Ischemic cardiovascular diseases mainly include coronary atherosclerotic heart disease (coronary heart disease), ischemic stroke, and transient ischemic attack. Among them, coronary artery disease is subdivided into acute coronary syndromes (including unstable angina, non-ST-segment elevation myocardial infarction and ST-segment elevation myocardial infarction) and stable angina. The causes of ischemic brain group include mainly cerebral thrombosis and cerebral embolism, which results in cerebral infarction.
Ischemic cardiovascular diseases have a common pathogenetic basis, namely coronary atherosclerotic lesions (atheromatous plaques). If an unstable plaque in a coronary atherosclerotic lesion ruptures, on top of which a thrombus forms and the vessel lumen is significantly narrowed or occluded, it can lead to cardiac or cerebrovascular events, which include unstable angina, myocardial infarction, cerebral infarction and transient ischemic attack as mentioned above.
Ischemic cardiovascular and cerebrovascular diseases cause the first death of our people. Cardiovascular and cerebrovascular diseases cause physical and intellectual disability, loss of work capacity, impact on quality of life, long-term need for treatment and care, and repeated hospitalization. The loss of life, health and material damage caused by cardiovascular and cerebrovascular diseases to individuals, families and society is incalculable.
Atherosclerotic lesions leading to cardiovascular and cerebrovascular events generally begin in adolescence, and the progression of lesions and the occurrence of events, in addition to age, gender and genetic factors (which cannot be changed), depend primarily on the presence or absence of risk factors that contribute to the development and progression of the disease, which include, among others, hypertension, dyslipidemia, disorders of glucose metabolism and smoking. These risk factors leading to the progression of atherosclerotic lesions, unlike age, gender and genetic factors, can be changed by appropriate interventions. In a word, controlling these risk factors can delay, control or even prevent the occurrence and development of atherosclerotic lesions and prevent cardiovascular and cerebrovascular events.
The prevention of cardiovascular and cerebrovascular diseases includes primary prevention and secondary prevention. Primary prevention is to prevent the occurrence of disease without disease, and secondary prevention is to prevent reoccurrence after disease, or to prevent the occurrence of events without events and to prevent reoccurrence of events with events. The prevention of ischemic cardiovascular diseases is to prevent the occurrence and development of atherosclerotic lesions and to prevent the occurrence of cardiovascular and cerebrovascular events.
Preventive measures for cardiovascular and cerebrovascular diseases and events include three main aspects, firstly changing the poor lifestyle. Poor lifestyles, such as smoking, uncontrolled diet, and little exercise are themselves risk factors, or are associated with hypertension, obesity, dyslipidemia, and dysregulated glucose metabolism. In other words, lifestyle leads to the occurrence and development of diseases, and affects the recovery and prognosis of diseases.
A healthy lifestyle should include the following points.
1. total diet control, structure adjustment, with total control as the main focus; less food and more activity, with less food as the main focus.
2. for exercise, should adhere to: gradual and orderly, according to the ability, persistent, according to local conditions.
3. control your mouth, let go of your legs; less stairs, more stair climbing; walk instead of car.
4. quit smoking and drinking, combine work and rest.
5. be productive in your old age.
6. love people and love yourself, mental health.
Diet should be balanced, nutrients should be appropriate, about omnivorous food, and then good things can not be more. The amount of diet should be mastered a degree, and not too little, eighty to ninety percent full is the degree. Soup before a meal may be a good way to control the amount of food. Exercise can not be excessive, and do not stick to the form, that is, not necessarily all go to the gym, not necessarily all climb the mountain, between work, to the bathroom, in the plane can take advantage of the opportunity to appropriate activities. I have met patients who had myocardial infarction climbing the mountain, it is not that climbing is bad, just do not overdo it. Exercise should not be forced, to master a degree, that is, in the activity does not feel particularly difficult or suffocating chest, do not feel very difficult to breathe, do not sweat a lot; activity after the day is still very relaxed, do not feel very fatigue. A small amount of alcohol is effective for the prevention of cardiovascular diseases, especially red wine, but hypertension, the acute phase of the disease and patients with active stomach disease should avoid drinking alcohol.
Career and love are the two pillars of life, and the pursuit of career and career success, and the fidelity of love and growing old together undoubtedly have many benefits for their psychological and physical health. But long-term physical and psychological overwork tension, long-term overload will also hurt your health, it is very important to take time out of your busy schedule, to have their own hobbies and ways to vent, the key is to love their career, enjoy the joy of work, so that you can enjoy life. The elderly, retired at home sometimes feel lost and lonely, but also easy to the reality of unaccustomed, which is to adjust their own mentality, find what they like to do, such as twirling rice rickshaw, ballroom dancing, swimming, morning exercise, chatting, etc., as well as to play spare time, give love, do more for the family, enthusiastic community service, love to be loved, love and be loved in the psychological balance, must not be their own Psychological balance should not be based on the psychological imbalance of others. Nowadays, psychological problems also plague laid-off or unemployed comrades, and I don’t know if it is appropriate to call it “laid-off syndrome”. The laid-off unemployed comrades can not lose their will, but also adjust their mindset, self-improvement, as soon as possible to find their own position and can do things, such as home services. Whether in life or work, there are often many unsatisfactory places, did not get the love, respect and self-fulfillment, in addition to tolerance, avoidance, more often need to be open-minded to treat all the bad, think about everything, it is best to be optimistic, positive attitude.
The second control of risk factors. Hypertension, hyperlipidemia, smoking, diabetes and other risk factors lead to the formation of atherosclerotic plaques, accelerating the progress of atherosclerotic lesions, making atherosclerotic plaques unstable and leading to cardiovascular and cerebrovascular events after rupture. To date, there are no drugs that can really “soften blood vessels”. The key to atherosclerotic lesions is to inhibit the progress of lesions, stabilize the plaques that have formed, and prevent the rupture of plaques so that acute vascular events will not occur. Strictly control blood pressure to the ideal level, take effective lipid-regulating drugs, control diabetes, improve insulin resistance and abnormal metabolic status, and quit smoking. Among them, blood pressure, lipids and blood glucose need to be checked regularly at the hospital and the medication should be taken regularly as prescribed by the doctor. The control of risk factors, like lifestyle changes, should be carried out throughout life.
Thirdly, effective antithrombotic therapy is administered in high-risk patients. High-risk patients mainly refer to those with a family history of cardiovascular disease and various risk factors, and the onset of cardiovascular disease is earlier in men than in women. In most cases, the most effective, inexpensive and easily available antithrombotic drug is aspirin, which is effective in both cardiovascular and cerebrovascular diseases, and in both primary and secondary prevention, but the application of aspirin should also be controlled for indications and applied under the guidance of a physician. The efficacy of warfarin is significantly better than aspirin in some specific patients, such as prevention of cerebral embolism in patients with atrial fibrillation. The new oral antiplatelet drug clopidogrel alone is more effective than aspirin, and is used in combination with aspirin in acute coronary syndromes without ST-segment elevation, and is equally effective in both high-risk and low-risk patients, with or without catheter intervention. In addition to the above-mentioned antithrombotic drugs, there are many other types of oral and intravenous drugs in clinical practice, which cannot be introduced here. However, among the oral antithrombotic drugs, the above three drugs are most widely used and their efficacy is the most certain.
Acute ischemic cardiovascular events occur as a result of thrombosis based on the rupture of atherosclerotic plaques, causing narrowing or occlusion of the blood vessels supplying the heart and brain, resulting in severe ischemia or necrosis of the heart and brain tissue. The principle of treatment for these diseases is to open the occluded blood vessels and maintain them in an open state to prevent serious ischemia and necrosis of heart and brain tissues, and thrombolysis, catheter intervention and antithrombotic treatment are the main means to open and maintain the opening, while other treatments are auxiliary measures.
After the acute treatment and rehabilitation, the next step of treatment is to prevent the lesions from progressing and forming new lesions, and to prevent the occurrence of cardiovascular and cerebrovascular events, which are often fatal. The most important thing for secondary prevention is to continue to adjust lifestyle, strictly control risk factors, and effectively resist thrombosis. No matter what measures are taken for inpatient treatment and how ideal the effect is, without strict secondary prevention, the disease will recur and the event will occur again. For the prevention and treatment of diseases just like the improvement of social security, “only comprehensive management and constant control can ensure long-term peace and security; we should combine fight and prevention, but strict fight is better than strict prevention”.
Infusion twice a year, once in spring and once in autumn, is the main means of prevention and treatment for many patients, prevention and treatment of embolism, this practice has no scientific basis. Not to mention what the drug is, how effective it is, 365 days a year, even if each infusion 2 weeks, what about the remaining 48 weeks, 2 infusions a year can be topped?
Finally, I would like to send another sentence, there may be some enlightenment, if there is help is my greatest comfort. For cardiovascular disease: the lesion begins in adolescence, the onset begins in middle age; death and disability lies in the event, the first offender is thrombosis; from a young age to prevent, benefit life and prolong life.