To effectively prevent and control diseases, correct understanding is the first step. Too many truths, listening to it many times is not not to understand, is not to believe... The following content is shared with those who are still "stuck in the pit"!
There are 4 major misunderstandings in the use of hypertension
Myth 1
It is a three-point poison of medicine, and it can not be eaten without eating
All drugs must be verified by a series of clinical trials before they are officially listed, and their safety and efficacy can be fully observed in healthy people and patients.
The harm of adverse reactions from taking antihypertensive drugs is far lower than the harm of myocardial infarction and cerebral infarction caused by high blood pressure!
The real horror is not antihypertensive drugs, but a series of adverse consequences of high blood pressure!
Therefore, it is recommended that patients take antihypertensive drugs regularly according to the doctor's instructions, even if there is a possible adverse drug reaction, they should inform the doctor in time, adjust the medication, and do not stop the drug on their own.
Myth two
Take medicine only if you have symptoms
Hypertension is called "silent killer" because most patients do not have any symptoms, but the increase in blood pressure, the harm to cardiovascular and cerebrovascular diseases is persistent, or need to be actively treated, can not be based on the symptoms of whether to decide whether to take medication.
One of the principles of treatment of hypertension is long-term stable blood pressure reduction, if you take medicine for a while and do not eat for a while, resulting in a large fluctuation in blood pressure, which is extremely unfavorable to patients.
Myth three
Antihypertensive drugs are dependent
When you start eating, you have to eat for a lifetime
Medication for hypertension is indeed long-term, unless there is a clear cause of hypertension (such as increased blood pressure due to renal vascular stenosis, etc.). Essential hypertension is impossible to cure, and it is the best treatment to take lifelong medication to control blood pressure at the ideal level and minimize the possibility of complications.
This is not "drug dependence", but the patient himself must adhere to long-term treatment because of high blood pressure to ensure that blood pressure is maintained within the normal range.
But not a day can not stop, such as summer weather hot, vasodilation, coupled with a lot of sweating, blood volume decline, blood pressure levels may be appropriately reduced, antihypertensive drugs can be reduced according to blood pressure levels or discontinued for a period of time; winter weather is cold, vasoconstriction, blood pressure rises, to increase the drug in time.
Therefore, attention should be paid to monitoring blood pressure, regular visits, and adjustment of medication.
Myth four
Short-acting antihypertensive drugs are good and can quickly lower blood pressure
Some patients are very nervous when there is an occasional sudden increase in blood pressure, such as systolic blood pressure exceeding 200 mmHg, and often want to take rapid antihypertensive drugs to lower blood pressure as soon as possible, such as sublingual nifedipine tablets.
In fact, this may be dangerous for patients and should be contraindicated, because when taking nifedipine tablets under the tongue, the drug is directly absorbed into the blood through the sublingual vein, and the blood concentration increases rapidly, which may lead to a sharp drop in blood pressure in a short period of time, and some patients may have symptoms such as insufficient cerebral blood supply, such as sudden fainting, which is very dangerous.
A sudden and sharp rise in blood pressure, especially with obvious symptoms, should be consulted as soon as possible.
If different diseases are combined, the strategy of antihypertensive therapy is different, and it is not safe to use drugs at home!
4 major misunderstandings of cardiac stents
Strenuous exercise stents could fall off?
Many patients have misunderstandings after stent surgery, one is to feel that the disease is better, improper, casual exercise; the second is that there is a heavy psychological burden, cautious and cautious, basically do not exercise.
Moderate exercise is beneficial for patients with coronary heart disease, can improve blood circulation, increase the strength of muscles and bones, and can also promote the regeneration of heart vessels and improve cardiopulmonary function.
The timing of exercise is mainly related to the patient's clinical situation, such as whether it is an acute myocardial infarction, the state of cardiac function, and whether there are serious complications during the perioperative period.
If physical conditions permit, exercise should be started as soon as possible, and it is recommended that aerobic exercise (swimming, walking, jogging, cycling, playing tai chi, etc.) be gradual and not overworked.
Chest tightness, chest pain, shortness of breath, and fatigue in the course of exercise and exercise should be stopped immediately. Exercise plate experiments can be done to scientifically assess cardiopulmonary function, determine the maximum safe amount of exercise for different patients, and then exercise step by step.
Will the bracket fall off? The brackets are made of stainless steel alloy material, which has strong support and corrosion resistance, and will not rust and collapse. The high pressure given during the intraoperative balloon expansion stent makes the stent tightly embedded in the coronary wall, and the stent will gradually be covered by the vascular lining after implantation in the human body, becoming part of the vascular wall, just like the wall of reinforced concrete: the stent is a reinforced steel, the vascular wall is equivalent to concrete, the two are integrated, and can no longer be taken out.
Therefore, the activity will not affect the stent and will not loosen the displacement.
After putting the stent, I had to take medicine for the rest of my life
Atherosclerosis is a systemic disorder that is the underlying cause of narrowing of blood vessels.
Many patients believe that the symptoms of coronary heart disease after stent surgery have disappeared, the disease will be cured, and it does not matter whether to take medicine or not.
Not really!
The stent solves the most severe narrowing of the coronary vein, but only relieves the physical narrowing of the coronary arteries, and the arteriosclerosis lesion is not eliminated, and the coronary heart disease itself needs to take medicine for life.
The purpose of taking medicine is twofold, one is to prevent re-narrowing at the stent, and the other is to prevent the re-aggravation of arteriosclerosis in other parts and the appearance of new arteriosclerosis in normal blood vessels.
In addition, patients with myocardial infarction also need to take drugs that inhibit cardiac remodeling, prevent and treat heart failure, improve poor lifestyles (healthy lifestyles include smoking cessation, alcohol restriction, healthy diet, moderate regular exercise, etc.), control blood pressure, blood lipids and blood glucose and other risk factors, including antiplatelet drugs, β blockers, angiotensin-converting enzyme inhibitors or angiotensin II receptor antagonists, and lipid-adjusting drugs. Most medications require lifelong medication.
After the stent, the medicine really can't be stopped!
Antiplatelet drugs
To prevent stent thrombosis after stent surgery, the drug cannot be stopped casually. There are mainly aspirin, clopidogrel, tigrelor, etc., aspirin is taken for life, clopidogrel or tigrelor can generally be discontinued after taking 1 year (according to medical advice).
Lipid-adjusting drugs
Mainly refers to statins, which are very important for preventing the progression of atherosclerosis and need to be taken for life after stenting. There are mainly atorvastatin, rosuvastatin, simvastatin, pravastatin, lovastatin, fluvastatin, and pitvastatin.
β receptor blockers
Drugs that protect the heart, anti-angina also have a hypotensive effect, generally need to take medicine for life. There are mainly metoprolol, bisoprolol and so on. Attention needs to be paid to heart rate and blood pressure, and a slow or low blood pressure requires consultation with a doctor. β patients with receptor blocker intolerance or poor efficacy may be treated in combination with ivabradine to control heart rate.
ACEI/ARB classes
Angiotensin-converting enzyme inhibitors (ACE Inhibitors) or Angiotensin Receptor Antagonists (ARBs) are drugs that protect heart function and have a hypotensive effect, even in patients without hypertension if they have a myocardial infarction, they can also be taken in small doses, with the aim of improving prognosis and inhibiting cardiac remodeling and deformation.
Angiotensin-converting enzyme inhibitors are also predicaments, mainly inzepril, perdopril, etc.; angiotensin II receptor antagonists are also sartans, mainly valsartan, irbesartan and the like.
Patients with concomitant heart failure can be prioritized with sakubatridan to improve remodeling anti-heart failure therapy based on renal function and blood pressure tolerance.
Nitrates
For example, isosorbide mononitrate dilates coronary arteries to improve circulation, and the nitrate-like drug nicodil improves microcirculation, which is effective for suspected microcirculation angina.
Stents have a lifespan, can only be managed for a few years?
There is no such thing as a term of expiration date or service life after stent implantation, but if you do not pay attention to medication, lifestyle improvement, and risk factor control after surgery, the risk of intrastental restenosis increases.
Specific can be used for several years, mainly depending on the postoperative patient's own situation, if there is no regular treatment after surgery, poor lifestyle has not changed, stent re-stenosis or stent thrombosis may occur soon, and re-intervention is required for treatment.
If the compliance is good, the medication is taken on time, and the stent is used for a relatively long time.
There are also a small number of patients whose compliance is very good, and may still have stent narrowing due to personal constitution, at this time, the blood vessel can be opened again by cutting balloons and drug balloons; it is also possible to restore the blood supply to the distal end of the blocked blood vessels by surgical bypass.
Can't do MRI after putting the stent?
This is a cliché.
At present, the main material for making coronary stents is alloy materials such as titanium, nickel, cobalt and chromium, which are weak magnetic or non-magnetic materials, and non-magnetic materials will not be forced in the magnetic field, nor will there be a thermal effect caused by the magnetic field. Weak magnetic materials will be forced and heated up in the magnetic field, but the temperature will not exceed 1 ° C, and there is no effect on the human body.
Therefore, the consensus of medical experts recommends that for weak magnetic stents, there is no problem with MRI after 6 to 8 weeks of implantation.
The consensus states that almost all of the product specifications for coronary stents on the market state the safety of magnetic resonance examination. Except for early peripheral arterial stents (prior to 2007) where magnetic weakness may be present, all other stent products, including all coronary stents, are safe on mrivisiology at ≤3.0 T.
4 big myths about aspirin
Is it a risk assessment by a professional doctor?
In many clinical trials, it has been found that many patients will start taking aspirin on their own to prevent the occurrence of various cardiovascular and cerebrovascular diseases.
But in fact, taking aspirin requires evaluation by a professional doctor.
Heart disease or stroke risk depends on a variety of known and unknown factors. If the risk assessment of heart disease and stroke is inaccurate, it may not be appropriate to use aspirin to prevent heart disease and stroke. Of course, if it is deactivated, it cannot be deactivated at will, and it also needs to be professionally evaluated.
Taking aspirin, do you have a history of taking medication?
When a patient presents with another medical condition, a history of taking aspirin should be explained to the doctor because of its interactions with other drugs.
More commonly, if surgery is to be performed during this time, the additional risks of surgery should be known. Because aspirin has an anticoagulant effect, it increases the risk of bleeding from surgery.
For a common procedure, the doctor will advise the patient to stop taking aspirin for at least several days before the operation, examination, or tooth extraction. If surgery is emergency, the time necessary for the operation needs to be re-evaluated.
Is aspirin a "panacea"?
Although aspirin is now a common drug in the cardiovascular field, do not forget that its appearance was first used for antipyretic and analgesic. Aspirin plays a large role in the field of disease health, including antipyretic, pain relief, and in recent years, studies have pointed out that aspirin has anti-cancer effects, so sometimes its effect is exaggerated.
But aspirin is not a panacea, not a panacea. In terms of heart disease and stroke prevention, maintaining a healthy lifestyle is more important than taking aspirin, rather than simply taking medication to sit back and relax and avoid cardiovascular and cerebrovascular diseases.
Suspect a heart attack, eat quickly, can save your life?
Aspirin is rumored on the Internet to be one of the three life-saving treasures at the bedside, and all people who suspect a heart attack need to take aspirin immediately to save their lives. Is it really so magical?
Patients with coronary heart disease have acute onset of angina, and nitroglycerin first aid is preferred.
Quick-acting heart-saving pills do not have nitroglycerin to act quickly. When there is no nitroglycerin, angina attacks, can be used to save the heart pills emergency.
When a myocardial infarction occurs, quick-acting heart-saving pills and nitroglycerin are useless, and aspirin may be useful, but first call the emergency phone to listen to the doctor's guidance.
In the event of a myocardial infarction, aspirin can quickly inhibit platelet aggregation and has a certain effect on delaying the development of the disease. In the case of myocardial infarction, taking aspirin can reduce mortality by 20% to 30%.
Guidelines recommend that if a myocardial infarction is suspected, emergency care should be called immediately, along with taking aspirin. However, non-professionals lack the knowledge of distinguishing heart disease, gastrointestinal diseases or aortic dissection conditions to take aspirin is harmful, it is recommended to call first aid when a heart attack is suspected, and use medication under the guidance of a doctor.
China Medical Tribune Small Circle Finishing
References (can be viewed by swiping up and down)
1. Practical Guidelines for Comprehensive Management of Primary Cardiovascular Diseases 2020[J]. Chinese Journal of Frontiers in Medicine (Electronic Edition), 2020.
2. 2019 Application of Aspirin in primary prevention of cardiovascular disease In China Expert Consensus Writing Group. 2019 Aspirin application in the primary prevention of cardiovascular disease Chinese expert consensus. Chinese Journal of Cardiovascular Diseases (online version). 2019; 2:e1-e5(2019-08-19).
3. Cardiovascular and Cerebrovascular Disease Professional Committee of Chinese Gerontology Society, Cardiovascular Disease Professional Committee of Chinese Rehabilitation Society, Inquiry Medical Professional Committee of Chinese Medical Doctor Association. Clinical manual of aspirin antithrombotic therapy. Chinese Journal of General Practitioners. 2015; 14(12):908-917.
4. Norms for the management of hypolipidemia at the grassroots level. Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Vol. 21, No. 2, April 2021.
5. Guidelines for the Primary Diagnosis and Treatment of Chest Pain (Practical Edition · 2019). Chinese Journal of General Practitioners, Vol. 18, No. 10, October 2019.
6. Cardiovascular Disease Branch of Chinese Medical Association. Consensus of Chinese experts on the clinical application of bioresorbable scaffolds in coronary arteries. Chinese Journal of Cardiovascular Diseases, 2020, 48 (05): 350-358.
7. Jingyitong. Who can save lives with the miracle medicine "quick-acting heart-saving pills" and "nitroglycerin"?
8. China Medical Tribune Today Cycle. 10 truths about scaffolding.
Disclaimer: WuXi AppTec's content team focuses on the global biomedical health research process. This article is for informational purposes only and the views expressed herein do not represent the position of WuXi AppTec, nor do they represent WuXi AppTec's support for or opposition to the views expressed herein. This article is also not recommended for treatment options. For guidance on treatment options, please visit a regular hospital.
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