At present, China’s elderly population over 60 years old has reached 200 million, and the average annual increase is about 10 million. Aging will bring many health problems to the elderly, especially “cardiovascular disease” has the highest incidence in the middle and elderly. According to statistics, there are more than 270 million patients with cardiovascular diseases in China, and nearly 3 million people die every year due to cardiovascular diseases. Cardiovascular disease is a chronic disease that seriously affects the health and quality of life of middle-aged and elderly people. Therefore, it is very important to lift the misunderstanding and correctly understand cardiovascular diseases. 1.Why does blood lipid rise? The first category is “eating” high blood lipid, which is easy to understand. These people are mostly obese, have uncontrolled diet and are fond of fat, sweet and thick taste, which affects the transportation function of spleen and stomach, and the excess fat is stored in the body. The second type of high blood lipid is caused by “qi”, which refers to the disorder of blood lipid metabolism caused by mental and emotional factors (anxiety, stress, high tension, depression, emotional disorder and staying up late). According to traditional Chinese medicine, the liver is the master of draining and regulating the emotions. This type of hyperlipidemia mainly affects the function of the liver, resulting in the imbalance of qi and blood, which in turn can affect the transportation function of the spleen and prevent the full utilization of water and grain essence, resulting in dyslipidemia. The third category is “old” lipid, which is caused by the declining function of various organs of the body as we grow older, and is often found to be abnormal after retirement. Of course, in addition to the above three categories, there are also some genetic related, which is relatively small. 2.Does the diet of hyperlipidemia patients mean eating less meat? What do people with hyperlipidemia need to pay attention to in their diet? Many people think that it is to eat less meat. In fact, different types of hyperlipidemia patients have different points to note in their diets. If the total cholesterol and LDL (these two lipids are the same) are elevated, these people should eat less fatty meat, greasy food, egg yolk, crab roe, and fish without scales, etc. If triglycerides are elevated, in addition to limiting the intake of greasy food and meat, special attention should be paid to limiting staple foods and sweets because starchy foods will be converted into triglycerides in the body. In addition, we should pay attention to weight loss and weight control, and treat fatty liver and diabetes, which are also common causes of elevated triglycerides; if the HDL is lowered, or “good blood lipids” as the people say, these people should pay special attention to quit smoking. In addition, the long-term application of a small amount of red wine also has a certain role in raising HDL, so the grape skin contains a resveratrol substance, which has a very good role in regulating blood lipids. 3.Can I stop taking medication after my blood lipids are normal? Some people with mild abnormal blood lipids and no cardiovascular disease can try to stop taking medication and continue to maintain a good lifestyle after their blood lipids have been reduced through medication and lifestyle improvement. However, for some high-risk patients who have been diagnosed with cardiovascular disease or have very high lipid index, lipid-lowering drugs often need to be taken for a long time and should not be discontinued (lipids will generally rise again after discontinuation) in order to minimize the potential harm of high lipids to the cardiovascular system. 4.How to find out whether there is plaque in blood vessels at an early stage? The adverse effect of elevated blood lipid is not in the blood lipid itself but in the atherosclerotic plaque deposited on the blood vessel wall, which is the main pathological basis of cardiovascular disease. The best test for early detection of healthy blood vessels and the presence of plaque is carotid ultrasound. Because the carotid artery is a very superficial artery, ultrasound can be observed very clearly and can be used as a window to reflect the health of blood vessels or not. Now some units have included it as a routine medical examination. 5.Can atherosclerotic plaque be eliminated? In the early stage, if the intima is slightly thickened and the plaque is small, the plaque can be controlled or even eliminated by insisting on taking medicine and improving the lifestyle. However, when the plaque is more obvious and causes narrowing and blockage of blood vessels, it often takes more than ten years or even decades, in this case, it is difficult to eliminate the plaque by drugs alone, but can only play the role of stabilizing the plaque and slowing down its development. Of course, do not be too pessimistic, modern medical development is very fast, for this kind of very serious plaque and stenosis, most of them can be treated by stent or surgery. 6.Can we relax our vigilance if the stenosis is mild? In the past, it was believed that the severity of coronary heart disease is closely related to the degree of stenosis, and a 90% blockage of blood vessels is more serious than a 50% blockage. Therefore, if the stenosis of heart vessels is <50%, the diagnosis of coronary artery atherosclerosis is usually not made. Patients and doctors often let their guard down in such cases. And this concept has been completely overturned in recent years. We know that acute myocardial infarction is the most serious condition of coronary heart disease, due to ischemic necrosis of myocardium caused by blockage of blood vessels, but studies have found that 70% of patients with acute myocardial infarction have less than 50% stenosis of heart vessels. The reason why acute myocardial infarction occurs is mostly due to plaque instability and sudden rupture, which causes acute thrombosis and blockage of blood vessels. Therefore, plaque stability is crucial, not just the degree of stenosis of the blood vessel. Therefore, patients with mild stenosis of heart vessels in clinical practice should not be taken lightly, and often take statin lipid-lowering drugs to slow down the development of plaque and have the effect of stabilizing it. < span=""> 7, angina can be carried to resist, try not to take drugs? Some people think that angina patients should try not to take drugs, worrying that old drugs will be resistant to take, and then take it again will not work. In fact, angina attack first aid drugs are mostly nitroglycerin, quick-acting heart pills, such drugs are short-acting drugs, fast-acting, the effect disappears quickly, the body quickly metabolized, generally will not produce drug resistance. If angina persists without relief, nitroglycerin can even be contained every five minutes, three times in a row is possible. Patients with angina, unless they have a lot of experience, know what amount of activity will cause angina, rest can be relieved, this situation does not necessarily take the drug every time. But the general patients with angina can contain drugs in time, do not have to worry too much about drug resistance, especially the pain is heavy, longer duration, rest does not relieve, this time must not carry, to contain drugs in time, through the expansion of coronary arteries can reduce the risk of heart attack. If the angina persists without relief, the pain time is greater than half an hour, this time must go to the hospital in a timely manner. Time is the heart muscle, the earlier the treatment saves the heart muscle, the smaller the risk of heart failure in the future. Do not be afraid of trouble, worry about affecting other people and dragged too long, lost the best time to treat, thus causing serious consequences. 8.Should stents be put in for coronary heart disease or not? Interventional therapy (stent-based) is an important advancement in modern medical treatment of coronary heart disease, and there are now 300,000 to 400,000 patients having stents every year in China alone. So what kind of people should have interventional treatment? Simply put, there are three cases, one is acute heart attack, and if conditions allow, it is recommended that intervention must be done as soon as possible to open blood vessels and reduce myocardial necrosis. Interventional therapy has a high success rate of opening blood vessels, which is better than thrombolytic drugs (the best thrombolytic drugs only have a blood vessel opening rate of about 60-70%), and has fewer bleeding side effects. Since interventional therapy has been used in the treatment of acute myocardial infarction, it has significantly reduced mortality and complication rates. There is another group of people who are relatively stable and have stenosis in the heart vessels examined, for example, 80% (below 75% are generally not put in stents, and are temporarily treated conservatively), but the patient does not have any symptoms, or angina only appears when physical activity exceeds a certain amount (which is often called stable angina), this situation can be treated without putting in stents, especially in patients of advanced age and with very little activity, and can be treated with drugs. However, if the symptoms of angina pectoris are more obvious, the effect of conventional drug treatment is not good, and the patient has higher requirements for quality of life (such as the desire to travel after retirement, etc.), stenting can be considered at this time. Between acute infarction and stable angina is unstable angina, which requires the doctor to decide whether to put a stent according to the patient’s risk stratification. It should be emphasized that even after stenting, it does not mean that the coronary heart disease is cured. Although the blocked blood vessel is solved, there is still a possibility of re-blocking after stenting, and other blood vessels may also develop atherosclerosis, so it is still necessary to insist on taking medicine to prevent the blood vessel from re-blocking and new lesions. 9.What kind of people should take aspirin? When to take it? What is the right dose? There are three categories of people who should take aspirin: the first category is for patients with diagnosed cardiovascular disease, including coronary heart disease or cerebral infarction, obvious plaque in blood vessels, and diabetes over 50 years old (diabetes is now considered to be a critical condition for coronary heart disease). The second category does not have cardiovascular disease and diabetes, but has hypertension, such patients if they are older than 50 years old or have target organ damage, (such as an ultrasound myocardial hypertrophy, or the occurrence of plaque on the blood vessels, protein in the urine) will need to take aspirin, of course, provided that the blood pressure is relatively stable control (control to 150/90mmHg or less). The third category is the absence of cardiovascular disease, diabetes, and hypertension, then as long as three or more of the following five indicators are present, it is more beneficial to take aspirin as a primary prevention than not to take aspirin. The five indicators are: age greater than 50 years; smoking; obesity; dyslipidemia; family history of early onset cardiovascular disease (father before 55 years old, mother before 65 years old). As for what time to eat, is not the main thing, the key is to adhere to long-term eating. Personally, of course, I think it’s relatively good to eat at night. In the past, aspirin flat tablets were irritating to the stomach and intestines, so they were taken after meals. Now aspirin is an enteric tablet that disintegrates in the intestines, so it should be eaten on an empty stomach. If you eat after a meal, there is rice in the stomach, the PH value has increased, which is equivalent to the environment in the intestine, and aspirin disintegrates in the stomach, but it will cause irritation to the stomach. Eat in the morning on an empty stomach, followed by breakfast, is not conducive to the intestinal disintegration of aspirin, and 8 or 9 pm to take the drug, the stomach is basically empty, so aspirin is better to eat in the evening, for reducing the high incidence of cardiovascular events in the early morning is also more helpful. What is the appropriate dose of aspirin, the internationally accepted standard is the long-term dose of 75 mg-150 mg (unless the emergency can be increased for a short period of time), the dose is too small to play a preventive role, the dose is too large is not necessary, but also increase the side effects. Those who cannot take aspirin, can be replaced by clobigrel. 10.How much exercise is appropriate for cardiovascular patients? Exercise should emphasize long-term, regular and persistent, rather than a one-time large amount of activity. The heart rate can be used as a criterion to judge whether the amount of activity is appropriate or not. The calculation method is: (220 – age) × 85%, which is the upper limit of heart rate during exercise, (220 – age) × 70%, which is the lower limit of heart rate during exercise. Above the upper limit there is some risk, below the lower limit there is not enough exercise. For example, a 60-year-old person, after using this formula, the heart rate should be between 112-136, which means that a reasonable amount of exercise is a heart rate between 112 and 136 is more appropriate when exercising. Of course, for the elderly, it is recommended that the heart rate reach the low limit when exercising is fine. 11, cardiovascular disease should be regular annual infusion “through” the blood vessels? The principles of rational drug use issued by the Health and Welfare Commission of China point out that drugs should not be used if they can be used without drugs, drugs should not be used more if they can be used less, injections should not be given if they can be taken orally, and infusions should not be given if they can be given. The drug enters the blood circulation directly during infusion, and although the effect comes quickly, there is a greater possibility of potential side effects. Some people think that they should pass blood vessels regularly every year, so they can avoid taking medication for a long time, which is a big misconception. The best way to reduce the occurrence of cardiovascular and cerebrovascular events is to adhere to long-term medication when the condition is stable, rather than to replace long-term oral medication with regular infusions. Of course, if the condition is unstable, it is necessary to give infusion therapy to stabilize the condition as soon as possible. 12, the treatment must use “new special drugs”? The U.S. FDA has done a study to investigate the adverse reactions of 1489 drugs, of which 1200 are old drugs, 289 are new drugs, the results of serious adverse reactions, 1200 old drugs accounted for 13%, 289 new drugs accounted for 87%! Due to the short time of new drugs on the market, not through the clinical long-term, large-scale application, some potential adverse reactions have not been fully revealed. And the old drugs after years of clinical application, the adverse reactions have come out, so it is relatively safe. Therefore, we must prevent the blind pursuit of new special drugs, or according to the condition and the actual clinical situation.