Coronary heart disease is the abbreviation of coronary atherosclerotic heart disease. Since the 1950s, coronary heart disease has become the leading cause of death in Western developed countries. In the United States, there are about 7 million cases of coronary heart disease each year, with about 1.5 million cardiac events and about $50 billion spent on coronary heart disease. The incidence of coronary heart disease in China is also increasing year by year, the incidence of coronary heart disease in China has increased 2-3 times in 10 years, acute myocardial infarction has increased more than 2 times in 10 years, and the death rate of coronary heart disease ranks third after tumor and cerebrovascular accident. The prevention of coronary heart disease is divided into primary prevention and secondary prevention. Primary prevention refers to reducing or controlling the susceptibility factors of coronary heart disease to reduce the incidence, which is the real prevention and the main prevention for middle-aged and elderly people. Secondary prevention is the use of pharmacological or non-pharmacological measures to prevent recurrence or exacerbation of coronary heart disease in patients already suffering from the disease. Hypertension, hyperlipidemia, hyperglycemia, high obesity, genetic factors, psychiatric factors, poor diet structure, insulin resistance, smoking, and low activity level are all risk factors for coronary heart disease. According to the susceptibility factors of coronary heart disease, the primary prevention includes: 1, control of blood pressure. 2.Rational diet structure and caloric intake, avoid overweight. Prevention and treatment of hyperlipidemia, reduce the level of blood quality of the population. 3.Cessation of smoking. 4.Actively treat diabetes. 5.Drink hard water. Soft water areas must be supplemented with calcium and magnesium. 6, avoid long-term mental tension, excessive excitement. 7, actively participate in physical exercise. Secondary prevention of coronary heart disease is for patients who have already suffered from coronary heart disease, in order to control or delay the progress of coronary heart disease, reduce the complications of coronary heart disease, keep the condition in a stable state for a long time, or make the original lesions improve, so as to achieve the purpose of reducing the rate of disability and mortality and improving the quality of life. The main measures taken are two aspects: I. Non-pharmacological treatment Because coronary heart disease is a lifestyle disease, its onset, treatment, disease control, rehabilitation, etc. are closely related to lifestyle, so therapeutic lifestyle change is the most basic method of clinical treatment, is the basis of drug treatment, must be done effectively. 1, do a good job of publicity and education of coronary heart disease. Patients and their families should often learn some knowledge about the prevention and treatment of coronary heart disease, understand the causes of coronary heart disease, aggravating factors, treatment measures, the use of commonly used drugs, and the problems that should be paid attention to in daily life, so as to give active cooperation in the prevention and treatment of the disease. Establish confidence in overcoming coronary heart disease and maintain emotional stability and optimism, which is very important for disease control and recovery. 2, pay attention to change the bad lifestyle. Including reducing the risk factors of coronary heart disease, such as quitting smoking, adjusting diet, reducing weight, moderate physical activity and exercise, etc. It is generally believed that exercise is most effective for patients with stable but symptomatic angina pectoris, or patients with occult coronary artery disease with ischemic changes in electrocardiogram, and appropriate exercise can be performed for patients after myocardial infarction and coronary artery bypass surgery without complications. 3.Avoid the triggering factors of coronary heart attack. Including full meals, excessive exertion, exertion, rage, terror, dry stools, alcohol consumption, heavy smoking, cold stimulation, orgasm, etc. 4.Regular examination. Pay attention to the changes of some indicators related to the disease, such as blood pressure, blood lipids, blood sugar, electrocardiogram, heart rate, pulse, weight, should be checked at least once a year, see the doctor in time to give timely and effective treatment and adjust the medication. Self-alarm for patients with coronary heart disease. Any sudden onset of pain in the upper abdomen or chest, chest tightness, panic, shortness of breath, fatigue, mental discomfort, irritability, dizziness and other symptoms must be checked at the hospital and treated promptly without delay. Second, drug treatment: is the main content of secondary prevention of coronary heart disease, directly related to whether the condition can be controlled, stable, improved, quality of life status, whether to reduce or avoid the emergence of myocardial infarction, sudden death and other serious risks, must be in accordance with the requirements of evidence-based medicine adhere to the selection of good drugs, use good drugs, to achieve the intended goal. 1, lipid-lowering drugs Statin drugs (simvastatin, pravastatin, atorvastatin) treatment has now become the basic treatment for secondary prevention of coronary heart disease, which can play the role of reducing blood lipids and stabilizing plaque, but also improve vascular endothelial cells, anti-inflammation in the blood vessels, stabilize plaque and not myocardial infarction, which is the key to prevent events. On the basis of diet control, active long-term application of statin drugs can reduce the prevalence of coronary heart disease by 20-30%, significantly reduce the occurrence of fatal or non-fatal myocardial infarction, significantly reduce the rate of death and disability of coronary heart disease. All patients with coronary heart disease should take it to reduce LDL-C level to below 2.60 mmol/L (100mg/dl), and for very high-risk patients (such as patients with combined diabetes or acute coronary syndrome) should intensify statin lipid regulating therapy to reduce LDL-C to below 2.07 mmol/L (80mg/dl). 2. Anti-platelet agents. Platelets are the culprit of thrombosis in coronary arteries, and aspirin is the best antiplatelet agent for secondary prevention. Small doses of aspirin (75-150 mg/d) can reduce the risk of MI and cardiovascular death in patients with chronic stable angina pectoris, have few gastrointestinal side effects, are inexpensive and easily available, and should be taken by patients with no contraindications. Clopidogrel can be used as an alternative treatment for those who are allergic to aspirin or cannot apply it. 3. β-blockers. It can reduce the risk of sudden cardiac death by 30-50%, which greatly increases the insurance factor for patients with coronary artery disease. As long as there is no contraindication, β-blockers should be used as the initial treatment for stable angina. The dose of the drug is beneficial to maintain the resting heart rate at the target level of 50~60 beats/min. 4.Angiotensin converting enzyme inhibitor (ACEI). ACEI can help reduce plaque and thrombosis, stabilize plaque, and slow the progression of AS. The efficacy of ACEI therapy in reducing cardiovascular events in patients with hypertension, heart failure, myocardial infarction, and diabetes has been confirmed by numerous clinical trials. ACEI therapy can significantly reduce the overall mortality rate in patients without heart failure and left heart insufficiency. 5. Calcium antagonists. In secondary prevention, long-acting calcium channel blockers (nifedipine controlled-release tablets) are often superior to long-acting nitrates because their efficacy lasts for 24 hours, and in patients with chronic coronary artery disease with hypertension, nifedipine controlled-release tablets have a significant therapeutic benefit, resulting in the primary benefit endpoint events (including all-cause death, myocardial infarction, intractable heart disease, and cardiac death). myocardial infarction, intractable angina, new-onset heart failure, disabling stroke and peripheral revascularization therapy) by 13%. It is especially indicated for those hypertensive patients with target organ damage, such as coronary artery disease, and has a double benefit. It can also prevent heart failure. 6, nitrate drugs. Commonly used isosorbide nitrate (cardiac pain) and isosorbide 5-mononitrate, which has a more reliable role in preventing angina pectoris and improving myocardial ischemia. Long-term use is easy to produce drug resistance. The duration of isosorbide nitrate is 4~5h, so it should be taken orally 3~4 times a day, and it should be given to patients with exertional angina during daytime. isosorbide 5-mononitrate can be given twice a day. If there are angina attacks during the day and night or early morning, isosorbide nitrate can be administered once every 6 h, but short-term treatment is recommended to avoid drug resistance. Clinical avoidance of resistance can be achieved by maintaining an appropriate daily “nitrate-free interval”, and the common dosage form should be used for “eccentric administration”, or a better formulation such as extended-release isosorbide 5-mononitrate (Imodium), etc. 7, Chinese medicine Chinese medicine to prevent coronary heart disease has a precise clinical effect, such as compound Danshin drops, Tongxinluo, musk heart pill and other drugs, with lowering blood lipids, lowering blood viscosity, improve microcirculation, antioxidant, anti-apoptosis, improve endothelial function and other effects. 8.Complex vitamins. Mainly including B vitamins, such as VB1, VB2, VB6, VB12 and folic acid, etc. Research has confirmed that homocysteinemia is prone to atherosclerosis and plays an important role in the development of hypertension and coronary heart disease. The supplementation of VB6, VB12, folic acid and other vitamins can regulate the metabolism of cysteine through different ways, thus effectively preventing coronary heart disease. 9, spare emergency drugs. Such as nitroglycerin, quick-acting heart pills, etc., once the acute attack of coronary heart disease, should be taken immediately under the tongue. In short, we should do three ABCDE: the first: A: angiotensin-converting enzyme inhibitors (ACEI), B: beta blockers (beta-blocker), C: quit smoking (Cigarette quitting), D: reasonable diet (Diet), E: exercise (Exercise). The second: A: Aspirin (Aspirin), B: Blood pressure control (Blood pressure control), C: Cholesterol-lowering (Cholesterol-lowering), D: Diabetes control (Diabetes control), E: Education (Education). Third: A: Angiotensin receptor antagonists (ARBS), B: body mass index control (BMI control), C: Chinese medicine (Chinese medicine), D: multivitamin (Decavitamin), E: emotion (Emotion). The third “ABCDE” has the same important role in the secondary prevention of coronary heart disease as the two aforementioned “ABCDE”. In conclusion, secondary prevention of coronary heart disease should include three “ABCDEs” to be more comprehensive and scientific. The development of coronary heart disease can only be delayed and even reversed by taking medications on time and adhering to a reasonable and healthy lifestyle under the guidance of a cardiovascular specialist to prevent the recurrence of heart attack. Patients who have undergone cardiac intervention or bypass should follow up regularly at the hospital or in the community to get guidance on disease prevention.