◎ Zhang Ran Yue Shuai
Cardiovascular disease is the most common non-communicable disease in the world, causing nearly 18.6 million deaths each year, accounting for one-third of global deaths.
The prevention and treatment of cardiovascular disease is a social problem faced by all mankind.
In order to promote heart health knowledge to the public, the World Heart Federation established World Heart Day in 1999. September 29, 2022 is the 23rd World Heart Day. This year's theme is "One Heart", which aims to advocate the public to be more active and attentive. Focus on, disseminate and practice the concept of heart health.
The "China Cardiovascular Health and Disease Report 2021" shows that the morbidity and fatality rate of cardiovascular disease in my country still ranks first, with the number of cardiovascular patients reaching 330 million, and 2 out of every 5 deaths are due to cardiovascular disease.
The report pointed out that my country is facing the dual pressure of population aging and the continued prevalence of metabolic risk factors, and the burden of cardiovascular disease will continue to increase.
This year's World Heart Day advocates the health management of cardiovascular disease throughout the life cycle and raises the public's awareness of cardiovascular health.
Each of us is the first person in our own health. We should pay attention to the primary prevention of cardiovascular disease, develop a healthy lifestyle, comprehensively control the risk factors of cardiovascular disease, and prevent the occurrence of cardiovascular disease from the source; strengthen the secondary cardiovascular disease. Prevent, scientifically standardize the diagnosis and treatment of cardiovascular disease, and delay the development of cardiovascular disease from the process.
Develop a healthy lifestyle
Moderate exercise can effectively reduce cardiovascular morbidity and mortality.
Studies have shown that people who actively participate in sports have a lower risk of cardiovascular disease than people who are sedentary.
Experts recommend that adults combine aerobic exercise such as running and swimming with resistance exercise such as strength and equipment exercise to reduce sedentary time.
The current widely accepted aerobic exercise regimen is at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic exercise per week.
Smoking is harmful to health, and quitting smoking is the most effective way to prevent cardiovascular disease.
Studies have shown that persistent smoking is a major risk factor for adverse clinical outcomes in patients with recurrent myocardial infarction and revascularization; most smokers have a higher risk of death from cardiovascular disease than lung cancer, and cardiovascular disease may be at the beginning of the onset. lead to sudden death.
A healthy diet can reduce the risk of cardiovascular disease.
Experts recommend dietary adjustments to replace animal-based diets with plant-based ones to reduce cardiovascular risk.
In 2017, nearly 3 million people worldwide died from cardiovascular disease caused by insufficient intake of coarse grains and excessive intake of refined grains.
A fruit- and vegetable-based diet can effectively reduce metabolic risk factors including blood pressure, blood lipids, and insulin resistance.
Replacing common table salt with potassium salt was associated with a 13% lower risk of cardiovascular disease and an 11% lower risk of heart disease or stroke.
Adverse psychological states such as depression, anxiety, anger and mental stress are also related to the occurrence of cardiovascular disease.
Elevated mental stress increases the risk of coronary heart disease, and depression is associated with an increased risk of death from cardiovascular disease in adults, especially men.
Experts recommend psychological counseling and mental health care to improve stress symptoms and quality of life, and reduce the risk of cardiovascular disease.
Controlling cardiovascular risk factors
Long-term high blood pressure can lead to hardening of the arteries, increasing the risk of coronary heart disease and heart failure.
There was a positive correlation between blood pressure levels and the risk of cardiovascular events, with a relative risk of 1.35 for normal hypertension, 1.92 for grade 1 hypertension, and 3.15 for grade 2 hypertension. Lowering blood pressure significantly reduced the risk of cardiovascular disease.
Experts recommend better control of blood pressure through weight loss, a healthy diet, low salt intake, dietary potassium supplementation, increased physical activity, and limiting alcohol consumption.
Low-density lipoprotein cholesterol (LDL-C) plays a key role in atherosclerotic cardiovascular disease, and early intervention is recommended.
For people with existing atherosclerotic cardiovascular disease, the LDL-C target value is less than 1.4 mmol/L; for people without atherosclerotic cardiovascular disease but at high risk of cardiovascular disease, the LDLC target value is less than 1.8 mmol/L /Lift.
Studies have shown that hypercholesterolemia increases the risk of symptomatic aortic stenosis and that lowering LDL-C is beneficial in preventing aortic stenosis.
Being overweight increases the risk of cardiovascular disease.
Experts recommend preventing obesity in childhood, changing dietary habits, and setting realistic nutritional goals, such as controlling cholesterol, carbohydrate intake, and eating more yogurt, fruit, whole grains, beans, fish and nuts in moderation.
It is easier and more effective to prevent weight gain than to lose weight, and weight should be controlled within a normal and reasonable range (BMI < 25) through reasonable diet and exercise to avoid the occurrence of overweight and obesity.
Accept scientific and standardized secondary prevention treatment of cardiovascular disease
Primary prevention of cardiovascular disease can effectively delay or avoid the occurrence of cardiovascular disease, thereby reducing the incidence of cardiovascular disease.
On the basis of primary prevention, secondary prevention can reduce the recurrence and death of cardiovascular disease through long-term scientific and standardized diagnosis and treatment, improve the quality of life of patients with cardiovascular disease, and reduce the mortality and disability rate.
The field of cardiovascular disease is a model of evidence-based medicine research and practice. The evidence-based medicine evidence and diagnosis and treatment guidelines formed by a large number of randomized controlled trials have greatly improved the diagnosis and treatment of cardiovascular disease.
Secondary prevention of atherosclerotic cardiovascular disease includes comprehensive measures such as therapeutic lifestyle improvement, exercise rehabilitation, comprehensive prevention and control of cardiovascular risk factors, and drug treatment.
Cardiac rehabilitation is an important part of secondary prevention of cardiovascular disease and life-cycle health management.
Evidence-based medicine shows that scientific exercise rehabilitation training can improve cardiopulmonary function, improve quality of life, and reduce the incidence of adverse cardiovascular events. It has been recommended by the European Society of Cardiology and the American Heart Association as a standard secondary prevention program for cardiovascular disease.
Antiplatelet drugs (aspirin, clopidogrel or ticagrelor, etc.), lipid-lowering drugs (statins, ezetimibe or PCSK9 inhibitors), renin-angiotensin system inhibitors and beta-blockers Drugs and other drugs play an important role in improving the symptoms of atherosclerotic cardiovascular disease and delaying the progression of the disease.
(The author Zhang Ran is a professor of the Department of Cardiovascular Medicine of the Chinese People's Liberation Army General Hospital, a member of the Cardiovascular Branch of the Chinese Medical Association, and Yue Shuai is a master student of the Department of Cardiovascular Medicine of the Chinese People's Liberation Army General Hospital)