Coronary heart disease, a widespread cardiovascular disease worldwide, affects the quality of life and life expectancy of millions of families. As a cardiologist, I am faced with not only complex heart disease cases every day, but also the life stories behind them and the hopes and worries of patients' families. In my career, I have come to realize that in addition to high-level medical procedures, proper medical treatment is essential to improve the prognosis and reduce the recurrence rate of patients with coronary heart disease.
I once had a particular case of a patient who was a retired principal who was brought to our hospital with chest pain. After a detailed examination, we confirmed that he had coronary heart disease. At the initial diagnosis, he was skeptical of any medication, believing that his life was already very healthy and that he did not need to rely on medication. However, after explaining in detail the principles of treatment of coronary heart disease and the important role of medications, he agreed to try the treatment options we recommended. By adhering to antiplatelet drugs, β-blockers, ACE inhibitors, statins, and nitrates, not only was his symptoms effectively controlled, but the results of several follow-up tests also showed significant improvement.
Treatment of coronary heart disease: the importance of antiplatelet agents
Coronary heart disease, a serious health problem caused by insufficient blood supply to the heart, poses a major threat to quality of life. Rational use of antiplatelet drugs is one of the key steps to control disease progression and improve prognosis.
Mechanism of action of antiplatelet drugs
The main role of antiplatelet drugs is to prevent platelet aggregation, thereby reducing the risk of thrombosis. This is crucial for people with coronary heart disease, as blood clots can block already narrowed coronary arteries, causing angina pectoris and even myocardial infarction.
Commonly used antiplatelet drugs
Aspirin: One of the most commonly used antiplatelet drugs that stops platelet aggregation by inhibiting cyclooxygenase in platelets, reducing the production of thromboxane. Usually, low-dose aspirin (75-100 mg per day) is sufficient to prevent cardiovascular events.
Clopidogrel: As a thienopyrimidine, clopidogrel reduces platelet activation and aggregation by irreversibly inhibiting ADP receptors on the platelet surface. It is often used in combination with aspirin in patients who cannot take aspirin or, in certain cases where dual antiplatelet therapy is required.
Suggestions for use
Before starting any antiplatelet therapy, patients should discuss their health condition with their doctor in detail, including any possible risk of bleeding or allergic reactions to the ingredients of the drug.
During treatment, regular check-ups are necessary to monitor the effect of the drug and adjust the treatment regimen in a timely manner.
Avoid self-discontinuation or dose changes, as abrupt discontinuation of antiplatelet agents may lead to serious thrombotic events.
The critical role of β-blockers in the treatment of coronary heart disease
β-blockers play a very important role in the treatment of patients with coronary heart disease. These drugs work primarily by slowing the heart rate, reducing the heart's workload, and lowering blood pressure, which can help reduce the amount of oxygen the heart needs and further protect the heart from angina or other complications caused by insufficient oxygen supply.
How does it work?
The main mechanism of β-blockers is to block adrenergic signaling, especially those that affect the heart. This blocking effect helps slow the rate of the heart and the force with which the heart contracts, so the heart needs less oxygen each time it beats. In addition, this drug can also indirectly lower blood pressure, further reducing the burden on the heart.
The main drug
Metoprolol and amolol are two common options when it comes to choosing β-blockers. Metoprolol is a non-selective β-blocker for a variety of heart conditions, including hypertension and angina. Amorolol is a selective beta-1 blocker that acts primarily on the heart and is used to treat high blood pressure, angina pectoris, and heart failure.
Precautions for use
Although β-blockers are very beneficial for people with coronary heart disease, there are a few things to keep in mind when using these medications:
Start with a small dose and gradually adjust to the optimal dose.
Monitor your heart rate and blood pressure to make sure the changes you bring about with your medication are within safe limits.
People with chronic obstructive pulmonary disease (COPD) and asthma need to use with caution because certain β-blocking agents may worsen these conditions.
Stopping the drug abruptly can lead to worsening of heart problems, so any decision about stopping the drug should be made in close cooperation with your doctor.
β-blockers are one of the core drugs in the management of coronary heart disease, and their correct use can significantly improve the treatment effect and reduce recurrence. However, each patient's specific situation is different, so the selection and adjustment of treatment should be done under the guidance of a doctor. This not only ensures the safety of the treatment, but also optimizes the outcome of the treatment according to the individual's health status.
The role of angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs) in the treatment of coronary heart disease
Angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs) play an indispensable role in the comprehensive management of coronary heart disease. These two classes of drugs are not only effective in controlling high blood pressure, but also help improve heart function and reduce the risk of cardiovascular events.
Angiotensin-converting enzyme inhibitors (ACE inhibitors)
ACE inhibitors block the production of angiotensin II by inhibiting the activity of angiotensin-converting enzyme, thereby lowering blood pressure and reducing the burden on the heart. Angiotensin II is a powerful vasoconstrictor substance that increases the heart's output to load and blood pressure. By reducing the production of this substance, ACE inhibitors help protect the heart and reduce the occurrence of cardiovascular complications.
Commonly used ACE inhibitors include enalapril, lamipril, and benazepril. These drugs are not only used in the treatment of hypertension, but are also commonly used in people with coronary heart disease, especially those who have experienced myocardial infarction, to improve their long-term prognosis.
Angiotensin receptor blockers (ARBs)
Similar to ACE inhibitors, ARBs also work by intervening in the angiotensin system, but with a slightly different mechanism. ARB directly blocks angiotensin II type 1 receptors and prevents angiotensin II from working, thereby helping to dilate blood vessels, lower blood pressure, and reduce the burden on the heart.
ARBs are commonly used in patients who cannot tolerate ACE inhibitors, such as those who discontinue ACE inhibitors due to cough or angioedema. Typical ARB drugs include locatelpril and irbesartan, among others.
The efficacy of these two classes of drugs in reducing the burden on the heart, improving cardiac function, and preventing cardiovascular events has been widely proven. Patients should use these medications under the guidance of a doctor to ensure safety and maximize efficacy.