Heart disease and strokes often seem to occur suddenly and can be challenging to prevent. However, these cardiovascular diseases are not acute; they result from the “three highs”—high cholesterol, high blood pressure, and high blood sugar. Cardiology specialist Dr. Colin Yip-yin states: “Excessive blood pressure can damage the lining of blood vessels, leading to the accumulation of platelets at the damaged site for repair, or forming blood clots that can completely obstruct blood vessels, resulting in coronary heart disease or stroke.” For patients undergoing “Tongbo Tsai” surgery, the metal stent acts as a foreign object, potentially triggering the body’s coagulation mechanism, causing platelets to accumulate on the stent and block the blood vessels. Therefore, whether or not they have had surgery, patients who have experienced a heart attack or stroke need to take antiplatelet medications to reduce the risk of recurrence.
High cholesterol can block blood vessels. The underlying concept is that blood vessels are structured like onions, consisting of the intima, media, and adventitia. When cholesterol levels are elevated, it can accumulate between the intima and media, forming plaque that causes the blood vessels to narrow. Dr. Lin explains: “If the patient also has high blood pressure, there is a risk that the intima of the blood vessel may be damaged, leading to plaque rupture. In such cases, platelets may initiate the repair process and form a clot, transforming a blood vessel that was originally 90% blocked into one that is completely obstructed.”
“Tong Bo Zai” is merely a temporary solution
Conversely, some patients believe that undergoing “Tongbo Tsai” surgery will permanently resolve the issue of blood vessel blockage. However, surgery is not a definitive solution. Dr. Lin points out: “When a blood vessel is found to be blocked, other areas of the body, such as the lower limbs, kidneys, and even the cerebral vessels, may also be affected, so patients should not take their post-surgery care lightly.” Ignoring the underlying causes can lead to the worsening of these conditions and result in problems such as stroke or lower limb ischemia.
Additionally, after undergoing Tongbo Tsai surgery, the metal stent may trigger the coagulation process, causing platelets to adhere to the stent. Dr. Lin stated: “Therefore, patients also need to take antiplatelet drugs post-surgery to prevent the formation of blood clots and the blockage of blood vessels.” Studies indicate that patients with coronary heart disease who continue to use antiplatelet medications after surgery can reduce their chances of experiencing a recurrence by 30%.
Emergency “Tong Bo Zai” patients require dual medications for at least one year
How long should patients continue taking medication after surgery? Dr. Lin mentions that patients who have undergone emergency “Tongbo Tsai” surgery will experience thicker blood, and many individuals may suffer relapses within the first year following the procedure. Consequently, it is generally recommended that these patients take two types of antiplatelet drugs during the first year post-surgery. After one year, the medication can be reduced to one type. For patients undergoing non-urgent “Tongbo Tsai” surgery, they may consider a lighter stent to shorten the time it takes for cells to cover the stent, resulting in a reduced duration for taking two antiplatelet drugs, which can drop to at least one month.
Regardless of whether the patient has had surgery, they must continue taking antiplatelet medications, although long-term use may impose a financial burden on the patient.
Generic medications can help alleviate patients’ financial burden
Generally, what a pharmaceutical company invests in for research and development is the original drug, which only they can produce and sell while under patent rights. Once the patent expires, the formula for the drug becomes public knowledge, allowing other pharmaceutical companies to produce generic versions. The active ingredients, dosage, and frequency of use in generic drugs are the same as in the original drugs, and their effects are similar. However, the price difference can be as much as 8 to 10 times. Preventing cardiovascular disease is a long-term endeavor, and patients may be concerned about the financial implications of prolonged medication. Generic medications offer patients an additional option. As individual conditions vary, it is advisable for patients to consult with their doctors to develop a suitable treatment plan tailored to their needs.
The above information is provided by Dr. Lin Yixian
Cardiology specialist Dr. Lam Yat-yin
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<article itemscope itemtype="http://schema.org/Article">
<meta itemprop="headline" content="Understanding Heart Disease: Risk Factors, Surgery, and Treatment">
<meta itemprop="description" content="Explore the causes, symptoms, and treatment options for heart disease and stroke, including the importance of medications and the role of stents.">
<h1 itemprop="name">Understanding Heart Disease: Risk Factors, Surgery, and Treatment</h1>
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Heart disease and stroke seem to occur suddenly and are difficult to prevent. However, these cardiovascular diseases are not acute conditions; they stem largely from the "three highs" – high cholesterol, high blood pressure, and high blood sugar. According to cardiology specialist Dr. Colin Yip-yin, "Excessive blood pressure will damage the lining of blood vessels, causing platelets to accumulate at these damaged locations, or blood clots may form, completely blocking the blood vessels, leading to coronary heart disease or stroke."
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<h2>Understanding the Three Highs</h2>
<p>
- **High Cholesterol**: Excessive cholesterol can block blood vessels. The mechanism is akin to an onion with layers; blood vessels have an intima, media, and adventitia. Accumulations of cholesterol between the intima and media can form plaques, leading to narrow blood vessels.
- **High Blood Pressure**: It can damage the intima, causing the plaque to rupture. This rupture activates platelets, which may lead to blood clot formation and complete blockage.
- **High Blood Sugar**: High glucose levels can also contribute to vascular damage.
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<h2>"Tong Bo Zai": More Than Just Surgery</h2>
<p>
Some individuals mistakenly believe that undergoing "Tong Bo Zai" (angioplasty) solves their blood vessel blockage issues. Dr. Lin points out that when a blood vessel is identified as blocked, there is a high likelihood that other body areas, such as the lower limbs, kidneys, and even cerebral blood vessels, may also have lesions. Therefore, patients should remain vigilant after surgery. If the underlying causes are not seriously addressed, these lesions can worsen, leading to strokes or lower limb ischemia.
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<h2>Importance of Antiplatelet Medication</h2>
<p>
After “Tong Bo Zai” surgery, the presence of a metal stent, a foreign object, may trigger the body's coagulation mechanism. “Patients must continue taking antiplatelet medications after the surgery to prevent blood clots that could block blood vessels,” says Dr. Lin. Studies show that coronary heart disease patients who consistently take antiplatelet drugs post-surgery can reduce their recurrence rates by 30%.
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<h3>Dual Medication for Emergency Cases</h3>
<p>
For patients undergoing emergency "Tong Bo Zai" procedures, Dr. Lin recommends dual medication for at least one year, as these patients often exhibit thicker blood and a higher incidence of relapses within the first year. After one year, the dosage can usually be reduced to one medication. For non-urgent surgeries, lighter stents may be used, allowing for a shorter period of dual antiplatelet therapy.
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<h2>Financial Considerations in Long-Term Medication</h2>
<p>
Regardless of surgical intervention, chronic use of antiplatelet drugs may impose a financial burden on patients. Generally, initial pharmaceutical developments are costly, leading to patented original drugs. Once a patent expires, generic versions (sub-factory drugs) become available, costing significantly less—often 8 to 10 times the original price. While these sub-factory medicines offer an economical solution, it is crucial for patients to discuss their options with a healthcare provider to establish an effective and personalized treatment plan.
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<h3>Benefits of Antiplatelet Drugs</h3>
<ul>
<li>Reduces the risk of further heart attacks or strokes.</li>
<li>Helps keep blood vessels clear, improving overall cardiovascular health.</li>
<li>Minimizes the occurrence of blood clots.</li>
<li>Offers a cost-effective alternative with sub-factory medications.</li>
</ul>
<h2>Additional Tips for Preventing Heart Disease</h2>
<p>Combining medication with lifestyle changes can further reduce the risk of heart disease:</p>
<ul>
<li><strong>Maintain a Healthy Diet:</strong> Eat a balanced diet rich in fruits, vegetables, whole grains, and lean proteins while avoiding trans fats and excessive sodium.</li>
<li><strong>Stay Active:</strong> Engage in regular physical activity for at least 150 minutes per week.</li>
<li><strong>Control Blood Pressure:</strong> Monitor and manage blood pressure levels through lifestyle changes and medication if necessary.</li>
<li><strong>Avoid Smoking:</strong> Smoking is a significant risk factor for heart disease; quitting can reverse some of the damage caused.</li>
<li><strong>Manage Stress:</strong> Incorporate relaxation techniques such as yoga, meditation, or deep-breathing exercises.</li>
</ul>
<h2>Case Study: Moving Forward Post-Surgery</h2>
<p>
Consider the case of a 58-year-old male patient, Mr. Wong, who underwent “Tong Bo Zai” due to multiple arterial blockages. Post-surgery, he maintained a medication regimen, incorporating two antiplatelet drugs for the first year. He diligently monitored his diet and began a jogging routine. One year later, follow-up tests showed improved heart function and a decrease in plaque buildup, validating the importance of lifestyle changes alongside medication.
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<p>The above information is provided by Dr. Lin Yixian, a cardiology specialist who advises on the importance of understanding heart disease, its treatments, and preventive measures.</p>
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