For people at high risk of cardiovascular disease, not only do our healthcare professionals need to provide disease-related guidance in the hospital, but more importantly, patients’ families and their caregivers, as well as the patients themselves, need to actively cooperate and adjust in their lifestyles in order to minimize the risk of cardiovascular disease events. So, what lifestyle and self-management habits should be adopted in daily life?
1.Balanced diet.
2, regular exercise.
3.Quit smoking and limit alcohol.
4.Control weight.
Goal: Overweight and obese people lose 5% to 10% of their body weight in 6 to 12 months, so that the BMI is maintained at 18.5 to 23.9 kg/m2.
Waist circumference control: male ≤ 90cm, female ≤ 85cm.
Recommended measures: Assess BMI and/or waist circumference at each visit and maintain or reduce weight through physical activity and lower caloric intake.
(5) Blood pressure control.
Target: <130/80 mmHg.
Recommended measures: Initiate or maintain a healthy lifestyle. Blood pressure >=130/90mmHg start antihypertensive treatment, preferably CCB class drugs (drug name is usually xxdipine) and as the basis of combination drugs, in addition to β-blockers, ACEI, ARB, etc.
(6) Control of blood lipids.
The choice of intervention depends on the baseline cholesterol level and its cardiovascular risk stratification. Lifestyle intervention is the main measure for low- and intermediate-risk patients. For those who cannot reach the LDL-C (generally known as “bad cholesterol”) standard after 2-3 months of lifestyle treatment, drug therapy can be considered; for high-risk patients, intensive lifestyle intervention should be accompanied by active initiation of statin therapy.
Recommended measures: Initiate or maintain a healthy lifestyle by reducing the proportion of saturated fatty acids to total calories (<7%), trans fatty acids and cholesterol (<200mg/d); increase the intake of plant sterols (2g/d). Increase physical activity and control body weight. Adherence to statins. Treatment options to lower non-HDL-C: increase statin dose, or statin conventional dose combined with ezetimibe, or statin plus fibrates or niacin therapy.
(7) Diabetes control.
Goal: glycated hemoglobin <7%.
Recommended measures: Lifestyle changes and use of glucose-lowering medications. Intensify the control of other risk factors. This includes weight control, blood pressure control, and cholesterol control. Work with an endocrinologist for diabetes management.
(8) Thrombosis prevention.
If there is no contraindication, all patients with coronary artery disease should be treated with long-term aspirin (75-100 mg/d) after discharge from the hospital. If aspirin cannot be applied due to the presence of contraindications, clopidogrel (75 mg/d) can be used as an alternative. Taking statin may also reduce the occurrence of cardiovascular events to some extent in patients with coronary artery disease.
Patients who develop ACS or undergo coronary intervention need to be treated with a combination of aspirin (75-100 mg/d) and clopidogrel (75 mg/d) for one year. Long-term use of statins is also recommended.
The following two drugs can be used as alternatives to clopidogrel: prasugrel 10 mg/d or ticagrelor 90 mg/d.
In patients undergoing CABG, it is recommended to start aspirin within 6 hours after surgery to avoid bridge vessel occlusion and to adhere to aspirin 100 mg/d for 1 year after surgery, or to use clopidogrel 75 mg/d instead if aspirin is not tolerated.
For patients with coronary artery disease requiring anticoagulant drugs, such as combined atrial fibrillation, post-prosthetic valve replacement, left ventricular thrombosis or venous thrombosis, the dose of aspirin should be small (75 mg/d) while using warfarin, but the intensity of anticoagulation therapy with warfarin should still be up to standard.
Warm tips: please combine the specific medication with clinical, by the doctor face to face guidance shall prevail.