Life-saving Guide: Don't let Web3's "high-frequency trading" deplete your irreplaceable heart

Author: Sequoia Capital China

Quick Highlights

• This is a heart health action guide tailored for entrepreneurs: from risk identification, self-assessment, daily prevention, to emergency response, systematically covering the most essential heart health knowledge for founders.

• Entrepreneurs’ daily lives are inherently a high-risk list: long-term high stress, sleep deprivation, overwork, and neglect of traditional risk factors—these are often not incidental but structurally coexisting.

• One often-overlooked item in health check packages: slight elevation of troponin levels, which indicates high risk even without symptoms of acute heart disease.

• “I’m still young” and “I exercise regularly” can be false senses of security: many sudden problems are unpredictable, and most cardiac arrests occur in “low-risk groups”; exercise is good, but excessive and anaerobic activity may trigger hidden heart issues.

• In case of sudden heart attack, the first step is to call 120: emergency services are equipped with devices and medical staff to start treatment en route.

Why entrepreneurs?

Data shows that in China, about 1 million new cases of heart attack occur each year, with the incidence among those under 50 continuing to rise. Due to long-term high stress, sleep deprivation, and overwork, entrepreneurs are among the highest-risk groups. Therefore, we’ve compiled a heart health action guide for entrepreneurs: from risk recognition, self-testing, daily prevention, to emergency rescue, hoping to help you in your entrepreneurial journey.

1. Long-term high stress: Cortisol quietly damages your blood vessels

Stress isn’t just emotional exhaustion. Persistent psychological pressure causes long-term elevation of cortisol, which directly damages the endothelium and accelerates atherosclerosis—one of the core pathological mechanisms of heart disease. Entrepreneurs face unprecedented sustained high pressure: funding stress, market competition, team management… These pressures don’t disappear after a successful pitch or impressive data; they are structural and long-lasting.

2. Sleep deprivation: Less sleep, more heart burden

Sleeping less than 6 hours daily leads to sustained blood pressure elevation, increasing risks to the heart and brain, and significantly raising mortality risk. Studies also point out that working over 13 hours a day is a critical threshold to watch out for.

3. Overwork: Not just a metaphor, but a medical diagnosis

“Overwork death” sounds like a sociological concept, but its real killer is heart disease. People with vascular or coronary artery disease, under continuous high stress and fatigue, can experience rapid blood pressure spikes, interrupted coronary blood flow, and sudden death.

4. Traditional risk factors: Amplified in entrepreneurs

Smoking, hypertension, high cholesterol, diabetes—decades of research confirm these four as the core triggers of heart disease. Among entrepreneurs, these factors are often neglected due to “being too busy,” and by the time they are noticed, it’s rarely just one issue.

How is your heart doing now?

When was your last check-up? Two years ago? Three? Or can you not remember? Being busy is the most common excuse. But the heart doesn’t pause its changes just because you’re busy.

Must-Check Items in a Health Exam

Health check packages vary widely. Which ones truly matter for the heart? Here’s a core list summarized by multiple professional organizations, with reference values.

■ Basic Blood Tests

• Lipids (Total Cholesterol, LDL-C, HDL-C, Triglycerides): LDL-C is the most critical—patients with coronary artery disease should keep it below 1.8 mmol/L. If they’ve had two or more acute heart attacks within a year, or have hypertension, diabetes, or smoking habits, aim for below 1.4 mmol/L.

• Blood Glucose (Fasting Blood Sugar + HbA1c): HbA1c reflects average blood sugar over 2–3 months. Diabetics should control it below 7%. Fasting blood sugar should be between 4.4–7 mmol/L.

• Blood Pressure: Target <140/90 mmHg; those with diabetes or kidney disease should aim for <130/80 mmHg.

■ Cardiac Structure

• ECG (Routine + Holter Monitoring): Normal ECG doesn’t mean no coronary disease. Atherosclerosis can’t be seen on ECG; Holter monitoring records 24 hours of heart rhythm, capturing intermittent arrhythmias.

• Echocardiogram: Assesses heart structure and function, especially if ECG shows abnormalities.

■ Body Metrics

• BMI: Keep between 18.5–23.9 kg/m²; waist circumference for men <90cm, women <85cm. Abdominal obesity poses a more direct threat to the heart than weight alone.

■ The Most Important Marker: Troponin

The BMJ published a large-scale study involving over 250,000 patients, finding that even slight elevation of troponin—without symptoms of acute heart disease—increases death risk in 18–29-year-olds by over 10 times. Previously, troponin testing was mainly for emergency diagnosis of heart attacks, but new research shows its value in early risk screening.

If you have a family history of heart disease, long-term high stress, or other abnormal findings in your check-up, proactively ask your doctor to test troponin. Those with family history or existing abnormalities can further consult whether to undergo coronary CT, angiography, cardiac MRI, or electrophysiological studies.

Self-Assessment for Daily Risk Recognition

While annual check-ups provide a snapshot, the heart operates in real-time. Here are some self-monitoring methods recommended by the American Heart Association.

■ Smartwatches:

The lowest threshold for heart rate monitoring

Smartwatches supporting heart rate tracking can continuously record resting and active heart rates, alerting when deviations occur. For entrepreneurs, this is the most accessible tool to sense heart health. Some devices now support blood oxygen monitoring and arrhythmia alerts—don’t ignore abnormal signals; get a formal ECG check.

■ Blood Pressure Monitors:

Should be at home

Regularly measure resting pulse and blood pressure to monitor heart health. Affordable and easy to operate, measure once in the morning; the readings tell you your current status.

■ Self-Check List:

Signs not to ignore

Any of these symptoms warrants serious attention, especially for men over 35:

• Unexplained dizziness, blackouts, especially after exertion;

• Chest tightness, cold sweat, lasting over several minutes, not relieved by rest;

• Shortness of breath, easier to get winded doing usual activities;

• Palpitations, irregular or rapid heartbeat.

You can also do a quick self-evaluation:

• Sleep less than 7 hours daily?

• Feel anxious or tense more than 3 days a week?

• Sit for over 90 minutes continuously?

• Skip exercise for over 2 weeks, citing “no time”?

• Rely on caffeine or energy drinks to keep going?

• Haven’t fully relaxed or rested for over 3 months?

• Feel constantly fatigued, even after rest?

If you answer “yes” to more than 3 items, your cardiovascular risk is significantly higher than normal.

How to Protect Your Heart Daily?

Knowing the risks and what to check is awareness. But awareness must translate into action. This section discusses what entrepreneurs can do in daily life. Start with understanding, because several misconceptions can cause your brain to filter out good habits.

Misconception 1:

“I exercise often, so I’m safe”

Exercise isn’t wrong, but it’s not a talisman. Overly intense exercise itself is a risk factor. Serious exercise-related complications, including myocardial infarction and sudden cardiac death, increase with intensity, frequency, and duration. Many sudden deaths occur in “low-risk” groups—so don’t assume you’re invincible just because you exercise.

Exercise is protective, but only if moderate, aerobic, and gradual. High-intensity anaerobic workouts may be the last straw for a heart with hidden vascular issues.

Misconception 2:

“I’m still young, these don’t concern me”

Recent statistics from the Chinese Journal of Cardiovascular Diseases show over a million new heart attacks annually, with rising rates among under-50s. “Young” is becoming a false sense of security. Heart damage is a long-term process; hidden risks in your 30s may manifest by your 40s.

Misconception 3:

“Heart attacks always have warning signs”

Not necessarily. Sudden cardiac death often has no warning. Even heart attacks can present atypically—elderly may just feel fatigue or dizziness; diabetics may have no symptoms at all, known as “silent MI.” Relying on “feelings” to judge your safety is a dangerous gamble.

Make these into habits:

■ Exercise:

At least 150 minutes of moderate aerobic activity weekly

Most cardiovascular guidelines recommend at least 150 minutes of moderate-intensity aerobic exercise per week—brisk walking, jogging, swimming, cycling, gradually increasing intensity. Remember: avoid high-intensity anaerobic activities like sprints, heavy lifting, or HIIT if you have risk factors. Those without diagnosis but with multiple risks should consider a stress test before high-intensity training.

■ Diet:

Two key practices

No need to overhaul your diet completely. Focus on two effective actions:

• Reduce salt intake: less than 5g daily (about a capful of beer). High salt intake directly raises blood pressure, a core risk factor.

• Increase dietary fiber: over 25g daily—vegetables (300–500g), fruits (200–350g), whole grains (50–150g). Most people consume far less than this.

■ Sleep:

6 hours is the minimum, not the goal

Less than 6 hours of sleep daily raises blood pressure and heart burden. “6 hours” is a safety baseline, not a point of pride. If sleep duration is hard to meet, at least ensure quality: fixed sleep and wake times, avoid screens an hour before bed.

These three—exercise, diet, sleep—serve the same purpose: reducing chronic inflammation and cardiovascular wear. Doing any one of them extends your heart’s lifespan.

■ Quit smoking and limit alcohol:

More challenging than expected, but worth it

Tobacco damages the heart directly and continuously; secondhand smoke does too. For alcohol, limit to ≤25g/day for men, ≤15g/day for women. In social settings, “drinking less” is often harder than expected—but it’s a line worth holding.

■ Regular check-ups and home emergency kit

Annual comprehensive heart check-ups are the lowest-cost risk management. Also, keep these items at home and ensure family members know where and how to use them: nitroglycerin (for acute angina, sublingually), aspirin (chew if suspecting MI, unless allergic or bleeding risk), blood pressure monitor.

Finally, know where your nearest AED is. Many think AEDs are only in airports or subways; in fact, malls, office buildings, community centers also have them. Knowing the location in advance can save precious seconds in an emergency.

What if it’s an emergency?

Prevention is ideal, but reality is, emergencies can still happen despite precautions. When that moment arrives, what can you do?

■ Recognize the symptoms immediately

If these symptoms appear, alert immediately:

• Chest pain or discomfort behind the sternum or in front of the heart, lasting over 30 minutes, unrelieved by rest or nitroglycerin;

• Pain radiating to the left shoulder, left arm, neck, jaw, or back; some may have upper abdominal pain mistaken for indigestion;

• Accompanying: cold sweat, pallor, cold limbs, difficulty breathing, nausea, vomiting.

Remember: it’s better to over-judge than under-judge. If any of these occur, don’t hesitate—start emergency procedures.

■ Four steps of emergency response:

Each step is critical

Step 1: Call 120 immediately—don’t wait or drive yourself.

Many think “wait and see” or “drive to hospital,” but both can be deadly.

Ambulance personnel are equipped and trained to start treatment en route. Self-driving means missing the critical early intervention.

When calling, clearly state: exact location (door number or floor), symptoms (how long chest pain has lasted), medical history (any known heart disease, medications).

Step 2: Lay the patient flat, loosen collar, keep airway open.

Have the patient lie down immediately, avoid standing or walking. Unbutton tight clothing, keep breathing passages clear.

If carrying nitroglycerin, place under tongue (0.5mg), repeat every 5 minutes if needed, up to 3 doses.

Note: contraindications include systolic BP below 90/60 mmHg, heart rate below 50 bpm, glaucoma history.

Step 3: If unconscious—start CPR immediately.

Unconscious + no normal breathing (or agonal gasps) + no carotid pulse—if all three are present, begin CPR:

• Position: Hands interlocked, heel on midline of chest between nipples;

• Force: Press down 5–6cm, fully release after each compression;

• Rate: 100–120 compressions per minute, equal time for compression and release;

• Rescue breaths: 30 compressions, then 2 rescue breaths. If no training, chest compressions alone are still effective—don’t stop.

CPR maintains basic circulation, buys time for defibrillation—keep going until professional help arrives.

Step 4: Find and operate AED

AED (Automated External Defibrillator) is user-friendly; voice prompts guide each step. Procedure: turn on → attach pads as instructed → analyze rhythm → deliver shock if advised → resume CPR immediately until help takes over.

Final Words

The heart is unique—only one. Heart muscle cells number around 2–3 billion; a severe attack can permanently lose about 1 billion—these cells do not regenerate.

Many entrepreneurs gamble in uncertainty or overextend for speed, but your heart isn’t a bet, and health can’t be overdrawn. Cultivate regular check-ups, prioritize sleep—these are the most important long-term investments you can make for your company.