As soon as 65-year-old Uncle Xiao retired, he was diagnosed by doctors with hyperglycemia and hyperlipidemia and needed to take hypoglycemic and lipid-lowering drugs.
thought that the condition was under control, but unexpectedly, as time went by, Uncle Xiao felt increasingly tired, palpitations and shortness of breath.
After a detailed investigation, the doctor made a diagnosis that caught Uncle Xiao off guard - heart failure.
It turns out that long-term use of lipid-lowering and hypoglycemic drugs is likely to damage cardiovascular health.
Diabetes and hyperlipidemia can also increase the burden on the heart, leading to heart failure before you know it.
Heart failure sounds lofty, but it actually means that the heart is in decline and cannot pump blood effectively.
It can be divided into acute and chronic, with the latter being more common and causing symptoms such as fatigue and difficulty breathing.
In fact, many seemingly harmless drugs can also quietly damage the heart when used in large amounts over a long period of time.
1. "Life-saving medicine" harms the heart
Many elderly people regard NSAIDs as a "panacea", and they will take one pill if they feel unwell.
It is true that the anti-inflammatory and analgesic effects of ibuprofen and aspirin are very rapid, but long-term use in large amounts may secretly damage cardiovascular health.
The mechanism of these drugs is to inhibit cyclooxygenase to achieve anti-inflammatory and analgesic purposes. The problem is that they simultaneously inhibit normal vascular regulation, leading to edema and high blood pressure, increasing the burden on the heart.
I think that the "super painkiller" rofecoxib was removed from the shelves after 5 years on the market because of cardiovascular safety issues.
In fact, both ibuprofen and aspirin are non-selective cyclooxygenase inhibitors, meaning they inhibit both COX-1 and COX-2 enzymes.
However, the only enzyme that is really involved in the inflammatory response is COX-2, and non-selective inhibition of COX-1 may affect normal physiological functions.
Long-term use of large amounts of non-steroidal anti-inflammatory drugs may lead to disruption of the balance between vasodilation and contraction, edema and increased blood pressure, and increase the burden on the heart.
Some studies have shown that long-term use of NSAIDs increases the risk of cardiovascular disease.
In fact, the medical community began to pay attention to the effects of non-steroidal anti-inflammatory drugs on the cardiovascular system as early as the 90s of the last century.
A well-known study found that Parkinson's patients who took ibuprofen for a long time had a significantly higher risk of cardiovascular events.
In 1999, rofecoxib, the first new drug that only inhibits COX-2, entered the market, and because it does not affect COX-1, its gastrointestinal response is small, and it has attracted attention for a while.
However, subsequent VIGOR studies found that rofecoxib was more likely to increase the incidence of cardiovascular disease than non-selective drugs.
In 2004, due to doubts about cardiovascular safety, rofecoxib had to be discontinued worldwide. This incident became an important turning point in the medical community's attention to the cardiovascular effects of NSAIDs.
Research on the cardiovascular safety of NSAIDs is ongoing. In addition to this, long-term use of statin lipid-lowering drugs may also harm heart health.
Statins reduce cholesterol synthesis by inhibiting the activity of HMG-CoA reductase and are the mainstay of drugs for the treatment of hyperlipidemia.
However, HMG-CoA reductase is also involved in the synthesis of CoQ10 in vivo. Long-term use of statins may lower levels of CoQ10.
Coenzyme Q10 is important for heart function and is a key substance for cardiomyocytes to achieve aerobic respiration.
Coenzyme Q10 deficiency will directly weaken the energy supply of heart muscle cells, resulting in decreased cardiac function.
Some studies have shown that long-term use of statins increases the risk of myocarditis and myocardial fibrosis.
Therefore, it is necessary to supplement with coenzyme Q10PAREN while using such drugs.
It can be seen that both NSAIDs and statins have the potential to "harm" the heart through different pathways, which is a wake-up call for a large number of long-term users.
We must recognize that all drugs have two sides, and that drugs can only be used correctly and rationally in order to maximize their therapeutic effects.
2. Commonly used antihypertensive drugs and hypoglycemic drugs
Antihypertensive drugs and hypoglycemic drugs are commonly used to treat cardiovascular disease, but they are like a double-edged sword, when used in the right amount, the condition can be improved, and when the dose is excessive, it can make the heart worse.
β blockers are an important class of antihypertensive drugs, which lower blood pressure by slowing the heart rate and reducing the contractility of the heart.
However, long-term use may weaken heart muscle function, leading to an increased risk of heart failure.
I think of an old gentleman who insisted on taking β blockers for a long time to control blood pressure, but unfortunately he was diagnosed with heart failure during a physical examination.
This leads us to reflect on the long-term risks of β blockers.
In fact, the mechanism by which overuse of β blockers affects the heart is that it blocks the heart's beta-1 receptors.
Beta-1 receptors are the most dominant receptor subtype of the heart, and activating it can enhance myocardial contractility and heart rate.
Inhibition of the action of beta-1 receptors by β blockers may directly lead to a decrease in cardiac output.
In addition, β receptors are also involved in cardiovascular self-regulation.
Long-term blockade of β receptor signaling weakens cardiovascular response and makes it more difficult for the heart to adapt to various physiological changes.
This is one of the reasons why β blockers may increase the risk of heart failure.
Another commonly used class of calcium channel blockers also has side effects. It affects the ability of the cardiovascular system to self-regulate, making the heart more fragile and at risk of heart attack and heart failure.
It has been reported that an elderly lady who has been taking calcium channel blockers for nearly 10 years has experienced frequent heart palpitations in recent years, and imaging tests have shown that her heart function has begun to decline.
Calcium channel blockers lower blood pressure and stabilize heart rhythm by inhibiting L-type calcium channels. However, long-term use will affect the sensitivity of the myocardium to changes in calcium ions and weaken the contractility of the myocardium.
At the same time, it may also affect the calcium signal dependent on vasodilation, impairing the ability of coronary arteries to regulate blood flow. All of this can lead to an increased risk of heart failure.
In addition, sulfonylureas commonly used in diabetic patients are also of concern. These drugs have a strong hypoglycemic effect, but they are also more likely to cause recurrent hypoglycemia.
According to an 8-year study in the United Kingdom, compared with other hypoglycemic drugs, patients who have been taking sulfonylureas for a long time are more likely to develop cardiovascular problems such as arrhythmias.
This is mainly due to the strong effect of sulfonylureas in stimulating insulin secretion, which can easily lead to a rapid drop in blood sugar, and repeated hypoglycemia can overstrain and stress the cardiovascular system.
If you stay in this state for a long time, eventually the heart will also fail.
It can be seen that the side effects of antihypertensive drugs and hypoglycemic drugs that are usually taken as "palliative medicines" also need to be vigilant.
It is hoped that the majority of patients should maintain good communication with doctors while taking medicine, pay attention to the body's reaction, and achieve safe medication.
3. Use prescription drugs under the guidance of a doctor
Many prescription drugs with significant efficacy, long-term use in large quantities, may have a negative impact on heart function and increase the risk of serious diseases such as heart failure.
There is no doubt that prescription drugs help control chronic diseases and improve quality of life in older adults.
But at the same time, we should also be wary of their potential side effects, and should not overdose for a long time, let alone increase or decrease the dosage on our own.
Rational use of drugs requires the joint efforts of both doctors and patients. On the one hand, the majority of patients should be patient in the process of taking medicine, actively communicate their feelings with the doctor, and conduct re-examinations on time.
On the other hand, doctors should also fully consider the overall condition of the patient and adjust the medication regimen according to the efficacy of the drug to ensure maximum treatment and prevent side effects.
For patients, rational use of drugs first needs to enhance health awareness and realize the importance of drug treatment.
Many older people see medication as a means to relieve symptoms, rather than as the key to controlling their condition. This attitude needs to be changed.
Secondly, patients should also develop a good Xi of regular follow-up visits and examinations. During the course of taking the medicine, report any discomfort or abnormal reaction to the doctor at any time.
Regular check-ups can help your doctor evaluate the effectiveness and side effects of your medications and adjust your treatment accordingly.
Patients should improve their compliance and take medication correctly according to the doctor's instructions. The dose cannot be changed or discontinued randomly, nor can the drug be repeated for a long time.
It is important to adhere to ongoing treatment, which requires the understanding and cooperation of the patient.
On the physician's side, the most important thing is to thoroughly assess the patient's condition, especially the concomitant medications. Understand other chronic diseases and medications to avoid interactions.
At the same time, it is necessary to consider factors such as the patient's lifestyle to develop a personalized treatment plan.
In follow-up treatment, doctors should strengthen monitoring and follow up the progress of the disease.
Adjust the dosage according to symptoms and examination results in a timely manner to maximize the achievement of treatment goals. In addition, it is necessary to strengthen the popularization of science and improve patients' awareness of drug treatment.
Only by working closely with doctors and patients can the great value of prescription drugs be maximized while minimizing their potential risks.
epilogue
Older people should be aware of the importance of drug treatment, but at the same time, they should be wary of the duality of drugs. Rational use of drugs requires the attention and cooperation of both doctors and patients.
The majority of patients should enhance their health awareness and maintain good communication with doctors; Doctors need to develop personalized treatment plans and strengthen monitoring and adjustment.
Improve medication adherence, adhere to treatment, and pay attention to the body's response and seek medical attention in a timely manner.
Only in this way can prescription drugs exert the maximum therapeutic effect, so that we can stay away from the infestation of diseases and live a healthy life.