I. The danger of cardiovascular disease
The natural life cycle of mammals is generally 5 to 6 times of their developmental cycle, and the developmental growth cycle of human is about 18 to 20 years, so according to this rule, the natural life cycle of human should be 90 to 120 years. However, so far, the average life expectancy of all countries in the world has not reached this level, and the reason for this is because of various diseases, traumas, natural disasters and other factors. The life expectancy of human beings in modern society is threatened by a number of undesirable factors, that is, early disease, early disability, early aging, and finally causing early death.
In recent years, the data released by the Ministry of Health show that at this stage, cardiovascular and cerebrovascular diseases account for the largest proportion of the main causes of death in China, and the sum of the two accounts for about 45%, followed by cancer, and again by various accidental trauma. In other words, at this stage, the main cause of death in China is cardiovascular disease, so cardiovascular disease has been called the “first killer” for many years.
Common cardiovascular diseases include hypertension, coronary heart disease and stroke, among which coronary heart disease can cause angina pectoris, myocardial infarction or even sudden death, while stroke can be an ischemic cerebral infarction or a hemorrhagic cerebral hemorrhage. At present, the onset of these several cardiovascular diseases in China is the trend of rejuvenation, that is to say, the age of cardiovascular disease is getting earlier and earlier, the number of cardiovascular and cerebrovascular patients in the age group of 30 to 40 years old encountered by the author is considerable, of which the youngest coronary heart disease 29 years old. At the same time, survey data show that China is becoming a large country of hypertension and coronary heart disease. Therefore, it can be said that cardiovascular diseases have become a social problem in China, not just a health problem.
However, fortunately: cardiovascular diseases can be prevented! The following are the methods of prevention, detection and treatment of each of the three common cardiovascular and cerebrovascular diseases.
II. Common cardiovascular and cerebrovascular diseases
(A) Hypertension
The normal blood pressure standard recommended by the international and domestic Hypertension Guidelines is less than 120 / 80 mmHg, and those within the range of 120-139 / 80-89 mmHg are called normal high blood pressure, while those reaching or exceeding 140 / 90 mmHg or more are hypertensive. Current survey data show that there are about 200 million hypertensive patients in China, which is a staggering number. Of these, 130 million are unaware that they have hypertension, and of those who are known to have hypertension, about 30 million are untreated; of those who receive antihypertensive treatment, 75 percent do not have their blood pressure under control.
This is a serious health and life-threatening condition, because although hypertension may not have any symptoms during normal times, the physical damage caused by increased blood pressure continues to progress unnoticed. Hypertension itself is a cardiovascular disease, but it can cause other cardiovascular diseases at the same time. The damage it causes to the body is mainly focused on four areas: heart, brain, kidney and blood vessels, and can cause coronary heart disease, heart failure, stroke, uremia, aortic coarctation aneurysm, etc.
If hypertension is not treated, the final possible results are: 50% die from coronary heart disease or heart failure, 33% die from stroke, and 10-15% die from kidney failure. A related survey in the United States concluded that hypertension is associated with 67% of myocardial infarctions, 77% of strokes, and 26% of kidney failures. The risk of hypertension increases with the increase in blood pressure.
If the risk of cardiovascular effects is 1 for 110/75 mmHg, the risk is 2 for 120-129/80-84 mmHg, 3 for 140-149/90-94 mmHg, and 10 for 180/110 mmHg. and controlled.
So, how do you find out early if you have hypertension? The specific measurement method is to take a sitting position in a quiet and warm environment, sit against the back for 5 minutes, place your arm at the level of your heart and measure with a mercury sphygmomanometer. If the blood pressure measured at different times reaches or exceeds 140/90 mmHg more than twice, it is considered hypertension.
How is hypertension treated if I have it? Current treatment options are non-pharmacological and pharmacological. Non-pharmacological treatments are mainly lifestyle interventions, including increasing activity, reducing weight, quitting smoking, low salt and low fat diets, diets with more vegetables and fruits, and controlling alcohol intake.
Pharmacological treatment means the use of antihypertensive drugs, including.
1, diuretics, such as indapamide extended-release tablets, hydrochlorothiazide, etc.
2, calcium antagonists, such as nifedipine, felodipine, amlodipine, nifedipine controlled-release tablets, lacidipine, etc.
3, angiotensin-converting enzyme inhibitors (ACEI), such as benazepril, enalapril, perindopril, midazepril, lenopril, etc.
4, angiotensin receptor blockers (ARB), such as cloxacin, valsartan, irbesartan, telmisartan, candesartan, etc.
5, beta-blockers, such as metoprolol, bisoprolol, carvedilol, aurolol, etc.
6, α-blockers, such as prazosin, terazosin, etc. Besides, there are some compound preparations composed of the combination of the above drugs.
Different people will respond differently to different kinds of antihypertensive drugs, and thus different kinds of drugs can be chosen for different people. In general, most patients with hypertension require a combination of drugs in order to reduce side effects and enhance the antihypertensive effect. ACEI or AR is often chosen in combination with diuretics or calcium antagonists.
The goal of hypertension is to lower the blood pressure to below 140/90 mmHg in the general hypertensive population, and lower it a bit lower to below 130/80 mmHg in those with combined diabetic nephropathy to protect the kidneys. For elderly hypertensive patients, the systolic blood pressure is required to be lowered to 150 mmHg, or further to below 140 mmHg if the patient can adapt.
Some points about hypertension treatment are worth clarifying. One, hypertension is a chronic disease, and blood pressure fluctuations are common, and it is not necessary to require a rapid, immediate reduction to normal. Second, the adjustment period of medication can be within 3 months. Third, medication treatment should be accompanied by lifestyle modification throughout. In addition, hypertension is a lifelong disease and requires continued medication after normal blood pressure control. Avoid sudden discontinuation of medication or indiscriminate changes in medication to avoid large fluctuations in blood pressure.
When a patient with hypertension has a sudden and severe rise in blood pressure at home, the first aid method at home is to rest in bed and take sublingual nifedipine or nicardipine.
(B) Coronary heart disease
The full name of coronary heart disease is “coronary atherosclerotic heart disease”, the coronary arteries are responsible for providing blood flow to the heart itself. This leads to ischemia of the heart, or coronary heart disease.
The main symptoms of coronary heart disease include: 1) angina pectoris, manifested as chest tightness and chest pressure during activities, which can be relieved after resting or containing heart pills or nitroglycerin. 2) arrhythmia, manifested as panic, palpitations, etc., which can cause sudden death in the most serious cases. 3) myocardial infarction, manifested as sudden and severe chest pain, shortness of breath, sweating, and a sense of near death, which is an extremely dangerous state.
How to detect coronary heart disease at an early stage? If you have the chest pain and other manifestations mentioned above, you should undergo coronary heart disease related examinations, the most common and common one is ECG, there are also exercise plate load ECG, myocardial nuclear imaging, coronary CT imaging, coronary angiography, etc. It is up to the cardiovascular doctor to decide which one to take. If there are myocardial ischemic changes on ECG or significant narrowing of coronary arteries on coronary angiography, it means coronary heart disease.
Treatment of coronary artery disease includes medication and surgery, of which medication is the foundation. Medications are needed to reduce ischemia, stabilize atherosclerotic plaque, and prevent thrombosis. Drugs to reduce ischemia include isosorbide nitrate, beta-blockers (such as metoprolol, bisoprolol, etc.), diltiazem, etc.; drugs to stabilize atherosclerotic plaque are mainly statin lipid regulators, such as simvastatin, atorvastatin, rasulvastatin, etc.; drugs to prevent thrombosis are mainly aspirin enteric coated tablets, clopidogrel, etc.
For severe coronary artery stenosis, surgical treatment, including vascular intervention and coronary artery bypass surgery, is required if drug treatment is not effective. Interventional treatment is a minimally invasive procedure to place stents in the coronary arteries, while coronary artery bypass grafting requires ah open-heart surgery. The choice of the procedure depends on the extent and degree of the coronary artery lesion and requires a specialist’s decision. In addition to drug and surgical treatment, non-drug treatment is also important for coronary artery disease, including dietary modification, reasonable exercise and psychological adjustment.
Specifically, a low-fat diet, mainly cereals, fruits, vegetables and fish, without overeating; adherence to regular exercise, the amount of exercise to not cause chest tightness; and a calm mind, avoiding great anger, great anxiety, great joy and great sadness. These methods do not need to spend a lot of money, but is the exact effective, but unfortunately has been underappreciated.
When angina occurs at home, stop all activities, rest in the prone position, take heart pills, nitroglycerin, and oxygen if conditions allow. If you can’t get relief, go to the hospital for treatment as soon as possible.
Coronary heart disease is the most common disease causing sudden death, and all sudden deaths will have more or less precursor symptoms before they occur, such as chest tightness and shortness of breath during activities, so people who are at risk of coronary heart disease should draw attention to these conditions as soon as they occur.
(C) Stroke
What is a stroke? Stroke, also known as stroke, is an acute cerebrovascular disease. A hemorrhagic stroke, or brain hemorrhage, occurs when a cerebral arteriosclerosis ruptures and bleeds. Ischemic stroke, or cerebral infarction, occurs when the blood supply is blocked by a high degree of cerebral artery stenosis plus local thrombosis.
The manifestations of cerebral hemorrhage are: rapid onset, severe headache, hemiplegia, aphasia, slanting mouth and eyes, and in severe cases, coma and abnormal breathing soon; cerebral infarction often has a less rapid onset, dizziness and headache of varying severity, and also hemiplegia, aphasia and slanting mouth and eyes.
How to detect a stroke? The main thing is to be alert to early symptoms, such as intermittent unfavorable mouth and tongue, paroxysmal disorientation of the arms and legs, headache and violent fluctuations in blood pressure. Once these conditions appear, it is important to go to the hospital for brain imaging in time for early diagnosis. Once the stroke is diagnosed, the acute treatment must be carried out in the hospital.
When a sudden stroke occurs, how to perform home first aid? First of all, let the patient lie on his back, with his head and shoulders slightly padded and his head tilted to the side to avoid accidental inhalation when vomiting occurs; unbutton his clothes to make it easier to breathe; if there are dentures or vomit in his mouth, take them out as soon as possible; put a cold water bag or ice on his head, but put hot compresses on his limbs. At the same time, it should be sent to the hospital in time.
Third, how to prevent cardiovascular disease
To prevent cardiovascular diseases, we must first understand what causes so many cardiovascular diseases. Among the risk factors of cardiovascular diseases, one category is unchangeable, such as age, gender and genetic factors, which we cannot intervene yet. The other category is modifiable, including hypertension, hyperlipidemia, smoking, diabetes, obesity, lack of exercise, mental stress, poor diet (high salt, alcohol), etc., of which hypertension is the number one risk factor. The hazards of hypertension have been fully introduced earlier, and the hazards of other risk factors are highlighted here.
Hyperlipidemia is an abnormally high level of cholesterol and triglycerides in the blood, which can lead to systemic atherosclerosis, coronary heart disease, fatty liver, and severe high triglycerides can lead to pancreatitis. Smoking is even more harmful, it can increase coronary heart disease by 200%, cerebral infarction by 100%, cancer by 45%, and bronchitis, emphysema, pulmonary heart disease and respiratory failure are common to almost all long-term smokers. Obesity is defined as a body mass index [weight (kg) ÷ height (m)2] of 25 kg/m2 or more. Obese people are prone to hypertension, hyperlipidemia, coronary heart disease, diabetes and fatty liver.
How to prevent cardiovascular diseases? It is to prevent by targeting each risk factor. The better the risk factors are controlled, the lower the chances of getting the disease. These include: 1. adopting a healthy lifestyle; 2. controlling high blood pressure; 3. controlling high blood cholesterol; 4. controlling high blood sugar; and 5. losing weight. Here we mainly introduce the healthy lifestyle.
The so-called healthy lifestyle is the World Health Organization recommended “reasonable diet, appropriate exercise, quit smoking and limit alcohol, psychological balance” sixteen words declaration.
Reasonable diet refers to eating more fresh fruits and green vegetables, more high-protein foods such as fish, chicken, duck, milk, eggs and beans, etc.; proper control of staple foods, increase the amount of coarse grains, do not eat too much; salt <6g/day, less high-fat foods, such as fatty meat, animal offal, fish roe and chicken and duck skin, etc.
Appropriate exercise, refers to adhere to aerobic exercise, such as jogging, cycling, rhythmic exercises, etc., to exercise after the pulse increased by about 20 times / min, and can be recovered within 15-30 minutes shall not be excessive, each exercise 30 to 60 minutes, 3 to 4 times a week.
Quit smoking and limit alcohol, means that smoking should be completely quit as far as possible, wine can be consumed in small amounts, it is recommended that men should not consume more than 30 grams of alcohol per day, which is converted into wine is less than 3 taels, beer is less than half a pound ~ 1 pound, white wine is less than 0.5 ~ 1 tael; women are reduced by half on the basis of men. The World Health Organization’s new recommendation for drinking is: “Wine, the less the better!”
Mental balance means to maintain a good state of mind, to self-regulate and adapt to the environment, which is essential for longevity and is the “golden key” to health. Although this lifestyle recommended by the World Health Organization requires a lot of perseverance to practice, if it can be truly adhered to, it will reduce the occurrence of hypertension by 55%, stroke and coronary heart disease by 75%, diabetes by 50%, and tumors by 1/3, which will probably extend the average life expectancy of residents by more than 10 years, and is therefore worth promoting and practicing with great effort. This is also one of the basic methods to prevent and treat all cardiovascular diseases.
Adhering to a healthy lifestyle is the best feasible solution for the prevention of cardiovascular and cerebrovascular diseases.
Only when we understand cardiovascular diseases and pay attention to them can we understand how to prevent them, how to detect them, how to treat them and how to treat them. Those who are not affected by it can prevent it before it happens; those who are already experiencing it can deal with it properly to be safe.