1.Sudden cardiac death is a sudden natural death caused by heart. Sudden cardiac death is the most common cause of sudden death, and sudden coronary heart disease is the most common cause of sudden cardiac death (at least 80% of sudden cardiac death). About 550,000 sudden cardiac deaths occur each year in China. With the aging of the population, the improvement of living standards and the acceleration of work pace and psychological pressure, the morbidity and mortality rate of coronary heart disease in China is increasing year by year, and there is a trend of rejuvenation. About 30-60% of the deaths of coronary heart disease patients are sudden deaths. Many patients have some aura before sudden death, but they fail to attract enough attention of patients and primary care doctors to take immediate treatment behaviors and interventions, which leads to tragedies. In recent years, our government has made great efforts to develop community health work and achieved remarkable results. Community medical personnel are facing many patients with coronary heart disease, and strengthening the management of coronary heart disease in the community is the key to prevent and treat sudden coronary death. The authors summarize the methods of community management of coronary heart disease from the following aspects. 2. Methods of community management of coronary heart disease (1) Publicity and education of the whole population of the community on the scientific knowledge of coronary heart disease The purpose of the publicity and education of the whole population on the scientific knowledge of coronary heart disease is to reduce the risk factors of coronary heart disease in the population and advocate to start from children to develop healthy living behavior habits. In the past 10 years, the number of obese children in China has increased by 50%, and some children even suffer from hypertension, diabetes, coronary heart disease and other adult diseases, so it is urgent to promote health education and popular knowledge for all people. (2) Management of coronary heart disease patients All patients with diagnosed coronary heart disease and high-risk patients should establish health records and follow-up mechanisms, stratify the risk of each patient according to the guidelines, and strengthen lifestyle interventions for individuals. The person in charge of follow-up can be a doctor, an experienced nurse or public health staff. (3) Emphasize that smoking cessation is a high-risk factor for coronary heart disease. At present, the domestic public is still far from being aware of the dangers of smoking, and the smoking rate has risen substantially since the 1970s. Since the health hazards of smoking will only become apparent after 20 years, smoking will still exert enormous pressure on the prevention and treatment of coronary heart disease in the future. In addition to education, strict legal requirements and enforcement are essential to reduce smoking rates. (4) Advocate effective and safe exercise at least 3-5 times a week for 20-30 minutes each time. Effective and safe exercise can improve cardiac function and can improve hypertension, hyperlipidemia, and hyperglycemia. However, we should pay attention to the safety of exercise, take aerobic exercise, heart rate should be controlled below 65% of the maximum heart rate, excessive exercise may induce sudden death. Patients who have had a serious coronary event should be rehabilitated by exercise under the guidance of a professional doctor. (5) Reasonable diet and control of alcohol intake encourage patients to have small and frequent meals, eat more vegetables and fruits (ensure 500 g per day), eat less sweets and less salt, eat mainly vegetable oil, eat less or no animal oil and offal, etc. Pay attention to good drinking habits (especially pay attention to drinking a glass of warm water before going to bed, drinking a glass of warm water when waking up at night and drinking a glass of warm water in the morning), and pay special attention to keeping bowel movement smooth. If you have a drinking habit, try to persuade them to stop drinking, at least to control the daily intake of alcohol below 25 grams. (6) Pay attention to psychological adjustment, stable emotions The development of coronary heart disease is closely related to a variety of psychosocial factors, and some studies have found that negative emotions are independent risk factors for coronary heart disease. Therefore, community medical personnel should pay attention to psychological intervention for patients with coronary heart disease, strengthen communication and exchange with patients, eliminate fear, guide patients to treat the disease with a positive attitude and good emotion, and help establish confidence to overcome the disease. (7) Supervise adherence to medication and regular review Coronary heart disease mostly coexists with hyperlipidemia, hypertension and diabetes, and often requires lifelong medication. It is very important to improve patients’ adherence to medication, which is especially important for preventing sudden death in young and middle-aged patients. Community physicians should intensively supervise the implementation of medication treatment plans according to the specific conditions of patients to avoid wrong and missed medications. Regular monitoring of blood glucose, lipids, blood pressure and body weight is also recommended. Patients with stable conditions are advised to visit the community once a month for review and 3-6 months for biochemical indexes. (8) Publicity and education on precipitating factors of sudden coronary heart disease. Patients with coronary heart disease often have precipitating factors before sudden death occurs, and community health workers are obliged to make each coronary heart disease patient under their management familiar with these precipitating factors and try to avoid them. Common precipitating factors include: excessive satiety, excessive alcohol consumption, overexcitement, exertion, constipation (forceful defecation), smoking, and violent fluctuations in blood pressure. (10) Education of family members of patients with coronary heart disease Good family environment and harmonious relationship are beneficial to the recovery of patients with coronary heart disease. The solution of lifestyle problems such as smoking and high-fat diet requires the active cooperation of family members. The services provided by community physicians are whole-person care, including the use of knowledge of family dynamics and interpersonal relationships to serve the family. Families of patients with coronary heart disease should be taught the basics of resuscitating sudden death, especially that chest compressions can buy time for emergency personnel to arrive at the scene and save the lives of patients with sudden death,. 3.Strengthen the training of community doctors to improve the ability to predict sudden death of coronary heart disease and comprehensive intervention The work of community doctors (i.e. general practitioners) highlights patient-centered, family-based and community-based comprehensive health care, and should play the role of the main force in the management of patients with coronary heart disease. The management of patients with coronary heart disease focuses on the community. Strengthening the training of community doctors and improving their ability to predict sudden coronary heart disease and comprehensive intervention can effectively prevent sudden death. Community doctors should pay attention to patients’ unusual angina pectoris, pay attention to arrhythmias such as consecutive pre-term contractions and ventricular tachycardia, pay attention to electrocardiogram changes, implement intensive lipid-lowering treatment programs, and control blood sugar and blood pressure. Reasonable application of beta-blockers to achieve adequate doses tolerated by patients. 4.Strengthen the construction of community and large hospital consortium to ensure smooth two-way referral of coronary heart disease patients Sudden death prevention and treatment of coronary heart disease focuses on early detection, early treatment and long-term management, which requires the establishment of a good two-way referral mechanism between the community and large hospitals, with stable coronary heart disease patients returning to the community and timely transfer to large hospitals for changes in condition. Community doctors implement secondary prevention measures under the guidance of experts from large hospitals. Only when large hospitals and communities form a consortium and general practitioners and specialists form a team, can we better manage patients with coronary heart disease and reduce the incidence of sudden death.