A friend left a message to Huazi, saying that he had coronary heart disease, had been taking statins and aspirin, could he treat coronary heart disease and prevent angina, and did not need to do other treatments?
Hanako told him that his understanding of the drug's effects was incorrect, and that people with coronary heart disease needed to take statins and aspirin, not to alleviate the symptoms of coronary heart disease, but to prevent myocardial infarction. If you want to reduce the incidence of angina, you need to use a combination of drugs that reduce the oxygen consumption of the heart.
First, what is coronary heart disease?
What we call coronary heart disease refers to the atherosclerosis of the coronary arteries that supply blood to the heart, and the lumen of the arteries becomes narrow, so that the blood supply capacity decreases, resulting in the lack of adequate blood and oxygen from the heart muscle cells, the decline of heart function, chest tightness, chest pain, dyspnea and symptoms of angina.
The diagnosis of coronary heart disease is divided by the degree of coronary artery stenosis.
If the degree of coronary artery stenosis does not exceed 50%, it is called coronary atherosclerosis, and there are usually no obvious symptoms at this time, but there will be abnormal manifestations through electrocardiogram, coronary angiography and other examination methods. When the coronary artery stenosis exceeds 50%, it is easy to have obvious symptoms of angina, which is called coronary atherosclerotic heart disease (referred to as coronary heart disease).
Second, the role of statins and aspirin
The main danger of coronary heart disease is not that the coronary artery blood vessels become narrowed, but that the atherosclerotic plaques in the arteries are prone to rupture. Because when the plaque is broken, it will induce platelets to gather to form blood clots, completely block the arteries, resulting in myocardial infarction, and the condition is very dangerous.
The main role of statins is to reduce the level of low-density lipoprotein cholesterol (LDL-C) in the blood, and studies have confirmed that when the LDL-C level is reduced to less than 1.8mmol/L, the LDL-C that has entered the arterial lining will be returned to the blood and 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 endarterial metabolism, anti-inflammatory, antioxidant, long-term use can reverse plaque, so that plaque volume reduction, reduce the degree of coronary artery stenosis, and can increase plaque stability, become less prone to rupture. So far, the reversing effect of statins on atherosclerotic plaques has not been replaced by other drugs.
Although statins can stabilize plaque, people with coronary heart disease still have a greater risk of plaque rupture. Therefore, it is also necessary to use aspirin to inhibit platelets. In the unlikely event of plaque rupture, the suppressed platelets do not aggregate, preventing the formation of thrombuses and avoiding myocardial infarction.
Third, the prevention and treatment of angina should reduce the oxygen consumption of the heart
Long-term use of statins and aspirin is mainly aimed at preventing the occurrence of myocardial infarction. However, there is no therapeutic effect on the common symptoms of angina in coronary heart disease. The occurrence of angina is related to cardiac ischemia and hypoxia, so the prevention and treatment of angina needs to start from two aspects, one is "open source" and the other is "throttling".
"Open source" refers to reducing the degree of coronary artery stenosis and improving blood and oxygen supply. In the long run, statin use can reverse atherosclerotic plaque, reduce the degree of coronary artery stenosis, and improve the blood supply to the coronary arteries, but it does not prevent short-term symptoms. Or use treatments such as balloons, stents, and bypasses to improve blood supply.
"Throttling" is to find a way to reduce the oxygen consumption of the heart, commonly used nitrate drugs, lore drugs, horizon drugs, nicodel and other drugs, reduce the workload of the heart, reduce the oxygen consumption of the heart, can prevent and treat angina. In addition to medication, you should also pay attention to avoid strenuous exercise, do not overwork, do not overweight, and avoid inducing angina.
To sum up, people with coronary heart disease use statins and aspirin to delay the progression of the disease, prevent the occurrence of myocardial infarction, and do not prevent angina. The prevention and treatment of coronary heart disease angina requires multi-drug combination therapy to reduce the oxygen consumption of the heart. Medications should be used under the guidance of a doctor, if you have any doubts about medication, please consult a doctor or pharmacist. I am a pharmacist Huazi, welcome to follow me and share more health knowledge.