Primary prevention of coronary heart disease
Preventive measures are taken to prevent the occurrence of coronary heart disease in people who have not yet developed coronary heart disease.
1.Primary prevention for high-risk individuals
High-risk individuals are those who have significantly increased or moderately increased low-density lipoprotein cholesterol (LDL) levels with other coronary heart disease risk factors (high cholesterol, HDL cholesterol too low <35 mg/dL, <0.9 mmol/L, LDL cholesterol too high >160 mg/dL), hypertension, smoking, diabetes, men >45 years old, women >55 years old, premature family history of coronary artery disease. In order to reduce blood cholesterol level, quit smoking, control blood pressure and physical activity, reduce weight, etc.
2. Primary prevention for people with moderate risk
Moderate risk individuals are those with high LDL cholesterol levels and no other risk factors. The risk is relatively high, but there is no risk of coronary heart disease in the near future. This group is large in number, mostly young and middle-aged men and women.
3.Treatment
(1) Early detection of abnormal blood cholesterol and its reduction. Some people believe that the risk of coronary heart disease can still be reduced to the baseline level if cholesterol is lowered only when atherosclerosis is advanced, which is incorrect.
(2) Guided improvement of dietary habits and increased physical activity. From the U.S. age-specified coronary heart disease, it is hypothesized that the reduced incidence is associated with lower blood cholesterol due to reduced cholesterol and saturated fatty acid intake. It is hypothesized that for age >40 years, total cholesterol decreases by 10% and the risk of coronary heart disease decreases by 50%; for age >50 years, total cholesterol decreases by 10% and the risk decreases by 39%; for age >60 years, total cholesterol decreases by 10% and the risk decreases by 27%. Mild cholesterol lowering in middle-aged people and maintaining it for life is a very effective preventive measure to reduce the risk of coronary heart disease.
(3) Consume a lot of vegetables and fruits.
4.Lifetime prevention
If effective prevention begins in childhood, the incidence of coronary heart disease is likely to be greatly reduced by the time they become elderly.
Primary prevention measures
Controlling and eliminating risk factors that produce coronary heart disease, such as hyperlipidemia, hypertension, smoking, obesity and diabetes, are fundamental measures to prevent the occurrence of coronary heart disease.
1. Dietary habits.
① Avoid eating too much animal fat and foods with high cholesterol content, increase unsaturated fatty acid foods (such as fish oil, sesame oil, corn oil, germ oil);
②The total calories eaten should not be too high;
③ Appropriate consumption of high-quality protein foods;
④Control the intake of carbohydrates;
⑤ Pay attention to the balance of the diet, so that a variety of food to eat;
(6) Avoid overeating.
2. Quit smoking and alcohol
3. Prevent high blood pressure disease
4. Diabetes.
①Prevent the occurrence of non-insulin-dependent diabetes mellitus;
② Early diagnosis, active treatment and control of the disease development for diabetic patients;
③Reducing and eliminating the burden on pancreatic islets to prevent the occurrence of diabetic heart disease;
④Participate in physical activities to enhance the ability to resist diseases, especially the ability to resist viral infections;
⑤ Change the bad lifestyle, reasonable diet, and prevent obesity.
5.Physical activity.
①Increase the average thermal energy consumption of the population;
②Strengthen the high-intensity sports activities of young people, to ensure the number, time and intensity of spare-time sports activities;
③ Reasonably arrange a certain amount of time for outdoor activities, such as walking, jogging, playing taijiquan, practicing qigong, doing health exercises, cycling, swimming, ball games, etc.;
④Participate in some recreational activities that can make the body and mind happy and relaxed, such as playing chess, cards, dancing, etc;
⑤ After middle age, it is best to avoid strenuous exercise.
6. Psychological factors.
Maintain optimism, avoid sadness; control excitement and impatience, avoid irritating stimulating environment; eliminate tension and handle daily affairs scientifically.
Secondary prevention of coronary heart disease
1. refers to existing coronary heart disease, active treatment of risk factors
(1) Diet: avoid high-fat diet, but also to ensure to meet the body’s various nutrients, to prevent malnutrition.
(2) Life and living: live a regular life, sleep a reasonable amount of time, and prevent sleep deprivation.
(3) Personal habits: smoking and alcohol abuse are known to cause and aggravate coronary heart disease. From the perspective of prevention, especially young people should stay away from these bad habits.
(4) Attention should be paid to the treatment of underlying pathologies: hypertension, diabetes, obesity, hyperlipidemia, high cholesterol, etc.
2. Prevention of heart attack
(1) Pay attention to diet: don’t overeat; reduce the intake of cholesterol, fat and sugar; eat a balanced diet with plenty of fruits and vegetables; remove excess fat through proper diet and exercise; and don’t put unnecessary burden on the heart.
(2) Do not smoke.
(3) Increase activity: make life dynamic, walk more, climb the stairs instead of taking the elevator, and exercise regularly.
(4) Cope with mental stress: seek various ways to mediate stress in your life, you can cultivate hobbies or loosen the tension in your daily life through exercise, control high blood pressure, high cholesterol and diabetes, check your body regularly and follow the instructions of your doctor.
Secondary prevention measures
If coronary heart disease has already occurred and has not yet developed symptoms that draw your attention, and early detection and early treatment can effectively stop the development of the disease.
1. Self-alarm for patients with coronary heart disease: Any sudden onset of epigastric or chest pain, chest tightness, panic, shortness of breath, fatigue, mental discomfort, irritability, dizziness and other symptoms must be checked at the hospital and treated promptly once diagnosed.
2. Regular checkups for high-risk groups: Anyone with one of the following six elements can be considered a high-risk group for coronary heart disease: hyperlipidemia; smokers with a history of smoking for many years; hypertensive people; obese people; diabetic people; people with a family history of coronary heart disease. Annual checkups should be performed.
Tertiary prevention of coronary heart disease
It refers to the rescue of serious diseases, prevention of complications and death of patients, which includes rehabilitation treatment. Tertiary prevention of coronary heart disease mainly refers to the treatment of unstable angina and acute myocardial infarction, because unstable angina is an intermediate state between stable angina and myocardial infarction, which includes exertional angina and spontaneous angina in addition to stable angina, among which worsening angina and spontaneous angina are also called “pre-infarction angina The worsening angina and spontaneous angina are also called “pre-infarction angina”.
Since unstable angina is mostly caused by atherosclerotic plaque rupture and/or atherosclerotic plaque hemorrhage, as well as by appendicular thrombus. Therefore, in addition to the intensive treatment talked about in secondary prevention, anticoagulation and thrombolytic therapy are required. Heparin and antiplatelet agents such as aspirin against platelet adhesion and aggregation have positive efficacy in unstable angina and have a preventive effect against myocardial infarction or reinfarction.
Tertiary prevention measures
Focus on prevention of complications of myocardial infarction and prevention of reinfarction. The combination of planned and rational treatment and active self-care for patients with coronary heart disease, as well as good diet, physical activity and drug prevention, is the key to preventing recurrence and deterioration of coronary heart disease, as well as the key to tertiary prevention.