood pressure and blood sugar
Take two medicines together, or take antihypertensive and antihypertensive drugs alone, depending on the blood pressure and blood sugar status of patients with coronary heart disease. If you are a patient with hypertensive , of course you don’t need to take antihypertensive drugs.
Hypertension, Hyperglycemia are important risk factors that promote the occurrence and development of atherosclerosis. Actively controlling blood pressure and blood sugar levels are one of the key points in reducing the risk of cardiovascular disease. In terms of antihypertensive drugs, you can consider choosing hologen drugs with cardiovascular protection effects and sartan (or Pril) antihypertensive drugs. If patients with rapid arrhythmias problems, you can consider using drugs such as diltiazem instead of hologen drugs. The goal of blood pressure control should be below 140/90mmHg as the basic goal, and it is better if it can be controlled below 130/80mmHg.
has a variety of anti-glycemic drugs, and they should also be reasonably selected based on the situation, that is, they can be used alone or in combination. The goal is to strictly control blood sugar. As long as it is not particularly serious, or there is a greater risk of hypoglycemia, it is still necessary to control glycated hemoglobin below 7.0%.
During the medication process, in addition to insisting on taking the medication, monitoring blood pressure and blood sugar, you should also pay attention to possible adverse reactions in the medication. If there are intolerable adverse reactions during the medication process, or if there is no good blood pressure, blood sugar control effect, the medication plan should also be adjusted in time.
. Drugs that control blood lipids and stabilize plaques
lipid-lowering drugs should be mentioned separately because while controlling blood lipids, this type of drug can also play a role in secondary prevention that stabilizes plaques and reduces the risk of cardiovascular disease. statin is the first choice and basic drug to control blood lipids, and can reduce the level of low-density lipoprotein cholesterol by about 30% to 50%. The low-density lipoprotein cholesterol in patients with coronary heart disease should be used below 1.8mmol/L as the standard value.
For the use of statins, it is recommended to use medium and low doses, and to perform regular reviews of liver function, blood lipid status, etc. to better ensure the safety of medication. Patients who cannot control the blood lipid standards by using statins alone can consider household cholesterol absorption inhibitors, PCSK9 inhibitors and other products, combined with lipid reduction and reduce cardiovascular risk.
. Drugs to control and reduce angina pectoris
For patients with coronary heart disease with stable angina pectoris , the first choice control drugs are beta blockers. Metoprolol, bisoprolol and other drugs are common drugs. This type of drug is highly selective, can effectively control the heart rate, reduce myocardial oxygen consumption, and reduce the secretion of catecholamines, inhibit the excessive excitation of sympathetic nerve , can effectively reduce the chance of angina pectoris, and reduce the risk of heart damage due to hypoxia.
drugs like
have a good effect in protecting the heart, but you should also pay attention to the fatigue that may be caused by long-term use, abnormal lipid metabolism , bradycardia , and male dysfunction. In addition, people with atrioventricular block problems should be banned. If the medication is required, the dose should be gradually reduced and the medication should not be stopped suddenly.
4. Drugs that antiplatelets and reduce thrombosis risk
For patients with coronary heart disease, you must pay attention to the risk control of cardiovascular and cerebrovascular events such as plaque rupture, cerebral infarction . To reduce the chance of thrombosis, the use of antiplatelet drugs is an important measure to reduce risks.The most common drug is aspirin, which is usually chosen to choose low-dose enteric-coated tablets. Taking them persistently can reduce the chance of thrombosis and reduce the risk of myocardial infarction. For patients with aspirin intolerance, they can consider choosing clopidogrel , ticagrelor and other drugs to replace.
It should be noted that whether it is aspirin or other drugs, taking such drugs has the antiplatelet effect and may increase the risk of bleeding in the body. Gastrointestinal bleeding is the most common, and risks such as subcutaneous bleeding, cerebral hemorrhage should also be prevented. Evaluation should be done, and the dosage and method of taking the drug should be selected based on the situation. Only if the benefits are significantly greater than the risks can you take this type of drug for a long time.
