What medicine should be taken to prevent heart disease?

There is no "magic pill to prevent heart disease" that is suitable for everyone. Whether or not to take medicine and what kind of medicine to take depends entirely on your personal cardiovascular risk stratification. Healthy people without high-risk factors who take medicine to prevent heart disease are simply spending their money to find trouble.

Last week, I went to a community free clinic with the department and met an aunt. She is 53 years old. Her blood pressure, blood lipids and blood sugar are all normal, and her BMI is only 21. No one in her family has suffered from premature coronary heart disease. I watched a short video anchor saying, "Take aspirin to prevent myocardial infarction. All middle-aged and elderly people should take it."

It really doesn’t mean that you can’t take medicine to prevent heart disease. It’s a shame. If you have been diagnosed with basic diseases such as high blood pressure, hyperlipidemia, and diabetes, or have been diagnosed with carotid artery plaque, coronary heart disease, or even missed a stent or had a myocardial infarction, then taking the corresponding medicine as prescribed by the doctor is the most effective preventive measure. For example, for people whose blood pressure has exceeded the standard for a long time, antihypertensive drugs that can stabilize blood pressure below 130/80mmHg are the best preventive drugs, such as the commonly mentioned satans and pruritans, which can not only lower blood pressure, but also delay ventricular remodeling and reduce the burden on the heart. ； If low-density lipoprotein exceeds the standard all year round and is accompanied by unstable plaques, statins can reduce blood lipids to the corresponding safe threshold and stabilize the plaques on the blood vessel walls without rupture, naturally reducing the risk of myocardial infarction. ； People who have been diagnosed with coronary heart disease should take antiplatelet drugs such as aspirin or clopidogrel as directed by their doctor to prevent platelets from aggregating to form thrombi and blocking blood vessels when plaques rupture.

Here we should also mention that the academic community has yet to fully agree on whether low-risk groups should use aspirin for primary prevention. Guidelines from previous years suggested that aspirin can be taken only if the cardiovascular risk exceeds 5% in 10 years. New studies in the past two years are more inclined to believe that as long as the risk is less than 10%, the risk of gastrointestinal bleeding and cerebral hemorrhage caused by taking aspirin is much higher than the benefit of preventing heart disease, so it is basically not recommended. There is also the question that everyone always asks whether health products such as Coenzyme Q10 and deep-sea fish oil are considered preventive medicines. The current research conclusions are also two-sided: some studies show that people who are diagnosed with heart failure or have muscle soreness after taking statins supplement Coenzyme Q10 to relieve symptoms. High-purity prescription fish oil has a lipid-lowering effect on people with hypertriglyceridemia. ； However, other large-sample studies have also confirmed that healthy people, whether they supplement coenzyme Q10 or take fish oil at the level of ordinary health products, cannot reduce the risk of heart disease at all. To put it bluntly, it is just a psychological comfort.

To be honest, I have been in the cardiovascular department for almost 9 years, and I have seen too many people who take medicine indiscriminately. Many people reverse the order of prevention-the heart is like your private car. You usually step on the accelerator every day, add low-quality oil, and never maintain it. Even if you add the most expensive fuel every day, it is useless. If you are really worried that you have a heart problem, go to the hospital for a cardiovascular risk assessment first and let the doctor calculate the probability of the disease for you. If you should take medicine, follow the doctor's instructions, and review and adjust the dosage regularly. If you shouldn't take medicine, quit smoking, stay up less late, and add less salt and oil to your meals. It is much more effective than buying a bunch of health care products and internet celebrity medicines. Don't follow the trend and take medicine randomly.