How to treat myocardial ischemia and low blood pressure, and what should we pay attention to?

The rhythmic beating of the heart forms the contraction and relaxation phases of the human heart function. So how should we treat myocardial ischemia and low blood pressure in our daily life? What should we pay attention to in case of myocardial ischemia?

Drug treatment

Since the mechanism of myocardial ischemia is mainly the imbalance between the supply and demand of myocardial blood (blood oxygen), the treatment of myocardial ischemia is nothing more than increasing the myocardial oxygen supply and/or reducing the myocardial oxygen consumption, so as to restore the balance between the supply and demand of myocardial oxygen.

1. Antiplatelet drugs prevent and treat thrombosis, prevent coronary and cerebral artery thromboembolism, and reduce the risk of myocardial infarction, stroke, and cardiovascular death in patients with stable angina. If there are no contraindications, they should be taken for a long time. Commonly used drugs include aspirin, clopidogrel, etc.

2. β-receptor blockers can slow down heart rate, reduce myocardial oxygen consumption, and prevent sudden death, such as metoprolol or its sustained-release tablets. β-receptor blockers are the first choice for stable angina pectoris. They can complement each other when used in combination with nitrates. Generally, they should be started with a small dose and adjusted according to the treatment response and heart rate changes.

3. Calcium ion antagonists can inhibit myocardial contraction, reduce myocardial oxygen consumption, dilate coronary arteries, relieve coronary artery spasms, and improve myocardial blood supply. Commonly used drugs include verapamil, nifedipine, etc.

4. Statins can lower cholesterol in plasma, stabilize arterial plaques, and prevent plaque detachment and thrombus formation, such as atorvastatin and rosuvastatin.

5. RAS (renin-angiotensin-aldosterone system) system blockers can prevent ventricular remodeling and improve cardiac function, such as benazepril and valsartan.

6. Nitrate drugs dilate coronary arteries and increase myocardial blood supply, such as isosorbide mononitrate.

7. Thrombolytic drugs dissolve acutely formed blood clots and are used for acute myocardial infarction.

What should I pay attention to in case of myocardial ischemia?

1. Quit smoking and limit alcohol consumption. Smoking promotes and aggravates arteriosclerosis and causes coronary vasospasm, so smoking should be quit; ethanol <30ml/day, equivalent to 720ml of beer.

2. Low-salt diet. Less than 6 grams per day. Excessive salt intake can cause sodium retention, increase blood pressure, increase heart burden and myocardial oxygen consumption.

3. Low fat intake. High fat can accelerate arteriosclerosis. For patients with coronary heart disease and myocardial ischemia, the goal of lipid-lowering is: according to my country's "Recommendations for the Prevention and Treatment of Abnormal Blood Lipids", cholesterol should be reduced to below 4.7, triglycerides should be reduced to below 1.7, and low-density lipoprotein should be reduced to below 2.6.

4. Pay attention to rest and avoid fatigue. Avoid mental tension and stimulation, especially when you have acute ischemic symptoms such as angina. For those with stable myocardial ischemia, appropriate activities such as brisk walking, jogging, Tai Chi, etc. can enhance cardiovascular and cerebrovascular functions, improve blood supply, and promote recovery.

5. Do not eat too much to avoid increasing the burden on the heart. Pay attention to keep warm to avoid triggering coronary artery spasm.