A comprehensive prevention strategy for coronary heart disease: from risk factor identification and tiered prevention programs to the "ABCDE" secondary intervention guidelines.

(4) Hypertension is a trigger for angina attacks. Increased blood pressure increases the workload on the heart and myocardial oxygen consumption, leading to an imbalance between myocardial oxygen demand and supply, thereby inducing and aggravating angina. (5) Some antihypertensive drugs can cause increased blood sugar and blood lipids, and decreased blood potassium and blood magnesium, leading to atherosclerosis.

Section 2 Prevention of Coronary Artery Disease (CHD) Coronary artery disease (CHD) is a heart disease caused by fixed (atherosclerosis) or dynamic (vasospasm) narrowing or blockage of the coronary arteries, leading to coronary circulation disorders and an imbalance between myocardial oxygen supply and demand, resulting in myocardial ischemia, hypoxia, or necrosis. It is also known as ischemic heart disease. The incidence and severity of CHD increase with age. Data shows that starting from age 40, the incidence of CHD doubles for every 10-year increase in age. After age 50 for men and age 60 for women, coronary artery sclerosis develops rapidly, and the risk of myocardial infarction also increases with age. Due to its high incidence and mortality, CHD seriously endangers human health and is thus known as the "number one killer of mankind." The World Health Organization classifies CHD as follows: primary cardiac arrest, angina pectoris, myocardial infarction, heart failure in ischemic heart disease, and arrhythmia.

I. Risk Factors for Coronary Heart Disease Who is prone to coronary heart disease? Epidemiological surveys have revealed the following factors related to the onset of coronary heart disease, which are called risk factors or predisposing factors for coronary heart disease. (1) Age: Coronary heart disease is a common disease among middle-aged and elderly people and is closely related to age. It usually occurs after the age of 40, and the incidence rate increases by about 10 times for every 10 years of age increase. The degree of coronary atherosclerosis increases with age. (2) Gender: Coronary heart disease is more common in men, with a male-to-female ratio of approximately (2-5):1. (3) Genetic factors: Genetic factors may cause metabolic defects, leading to hyperlipidemia, intimal damage, obesity, hypertension, etc., all of which promote the formation of atherosclerosis and trigger coronary heart disease. (4) Weight: Many studies have shown that obese people are prone to coronary heart disease. (5) Hyperlipidemia: Population studies have also shown that people with high blood lipids have a high incidence of coronary heart disease. In particular, those with high cholesterol and low-density lipoprotein levels have a high incidence of coronary heart disease, showing a positive correlation. (6) Hypertension: The incidence of coronary heart disease in hypertensive patients is 2 to 3 times higher than in people with normal blood pressure. Hypertension increases intravascular pressure, damaging the intima, and can accelerate plasma entry into the blood vessel wall, thereby promoting the deposition of plasma lipids in the intima and accelerating the formation of atherosclerosis. (7) Smoking: It is now widely recognized that smoking has adverse effects on the cardiovascular system. It is the third largest risk factor for coronary heart disease, after hyperlipidemia and hypertension.

II. Prevention First: Blocking the Early Onset and Development of Coronary Heart Disease (CHD) CHD is the leading cause of death worldwide, directly threatening individual safety, family stability, and social harmony and development. Approximately one in three adults over 18 years of age is associated with cardiovascular disease. One of the most serious harms of CHD is sudden cardiac death. Discovering and researching the sub-health state of cardiovascular disease is crucial for early detection and prevention of myocardial ischemia, which is the fundamental way to completely overcome CHD and its harms. Cardiovascular disease remains rampant in my country and worldwide, becoming a serious social problem. While focusing on the diagnosis and treatment of CHD, special attention should be paid to actively preventing the sub-health state of cardiovascular disease. Helping individuals identify their individual and unique causes of the disease, providing timely advice, and assisting them in adjusting their lifestyle and work habits, along with appropriate medication as needed, will help them return to a healthy track as quickly as possible. Only in this way can they be free from the torment of cardiovascular disease and work healthily for 50 years. We advocate hard work, not overwork. From a long-term perspective, sacrificing one's health for short-term, temporary results may not be as valuable as the results achieved through healthy and efficient work.

(I) Echocardiography is an important means of detecting early coronary heart disease. The fundamental direction of medical reform is to gradually shift from a medical model that passively waits for patients to come to the clinic to a medical model focused on prevention and health maintenance, truly realizing the medical policy of prevention first. Echocardiography is a highly recommended method. Animal experiments have confirmed that when coronary blood flow is completely blocked, echocardiography can detect the earliest abnormal wall motion, earlier than electrocardiogram findings, and even earlier than the animal's pain response. This sensitive method has been confirmed in long-term practice. Any symptoms related to the heart, such as precordial tightness, shortness of breath, palpitations, and wheezing, can be seen on echocardiography with corresponding abnormal wall motion and/or blood flow. To prevent the occurrence and development of coronary heart disease, echocardiography may be one of the most effective diagnostic tools for early diagnosis. However, facing the devastating effects of coronary heart disease and sudden cardiac death, our common goal is to use all methods to cut off the path of early occurrence and development of coronary heart disease. Any minor deformation or abnormal motion of the heart should be included in the discussion. Echocardiography can fully display every corner of the heart and even the smallest lesions on the screen, making them easy for people to identify.

(II) Establishing a virtuous cycle of employee health monitoring, healthcare, and prevention. We should strive to rationally use limited medical resources for monitoring people's health status, disease prevention, healthcare, and wellness, guiding individuals and organizations to enter a virtuous cycle model based on the principle of preventive healthcare. All aspects of clinical medicine should strive to achieve a virtuous cycle medical model with prevention as the main focus. Such a virtuous model should include the following characteristics and indicators: (1) The total medical resources per unit time should be lower than in the same period in the past. (2) Everyone truly enjoys the practical attention of healthcare. The incidence rate should be significantly reduced, the age of onset should be delayed, and the overall condition of the patient population should be alleviated (including a significant reduction in the rate of sudden cardiac death). (3) Everyone should establish the concept of prevention and healthcare first and put it into action. Establish personal health records so that everyone is aware of their health status and consciously adjusts their life and work status at any time. (4) Establish trust between doctors and patients and form a green channel for disease prevention and treatment.