A friend left a message to Hua Zi, saying that he has coronary heart disease and has been taking statins and aspirin. Is it possible to treat coronary heart disease and prevent angina pectoris, and whether other treatments are needed? ?
Hua Zi told him that his understanding of the effect of drugs was wrong, and that people with coronary heart disease need to take statins and aspirin, not to relieve the symptoms of coronary heart disease, but to prevent Myocardial infarction occurred. If you want to reduce the occurrence of angina pectoris, you need to use drugs that reduce the oxygen consumption of the heart.
One, what is coronary heart disease?
By coronary heart disease, we mean atherosclerosis of the coronary arteries that supply blood to the heart, narrowing the lumen of the arteries to such an extent that they cannot supply blood Decreased, resulting in insufficient blood and oxygen for myocardial cells, decreased heart function, chest tightness, chest pain, difficulty breathing, and angina pectoris symptoms.
The diagnosis of coronary heart disease is based on the degree of coronary stenosis.
If the degree of coronary stenosis does not exceed 50%, it is called coronary atherosclerosis. At this time, there are usually no obvious symptoms, but through ECG, coronary angiography and other examination methods, there will be abnormal performance. When coronary artery stenosis exceeds 50%, obvious symptoms of angina pectoris are likely to occur, which is called coronary atherosclerotic heart disease (referred to as coronary heart disease).
The role of statins and aspirin
The main risk of coronary heart disease is not the narrowing of the coronary arteries, but the tendency of the atherosclerotic plaques in the arteries to rupture. Because when the plaque ruptures, it will induce platelet aggregation to form a thrombus, completely blocking the artery, causing myocardial infarction, and the condition is very dangerous.
The main effect of statins is to reduce the level of low-density lipoprotein cholesterol (LDL-C) in the blood. Studies have confirmed that when the level of LDL-C is reduced to 1.8mmol/L At the following times, the LDL-C that has entered the arterial intima will return to the blood and be transported back to the liver for decomposition, so Patients with coronary heart disease need to control LDL-C below 1.8mmol/L for a long time .
Statins can also promote arterial intima metabolism, anti-inflammatory, antioxidant, long-term use can reverse plaque, reduce plaque volume, reduce coronary stenosis, and increase plaque Block stability, becomes less prone to collapse. So far, there is no other drug that can replace statins’ reversal effect on atherosclerotic plaque.
Although statins stabilize plaques, people with coronary heart disease are still at greater risk of plaque rupture. Therefore, it is necessary to use aspirin to inhibit platelets. In the event of plaque rupture, the inhibited platelets will not aggregate, which can prevent thrombosis and prevent myocardial infarction.
Three, the prevention and treatment of angina pectoris should reduce the oxygen consumption of the heart
Long-term use of statins and aspirin is primarily aimed at preventing myocardial infarction. However, there is no therapeutic effect on angina pectoris, a common symptom of coronary heart disease. The occurrence of angina pectoris is related to cardiac ischemia and hypoxia, so the prevention and treatment of angina pectoris needs to start from two aspects, one is “open source”, and the other is “throttling”.
“Open source” refers to reducing coronary stenosis and improving blood and oxygen supply. In the long term, the use of statins can reverse atherosclerotic plaque, reduce the degree of coronary stenosis, and improve coronary blood supply, but cannot prevent short-term symptoms. Or use balloons, stents, bypasses and other treatments to improve blood supply.
“Throttling” is to find a way to reduce the oxygen consumption of the heart, commonly used nitrates, lorols, dipines, Cordil and other drugs can reduce the load on the heart and reduce the oxygen consumption of the heart, which can prevent and treat angina pectoris. In addition to medication, you should also pay attention to avoiding strenuous exercise, overexertion, and overeating. You can also avoid inducing angina pectoris.
To sum up, people with coronary heart disease use statins and aspirin to delay the progression of the disease and prevent the occurrence of myocardial infarction, but cannot prevent angina pectoris. Prevention and treatment of coronary heart disease angina pectoris requires multi-drug combination therapy to reduce cardiac oxygen consumption. The medicine should be used under the guidance of a doctor. If you have any doubts about the medicine, please consult your doctor or pharmacist. I am Huazi, a pharmacist. Welcome to follow me and share more health knowledge.