commandments to avoid heart Attack

Source: The Hitavada      Date: 23 Oct 2017 11:14:39


 

By Dr p p deshmukh,

There is a silent but deadly epidemic of ischemic (i.e. deficiency of blood supply) heart disease, heart attack looming large over Indian subcontinent. It is much larger than plague and polio epidemics the world has seen. It is roughly estimated that one out of every ten Indians is suffering from this disease. There are roughly 3o million patients of Ischemic Heart Disease (IHD) in India. While our western counterparts have controlled this epidemic and their charts are showing a reverse trend, in India this incidence is rising. Though genetically we are more susceptible for having heart attacks, it is our lifestyle changes, which is triggering this genetic gun. The traits of this disease peculiar to Indians include: an early age of onset, increased severity, killing more patients than western world, and equal distribution among men and women. Though this tsunami seems unstoppable due to lack of awareness and casual approach, it can definitely be slowed down and reversed with great efforts. Talking about the individual prevention of this malady, if you follow the ten tenets you can avoid the risk of heart attack by over 80 per cent.

Stop tobacco


It is the most important of all risk factors in India, responsible for heart attack in 36 per cent of patients. Though smoked tobacco i.e. cigarette or beedi is blamed, oral ingestion of tobacco in the form of ghutkas is equally responsible for premature attacks. So stop it at once. The good part of stopping tobacco is that all the deleterious effects arising thereof are completely reverted in two years. Similarly the risk of cancer also comes down phenomenally.

Exercise regularly


A brisk walk of 150 minutes per week, or an aerobic exercise of 75 minutes like jogging, running, cycling, tennis or badminton, per week is recommended. The best way is to alternate between walking, aerobics and muscle strengthening exercises of all muscle groups on different days for most days in a week. Exercise has a salutary effect on weight management, diabetes control, blood pressure control and the risk of having a heart attack and, if at all there is an attack, then it is less severe in intensity, less damaging with better chance of survival. Exercise increases longevity, reduces all cause mortality, and produces endorphins, hormones responsible for positive feelings. So start exercising today!

Keep Blood Pressure in normal range


Get your BP checked by your physician and keep it below 140/90 throughout the day. In older patients around 150/90. High BP is responsible for 18 per cent of attributable risk for heart attack. Don’t hesitate to take medications as prescribe, as modern day medicines are extremely safe and effective. Don’t stop medications on your own without expert’s advice. Limiting additional salt in meals, avoiding pickles, papad, chips and those in which salt is added as a preservative should be avoided. Losing weight and eating fruits and vegetables in everyday life has an immense impact on controlling high BP.

Keep blood glucose in normal range


Elevated blood glucose is responsible for 10 per cent attributable risk for myocardial infarction i.e. heart attack. Patients with diabetes are now considered as CHD risk equivalent. Meaning thereby that all diabetics should be treated aggressively, as if they have already suffered a heart attack. Diabetes amplifies the risk of heart attack as it predisposes to high BP, obesity, increasing bad cholesterol, and increasing clotting potential of blood. Life style modification, exercise and medications should be strictly followed up with.

Keep cholesterol in normal range


High bad cholesterol (LDL) level is perhaps the most sinister risk factor and is responsible for 49 per cent attributable risk for heart attack. Many a time it is genetically inherited. Discovery of statins, a drug which reduces bad cholesterol is perhaps the best discovery of the last century. This medication is useful for primary as well as secondary prevention of ischemic heart disease. Similarly high level of the good cholesterol (HDL) protects an individual from heart attack. Exercise induced increase in good cholesterol is perhaps one of the best ways to prevent a heart attack. Indians are genetically more prone to heart attacks due to high prevalence of lipoprotein (a), a special kind of cholesterol which can be lowered by exercise only. Dietary restrictions in fat intake, exercise and statins are some ways to control your cholesterol.

Keep normal weight


Obesity is defined when your body mass index is equal to or more than 30. Its very prevalent now due to sedentary lifestyle and lack of exercise, It invites many problems like high BP, insulin resistance, glucose intolerance and increased bad cholesterol. There is a linear relationship between obesity and heart problems. If you are obese then try to reduce weight in a uniform and sustainable manner because frequent cycles of weight gain and weight loss are more frequently associated with heart problems. Reduction in weight should be under the supervision of an expert if it is in morbid form. It is interplay of calorie intake versus calorie expenditure.

Eat healthy diet


Foods with a high glycemic index such as sugar, bread, maida, flour based products, bakery products, potatoes, cold drinks and sugar mixed fruit juices should be strictly avoided. More emphasis should be on whole grains, fruits and vegetables. Protein intake (legumes, pulses, fish, poultry) should be increased. Those who do not eat fruits and vegetables in their daily diet have 14% more risk of heart attack. Higher intake of red meat and high-fat dairy products is associated with a higher chance of heart attack. Foods rich in fibre are beneficial. Oils containing more polyunsaturated fatty acids (PUFA) should be preferred. Ghee, saturated fats and vanaspati, containing Trans fats should be strictly avoided. Special attention should be given to vitamins and mineral intake. Oils like olive oil, canola oil, flaxseed oil, avocado oil, walnut oil, sesame oil, and grape -seed oil are beneficial. In day to day life, rice- bran, sunflower and groundnut oil can be used in moderation. Coconut and palm oil should be strictly avoided. Dry fruits have been shown to be good for health.

Reduce stress & factors causing depression


Stress increases your chances of developing heart attack twofold. After fifty, avoid peer pressure and competitive attitude in your work place .It is time to take life easy .Stress also invites bad traits like smoking and alcoholism in a vain attempt to nullify stress by individual. Depression also increases your chance of having a heart problem. Identifying it and getting it treated with psychotherapy and medications if required is strongly recommended.

Yoga and meditation


It has a great impact on mental health by inducing tranquillity and positive emotions. It reduces sympathetic drive from the brain which is responsible for many ailments. It is recommended that yoga done in group instills positive feelings.

Self awakening


Knowing that you are at risk of developing a heart problem is the biggest virtue one can learn. Many patients do not understand the gravity of problems as told by physicians or it may be due to lackadaisical attitude of an individual. Many individuals give up tobacco only after they have suffered their first blow. Those folks who have a history of premature heart attack in their family (below the age of 55 yrs) should be extra careful as they are extremely prone to it at a younger age and with greater severity. I have seen disciplined diabetics living far longer than their non-diabetic counterparts just by virtue of following a healthy lifestyle more vigilantly.


So in précis, to be ‘mindful’ about your health resulting in conscious changes in your lifestyle is of utmost importance to avoid heart problems with reduction in risk by a whopping 80 per cent.
(The author is Associate Professor, dept
of cardiolgy, gmc and ssh, Nagpur) l