Maintain your heart health
By MP Ravindra Nathan, MD, FACC, FACP, FRCP
Despite all the modern advances in the diagnosis and management of heart disease, most specifically coronary heart disease (CHD) which includes the “heart attacks” you often hear about, it still seems to be the number one killer in the United States, representing more than 350,000 deaths per year. There are many risk factors for heart disease and understanding these factors is essential for the prevention of cardiovascular morbidity and mortality. And many of these risk factors are modifiable and if we can pay attention to these factors a little closer, we can prevent many heart attacks and premature deaths.
All of us adults are at high risk for heart disease and we must do everything we can to stop this killer. Coronary artery disease (CAD) has now become the most predictable, preventable and treatable of all chronic diseases. People at high risk of developing cardiovascular disease should be identified and preventive measures should be taken. This is called risk stratification.
Research reveals that nearly 50% of all illnesses are lifestyle-related, especially heart attacks and strokes. So why not follow the advice of medical professionals and make the appropriate changes to your lifestyle? Heart disease can be prevented or at the very least delayed into old age if you pay close attention to your own risk. Prevention is much cheaper too, in the long run. It is therefore up to us to take the first steps to reduce the burden of this serious disease in the community. Even if one has already been diagnosed with the disease, future complications can be avoided by adopting the basic principles listed below, which is called “secondary prevention”.
Some risk factors like family history and gender (men are more at risk than women) are not modifiable, but many others are modifiable and treatable and everyone should pay special attention to them.
Let’s look at some of the factors.
Bad eating habits: “What you eat today is what will contribute to your heart health tomorrow,” I remind my patients quite often. The “fried, oily, greasy, salty and sugary foods” we consume on a daily basis are an invitation to heart disease, so cut down on meats, butter, cream, hydrogenated fats, sweets, etc. Too many refined carbohydrates could lead to the early development of type 2 diabetes mellitus, another heart disease risk.
Arterial hypertension (BP), is a common problem in our clinical practice. The American Heart Association recommends that the ideal BP should be around 130 (systolic)/ 80 diastolic. But one can expect an age-related increase as one gets older. Every pharmacy has a free blood pressure measuring station and you can quickly get a reprint of your current blood pressure. Controlling it requires following a low-salt diet, exercising regularly, maintaining a normal weight, and taking medication as needed.
Smoking, also other forms of tobacco abuse, is the number one preventable cause of death, contributing to heart disease, cancer and a host of other causes of death. This is especially true among young people. So quit smoking in any form immediately.
High blood cholesterol: Check your “lipid profile” and pay particular attention to total cholesterol and bad cholesterol (LDL) levels. They must be controlled with a low-fat diet, exercise and appropriate medications such as ‘statins’. We don’t often see heart attacks in patients with significantly low cholesterol. As a general rule, total cholesterol should be below 200 and LDL below 100, but in high-risk individuals LDL should be below 70. In fact, the general agreement is: “The higher your level lower cholesterol, the better for you.”
Diabetic sugar is one of the most common causes of heart disease and therefore needs to be under strict control. Unfortunately, many people with diabetes do not even know they have the disease and even among those with established disease, good control is lacking.
Physical inactivity: The beneficial effect of physical activity through aerobic exercise is well known. The recommended duration is about 150 minutes of moderate-intensity exercise per week – 30 minutes per day, 5 days per week – such as brisk walking, gentle jogging, swimming, jazzercise, etc. In addition to heart fitness, exercise improves lung capacity and can delay off Alzheimer’s disease too. So get moving.
Excessive alcohol use is not good for the heart. In fact, no amount of alcohol is safe; However, if you must use it, wine is safer than hard liquor and that too in limited quantities.
Obesity: Overweight and obesity have become all too common and result from excess body fat, which increases the risk of serious health problems like heart disease, diabetes, high blood pressure and certain cancers. Obesity mainly results from the consumption of excess calories and therefore a low calorie diet along with regular physical activity is the main treatment.
Stress reduction: Lately with the Covid-19 pandemic, lockdown, social distancing and other factors our stress levels have been high and we just need to find ways to reduce our anxiety, tension and fears for a better health.
Based on all of these known risk factors, everyone should perform a personal risk stratification and come up with an appropriate treatment regimen in consultation with their doctor. The take home message is, “Preventive strategies work, and at any age, they are well worth the effort it takes to implement them.”