Coronary heart disease patients need long-term oral drug treatment, but many patients are worried about long-term drug adverse reactions, always want to stop. In fact, suffering from coronary heart disease, some drugs can not stop, especially the secondary prevention of coronary heart disease, improve the prognosis of coronary heart disease drugs. First of all, explain what is the secondary prevention of coronary heart disease? The secondary prevention of coronary heart disease refers to the strict control of risk factors for patients who have developed coronary heart disease, and its purpose is to improve clinical symptoms, prevent recurrence and progression of disease, improve the prognosis of patients with coronary heart disease, and reduce cardiovascular mortality. Its main measures include non-pharmacological interventions (including therapeutic lifestyle improvement and exercise rehabilitation) and pharmacological treatments as well as comprehensive prevention and control of cardiovascular risk factors. Combined with the latest Chinese Guidelines for the Prevention of Cardiovascular Disease (hereinafter referred to as the Guidelines), let’s talk about what are the main drugs for secondary prevention of coronary heart disease? 1. Antiplatelet therapy drugs Mainly include aspirin, clopidogrel, tegretol and other drugs. These drugs are crucial for patients with coronary heart disease, especially in the secondary prevention of coronary heart disease plays an important role in the prevention of thrombosis. Guidelines recommend that all patients with coronary artery disease should be treated with long-term aspirin (75-150 mg/d) if there are no contraindications. For those who cannot take aspirin because of contraindications or intolerance, clopidogrel (75 mg/d) can be substituted. For patients undergoing coronary intervention, combine aspirin and clopidogrel for at least 12 months; for those who cannot tolerate clopidogrel or have clear evidence of resistance, substitute tegretol or prasugrel. 2. ACEI (Prilosec) and ARB (Sartans) These drugs mainly include: Benadryl, Perindopril, etc. and Chlosartan, Valsartan, etc. In addition to lowering blood pressure, ACEI (Prilosec) drugs can also protect the endothelium, reduce endothelial apoptosis, inhibit the renin-angiotensin-aldosterone system in plasma and cardiac muscle tissues, dilate blood vessels, and reduce the load on the heart;, prevent or reverse cardiomyocyte hypertrophy, reduce infarct size, limit ventricular dilatation after myocardial infarction, inhibit ventricular remodeling, prevent or delay heart failure and improve cardiac function, etc., and improve the survival rate of patients. Long-term treatment with ACEIs is beneficial to most patients with chronic coronary artery disease, but the degree of benefit is related to the patient’s risk level. Guidelines recommend that patients with asymptomatic left ventricular systolic function abnormalities, chronic heart failure and myocardial infarction after high-risk chronic coronary artery disease, as well as coronary artery disease combined with hypertension, diabetes mellitus and other diseases, taking ACEI treatment benefit more. Therefore, it is recommended that all patients with coronary artery disease should take ACEI for long-term secondary prevention if there is no contraindication. Patients who have indications but cannot tolerate ACEI therapy can take ARBs. 3. β-blockers (Lorazepam) These drugs mainly include: metoprolol, bisoprolol, etc. β-blockers have both anti-ischemic and prognostic effects. Although the recommendation for beta-blockers in patients with coronary artery disease without a history of myocardial infarction or coronary artery disease and with normal left ventricular function tends to be conservative, it is still recommended that beta-blockers be used if there are no contraindications. However, it is still recommended that all patients with coronary artery disease should be treated with long-term beta-blockers as secondary prevention if there are no contraindications.Patients with ST-segment elevation myocardial infarction or non-ST-segment elevation acute coronary syndromes who are not able to use them due to contraindications in the acute phase should be reevaluated prior to discharge, and beta-blockers should be applied as much as possible in order to improve the prognosis, and the therapeutic dosage should be individualized according to the patient’s tolerance. Guidelines recommend the use of beta-blockers without intrinsic sympathomimetic activity. It should be noted that if the patient develops symptomatic severe bradycardia (heart rate <50 beats/min) after the administration of the drug, the dosage should be reduced or suspended, rather than discontinued, otherwise it is likely to lead to a rebound increase in the heart rate, with the risk of causing myocardial ischemia or the recurrence of angina symptoms. 4. Statins These drugs mainly include: atorvastatin, resuvastatin, simvastatin and so on. Statins, i.e. 3-hydroxy-3methylglutaryl coenzyme A reductase inhibitors, are currently the most effective lipid regulating drugs, which can not only strongly reduce bad cholesterol (low-density lipoprotein cholesterol LDL-C), but also raise good cholesterol (high-density lipoprotein cholesterol) to a certain extent. In addition, statins can improve vascular endothelial function, inhibit the proliferation and migration of vascular smooth muscle cells, antioxidant effect, anti-inflammatory effect, inhibition of platelet aggregation and antithrombotic effect, etc., which is conducive to preventing the formation of atherosclerosis or stabilizing and narrowing the atherosclerotic plaque. It has now become the most effective drug for the prevention and treatment of coronary heart disease, and has been recognized and recommended by many guidelines. Therefore, China's cardiovascular disease prevention guidelines point out that: in addition to effectively lowering the level of TC and LDL-C, statin therapy also has the effect of delaying plaque progression, stabilizing plaque and anti-inflammatory. If there is no contraindication, long-term use of statins to reduce LDL-C to <1.8 mmol/L (70 mg/dl) is reasonable.