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 Heart

May 2010
Take Care of your Heart
Dr Debasish Ghosh
 
A few weeks ago the national media was rife with the news of a well known actor’s sudden hospitalisation with chest pain. Subsequently it was reported that a clot was detected in an artery of his heart which was treated and a heart attack was aborted. Was this something that happened overnight? Or was it something that was building up over time, something that could have been prevented?
 

Risk Factors of Heart Disease
A clot forming inside the heart artery is the final event in a cascade of injuries to the artery’s delicate inner lining which has gone on for a prolonged period, often starting in early teens.

Behavioural factors: poor diet, physical inactivity, cigarette smoking, excessive alcohol

External factors:
socio economic, cultural and environmental conditions, including modernisation, mechanisation, urbanisation and globalisation.

These, if not checked can lead to myocardial infarction (what we commonly call heart attack), stroke, coronary heart disease, peripheral arterial disease and congestive heart failure.

6 Modifiable Risk Factors
Age, sex and genetic predisposition are three things we cannot modify to protect against heart disease. But there are culprits which make it worse, like:
  1. Elevated LDL (or bad) cholesterol
  2. Reduced HDL (or good) cholesterol
  3. Obesity
  4. Hypertension
  5. Diabetes
  6. Smoking

Cholesterol
Bad cholesterol (LDL) deposits fat in the arteries and injures them, while good cholesterol (HDL) removes excess of fat from the circulation and prevents deposition in the arteries. So we have to reduce the LDL and raise the HDL.
  • Lifestyle measures can help reduce fats though diet, exercise and weight loss
  • When these measures fail, statin drugs can be used to lower the LDL.
Obesity
One third of the world population is overweight! This increases risk of elevated BP and diabetes. A waist heavy person is more prone to heart disease.
  • Aim to lose one kilo per week. Crash dieting rarely helps.
  • Eat smaller amounts; do not snack.
  • Cut down the fat in the diet.
  • Exercise regularly.
Risk of heart disease can be elevated by dehydration too. Certain studies have correlated high daily intake of water (five glasses) and other fluids to a lower risk of heart disease.

Remember that modest changes in diet, weight, and exercise can have a big impact on your cardiac risk. A hearthealthy lifestyle should be encouraged from youth, but even when changes are made later in life, they lead to important benefits. Work with your doctor to set realistic goals.

Hypertension
A silent threat, high blood pressure initially does not cause symptoms but damages you stealthily.
  • Lifestyle measures of losing weight and exercising regularly are a must.
  • Cut excess salt from your diet.
  • Take medicines regularly if prescribed, to maintain target BP (140/85). Target BP is the same for all age groups.
  • Target 130/80 if you are diabetic.

Diabetes
You increase your risk of heart disease three fold if you are a diabetic. Your risk multiplies if you are a smoker, have high BP and LDL levels: these often coexist.

  • If these dangers are coexisting, do ensure to maintain ideal body weight, exercise, lower cholesterol level and BP
  • Blood sugar levels can be managed with proper diet, lifestyle measures and medicines
Smoking & Tobacco Use
Even small amounts of tobacco are harmful – they increase the risk of heart attack four fold. You are at risk even if you don’t smoke – but your spouse or co-workers whom you share your time and space with, do. Quit the earliest you can – it takes a smoker five years to lower himself to the risk level of a non smoker – after he quits! Quit now, quit completely.

 

Dr. Debasish Ghosh is Consultant Interventional Cardiologist Apollo Gleneagles Hospitals, Kolkata

         


    
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