Drug treatment of coronary heart disease

Clinical coronary heart disease can be divided into five types, of which less serious symptoms, the more common for clinical occult coronary heart disease and angina of coronary heart disease. Occult coronary heart disease, simply said conventional ECG or exercise test, a 24-hour Holter ST-T performance of myocardial ischemia, but no clinical consciously do not apply the so-called "normal"; angina of coronary heart disease, is Coronary insufficiency, cardiac sharp, temporary and hypoxia ischemia caused by the syndrome. Clinical manifestations of paroxysmal the left front, the rear is sternum-crushing pain, or pressure, sometimes accompanied by Fang Shetong Zhixin former district. About half of conventional ECG in the normal range, and can also have ST-segment and T-wave abnormalities. The occult-type coronary heart disease and angina, most scholars that the medical drug treatment, below the respective interpretations of drug use and use. (1) β-receptor blockers, such as metoprolol, atenolol, each 1/4-1 tablet (6.25 mg -25 mg), 1-2 daily. This is mainly to reduce myocardial oxygen consumption, increased exercise tolerance, so as to improve angina, heart rate slowed down because, as well as extended time diastolic blood pressure dropped after the load to reduce tension and improve the wall, which makes subendocardial myocardial blood A corresponding increase in flow, from both the supply and demand to improve myocardial ischemia. The main side effect is bradycardia or block. (2) nitrates, such as long-acting nitroglycerin or isosorbide dinitrate (isosorbide dinitrate) 1 (10 mg), three times a day, or 5 - single-nitro-isosorbide, Isoket or Lunan Xinkang 1 (20 mg), 1-2 times a day, their long serum half-life, high bioavailability, the role of sustainable more than eight hours. Such as Germany-clock, different music will generally be a daily. The basic role of such drugs is a direct relaxation of vascular smooth muscle. Since the expansion of the veins around the effort to reduce traffic, reduce the load left ventricle, thereby reducing myocardial oxygen consumption, improve angina. And in recent years has confirmed that such drugs on the coronary lesions have a significant expansion of the role, but also expansion of collateral circulation to increase blood flow to the ischemic region, the nitrates angina have a good effect. Particularly acute, as long as the clothes 1-2 sublingual nitroglycerin tablets quick-impact class or isosorbide dinitrate, 2-4 minutes from the effect of nitroglycerin oral spray, spray after 15-30 seconds from the Xiao ,3-four minutes of the peak, can be maintained 1-2 hours. Isosorbide dinitrate skin spray, 30 seconds -1 hour from the efficiency, efficacy can be maintained 12 hours. The role of nitrates alleviate angina is complete, rather than part of. The side effects of nitrates is mainly headache, dizziness, and so on. (3) calcium antagonist, diltiazem formulations, Yier heart, He Xin Shuang, an oral (30 mg), three times a day, and its main role is to make vascular smooth muscle and coronary artery expansion and increase coronary blood Anti-flow and coronary spasm. Its side effect was not obvious, few people have bradycardia. (4) anti-platelet drug accumulation of large-scale clinical trial has proved that aspirin is effective in the anti-thrombosis drugs, usually sleep that night when blood flow slow, prone to thrombosis disease, and aspirin shorter half-life , Only 15-20 minutes, so many people believe that taking aspirin before bed more effectively. Under normal circumstances, gastric emptying for 4-6 hours, although the enteric-coated aspirin does not directly damage gastric mucosa, but broken down into salicylic acid in the body after the gastrointestinal mucosa there are still injury, because aspirin in The suppression of thromboxane also affect the prostate-Central Synthesis, weakening the latter on the protective effects of gastric mucosa. Aspirin the half-life is short, but its effective role in sustainable anticoagulant 24 hours. Therefore, daily breakfast after the service more effective and safe. What is more noteworthy is that aspirin be used low-dose anticoagulant, 50-100 mg per day (1-2 tablets), medium and large doses of aspirin despite anticoagulation, but the vascular endothelial function Have very adverse effects, and is mainly used in clinical antipyretic, analgesic, anti-rheumatism. (5) myocardial metabolism of drugs: vasoel 20 milligrams, three times a day, can regulate energy metabolism, reducing myocardial oxygen consumption, promoting aerobic myocardial ischemic new balance between supply and demand, to achieve anti-angina, In recent years, anti-angina drugs. (6) stable plaque drugs: statin drugs like Simvastatin, Lipitor, to be suitable, its role is hypolipidemic, it also stable or eliminate plaque and reduce vascular thrombosis in white Role. Mainly at night because of lipid synthesis in the liver, the use of such drugs to the evening, one night, each 10 to 20 mg (1). Its side effect is a transient aminotransferase increased. (7) of proprietary Chinese medicines: Fufang Danshen Diwan, coronary Danshen Diwan 5-10 tablets, three times a day, the Austrian Culture and Sport an effort, three times a day, Wei Aoxin two, three times a day . Suxiao Jiuxin pill, generally only in angina attack as a first-aid treatment, the tablets are each 3-10. Such drugs are promoting blood circulation, blood and qi, the pain, pain relief and care for vascular, microcirculation and clear the coronary circulation, it can relieve chest tightness to ease the angina attack. If a stomach ulcer disease, should not be selected with the Effect of Fufangdanshendiwan borneol, and these drugs are not long-term personal clothes placed in the pocket as a result of some essential medicines and lead to decline in effect, or even disappear. Several types of drugs can be combined with, but only similar to the election of a drug, plus optional 1-2 category of proprietary Chinese medicines category. Tian Seoul heart, β-blockers should not be the general use, for use of small doses. A small number of drug treatment can not alleviate angina, subject to the percutaneous transluminal coronary angioplasty (PTCA) or coronary stent, or aorta - such as coronary artery bypass grafting. Against coronary heart disease risk factors, such as cholesterol-lowering and controlling high blood pressure, diabetes and smoking cessation, weight reduction, regular exercise, all the prevention and treatment of angina pectoris useful.