Coronary heart disease, full name of coronary atherosclerotic heart disease, sometimes also called ischemic heart disease, refers to the heart disease caused by myocardial ischemia and hypoxia caused by coronary atherosclerosis.
1. Pathological characteristics of coronary heart disease
Its main features are: the deposition of lipids in the coronary arteries starts from the intima, followed by fibrous tissue proliferation and calcium deposition, which in turn causes thickening and hardening of the vessel wall, weakening of elasticity, narrowing of the lumen, and ultimately leads to ischemic degeneration of the heart.
2. Risk factors for coronary heart disease
(1) Hyperlipidemia. (2) High blood pressure. (3) Smoking. (4) Diabetes. (5) Others: such as age, obesity, long-term alcohol consumption, women after menopause, and patients with family history of hypertension and diabetes have a higher incidence rate.
3. Treatment of coronary heart disease
Mild coronary atherosclerosis is often treated with diet, and proper physical activity is required to avoid the risk factors for the occurrence and development of atherosclerosis, such as smoking; Actively treat related diseases, such as hypertension, diabetes, etc. Severe patients need to be treated with anti atherosclerosis drugs in addition to general therapy. In addition, surgical treatment, gene therapy, and other methods can also be used.
(1) Non pharmacological therapy: ① Reasonable diet: Limit calorie intake, emphasize low cholesterol and low animal fat diet;
② Increase physical activity and exercise: Physical activity and exercise are beneficial for the metabolism of fats and carbohydrates, helping to reduce weight and regulate blood lipids;
③ Maintaining psychological balance: With the accelerated pace of modern society and increasingly fierce competition, mental stress and inability to release stress can lead to long-term endocrine disorders, which can easily cause hypertension and heart disease;
④ Quitting smoking: relevant data show that the incidence rate of coronary heart disease in smokers is 1.6 times higher than that in non-smokers, and up to 25% of avoidable coronary heart disease deaths are related to smoking. Smoking is one of the main risk factors for coronary atherosclerosis.
(2) Drug therapy: Drug therapy must be carried out under the guidance of clinical doctors. The commonly used classic drugs for treating coronary heart disease mainly include the following categories: ① Statins, represented by the drug lovastatin. It plays its role mainly by inhibiting cholesterol synthesis, regulating endothelial function, anti platelet adhesion and aggregation, anti thrombosis, stabilizing atherosclerotic plaque, anti-oxidation, anti-inflammatory, inhibiting myocardial hypertrophy and other ways. ② Bile acid binding resin, represented by the drug colexanide (cholesteryl amine). It is an alkaline anion exchange resin that is insoluble in water and is not absorbed after entering the intestine. It firmly binds with bile acids, blocking their hepatic intestinal circulation and repeated utilization, thereby reducing cholesterol absorption.
③ Cholesterol absorption inhibitors, represented by the drug ezetimibe. Lowering cholesterol by blocking the exogenous absorption pathway of cholesterol. As an inhibitor of intestinal cholesterol absorption, ezetimibe can significantly reduce blood lipid levels when used in combination with statins, thereby improving coronary atherosclerosis.
④ Bete class, represented by drugs such as benzalbert and cyproterone. These drugs have the functions of regulating lipid, anti inflammation, reducing fibrinogen and some coagulation factors, improving insulin sensitivity, improving endothelial cell function, and preventing coronary atherosclerosis.
⑤ Niacins, represented by the drug Axiolimus. The therapeutic effect is mainly achieved by reducing extremely low-density lipoprotein, lowering plasma triglycerides, low-density lipoprotein cholesterol, etc.
⑥ Antioxidants, represented by the drug Probucol. The main mechanism of action of this type of drug is to block lipid peroxidation, reduce the production of lipid peroxides, and lower blood lipids, resulting in a decrease in cholesterol synthesis. When combined with statins or bile acid binding resins, it can enhance the lipid-lowering effect.
Coronary heart disease is one of the main diseases that threaten human health. Timely detection and early adherence to medical advice are crucial for the treatment and recovery of patients.