Heart disease prevention and health path

There is no so-called "magic formula" for heart disease prevention. The core logic is - early identification of controllable risks, personalized lifestyle adjustments, and regular targeted screening. If these three things are done well, more than 80% of the risk of premature heart disease can be prevented. Don’t believe the nonsense that you can 100% prevent it by eating a certain kind of food or doing a certain kind of exercise. Everyone’s physical foundation is different, and the suitable path is completely different.

When I was doing free clinics in the community two years ago, I met Uncle Zhang, a 52-year-old man who walks 15,000 steps every day. He pats his chest when meeting people and says he is exercising well. This is definitely not related to heart disease. As a result, during the blood lipid test, his low-density lipoprotein soared to 4.8mmol/L. A further coronary CT scan revealed that the blood vessels had 30% atherosclerotic stenosis. He was confused on the spot and asked, "How could something happen to me if I walk so much every day?" After careful questioning, I found out that he drinks two taels of white wine with every meal and eats soy pork elbows at least three times a week. The amount of exercise he consumes cannot withstand the burden that high oil and alcohol put on his blood vessels.

There is a lot of quarrel on the Internet right now about "should we give up red meat?" In fact, there is no unified conclusion in the industry. Some doctors mainly recommend the DASH diet, which means that whole grains, vegetables and fruits account for the main proportion, and saturated fat intake is strictly controlled. This is indeed supported by large-scale clinical data. If you stick to it, you can reduce the risk of cardiovascular disease by about 15%. ； However, some colleagues who have been doing free clinics in pastoral areas all year round said that many herdsmen eat beef and mutton and drink butter tea all their lives, and rarely eat refined rice and noodles. Their vascular condition is actually better than that of office workers who eat light takeaway every day. To put it bluntly, the core is not whether you can eat red meat at all, but the amount you eat and whether the other foods are appropriate. Eating one tael of lean beef two or three times a week is absolutely fine. Eating half a pound of fatty butter hotpot every meal will make no difference even if you run five kilometers every day.

Don’t think that having a normal ECG every year for physical examination will make everything fine. To be honest, I have seen too many patients with occult coronary heart disease, and routine resting ECG cannot detect any abnormalities at all. If you have a family history of high blood pressure or heart disease, or you already have high blood lipids and smoking habits, it is best to do a full blood lipid profile and an exercise treadmill test every year after the age of 40. If you often have chest tightness and left shoulder pain, go directly to a coronary CT scan. Don't worry about the examination fee. If you really wait for a myocardial infarction, you may not be able to get back the time.

After talking about screening, let’s talk about the issue of health care products that are currently very controversial, such as coenzyme Q10 and deep-sea fish oil. On the Internet, they are touted as “heart-protecting medicines” and at the same time called “IQ taxes”. In fact, both sides are reasonable. Current clinical research has confirmed that for patients who already have myocarditis, heart failure, or who experience muscle soreness as a side effect of taking statins, supplementing high-purity coenzyme Q10 as directed by their doctor can indeed relieve symptoms and help improve myocardial function. ； However, healthy people can consume enough coenzyme Q10 by eating some meat and nuts normally, and taking additional health supplements will not have any additional heart-protecting effect. The same goes for fish oil. Only prescription-grade high-purity Omega-3 fish oil can regulate patients with hypertriglyceridemia. Ordinary health products, low-purity fish oil that is adulterated with a large amount of saturated fat, only count as a supplement of calories and have no practical use.

In addition to the clichés such as diet and exercise, there is also a hidden risk factor that many people do not take seriously - long-term emotional stress. Last year, I treated a 32-year-old middle school teacher. He usually eats a light diet and maintains the habit of yoga three times a week. He does not smoke or drink, but he often suffers from chest tightness. After a round of investigation, it was found that the sympathetic nerves were highly excited for a long time. In addition, he was born with a myocardial bridge, and his vascular condition was worse than that of many young people who eat takeout every day. Nowadays, many young people stay up late and work overtime every day, focusing on projects continuously. They may not seem to be uncomfortable, but in fact, the blood vessels are always under high pressure. If something goes wrong over time, it will be a big problem.

I have been doing cardiovascular health education for almost 10 years, and I have seen too many people who either don’t take it seriously, eat and drink all the time and stay up late to endure it, or they are so anxious that they buy medicine everywhere due to the occasional premature beat. In fact, the way to prevent heart disease is to get along well with your own body. You don’t need to compare with others in how many steps you walk every day. You don’t need to follow the trend and buy a bunch of useless health products. You can eat, move and sleep comfortably, and get regular targeted examinations. This is better than anything else. After all, what we are preventing is disease, not that perfect physical examination number, right?