Can people with coronary heart disease treat angina pectoris by taking statins and aspirin?

A friend left a message to Huazi saying that he has coronary heart disease and has been taking statins and aspirin. Can these drugs treat coronary heart disease and prevent angina pectoris? Is it necessary to do other treatments?

Huazi told him that he had a wrong understanding of the effects of drugs. People with coronary heart disease need 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 occurrence of angina pectoris, you need to use drugs that reduce the heart's oxygen consumption.

1. 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. The arterial lumen becomes narrow, so that the blood supply capacity decreases, resulting in myocardial cells not getting enough blood and oxygen, decreased heart function, and symptoms of chest tightness, chest pain, difficulty breathing and angina pectoris.

The diagnosis of coronary heart disease is based on 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 angina symptoms, and it is called coronary atherosclerotic heart disease (abbreviated as coronary heart disease).

2. The role of statins and aspirin The main danger of coronary heart disease is not the narrowing of the coronary arteries, but the rupture of atherosclerotic plaques in the arteries. When plaques rupture, they will induce platelets to aggregate and form thrombi, completely blocking the arteries and causing myocardial infarction, which is a very dangerous condition.

The main function of statins is to lower the level of low-density lipoprotein cholesterol (LDL-C) in the blood. Studies have confirmed that when the LDL-C level is reduced to below 1.8mmol/L, the LDL-C that has entered the arterial intima will return to the blood and be transported back to the liver for decomposition. Therefore, patients with coronary heart disease need to control LDL-C below 1.8mmol/L for a long time.

Statins can also promote the metabolism of the arterial lining, and have anti-inflammatory and anti-oxidative effects. Long-term use can reverse plaques, reduce the size of plaques, reduce the degree of coronary artery stenosis, and increase plaque stability, making them less likely to rupture. So far, no other drug can replace the reversal effect of statins on atherosclerotic plaques.

Although statins can stabilize plaques, people with coronary heart disease still have a greater risk of plaque rupture. Therefore, aspirin is also needed to inhibit platelets. In the event of plaque rupture, the inhibited platelets will not aggregate, which can prevent the formation of blood clots and avoid the occurrence of myocardial infarction.

3. To prevent and treat angina pectoris, it is necessary to reduce the oxygen consumption of the heart. The main purpose of long-term use of statins and aspirin is to prevent the occurrence of myocardial infarction. However, it has no therapeutic effect on the common angina pectoris symptoms of coronary heart disease. The occurrence of angina pectoris is related to cardiac ischemia and hypoxia, so the prevention and treatment of angina pectoris needs to start from two aspects: one is "increasing revenue" and the other is "reducing expenditure".

"Open source" means reducing the degree of coronary artery stenosis and improving blood and oxygen supply. In the long term, the use of statins can reverse atherosclerotic plaques, reduce the degree of coronary artery stenosis, and improve coronary artery blood supply, but it cannot prevent short-term symptoms. Or balloons, stents, bypass grafts and other treatments can be used to improve blood supply.

"Throttling" means to find ways to reduce the oxygen consumption of the heart. Commonly used drugs include nitrates, lorals, dihydrotestosterone, nicorandil and other drugs, which can reduce the heart load and reduce the heart's oxygen consumption, and prevent and treat angina pectoris. In addition to taking medicine, you should also pay attention to avoiding strenuous exercise, overwork, and overeating in your daily life, which can also avoid inducing angina pectoris.

In summary, people with coronary heart disease use statins and aspirin to delay the progression of the disease and prevent myocardial infarction, but they cannot prevent or treat angina pectoris. To prevent and treat angina pectoris caused by coronary heart disease, multi-drug combination therapy is needed to reduce cardiac oxygen consumption. Drugs must be used under the guidance of a doctor. If you have any questions about medication, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.