As the age advances, cholesterol, smooth muscles cells, calcium and fibrous tissue gets deposited beneath inner layer of coronary arteries This pathological process is termed Atherosclerosis.
Is heart disease preventable? How can we save ourselves and our near and dear ones from this fatal disease…There are effective strategies to prevent heart disease..the secret is to start early
1. When should we start the life style changes for the prevention of heart diseases? Prevention is better than cure remains true in terms of heart diseases to a great extent. Heart diseases are often considered to be disease of the latter part of ones life as the symptoms are mainly expressed in the fifth or sixth decades of life in majority of life. This loses the window of opportunity for prevention. In fact, fatty streak formation which is the beginning of fat deposition inside the arteries begins in the second decade of life and later on, the gradual accumulation of cholesterol, fibrous tissue and calcium occurs during third, fourth and fifth decades of life forming the atherosclerotic plaque. Unless the preventive efforts are focussed in the earlier part of life and wait for the symptoms to appear, it gets too late.
2. Can we predict the chances of heart disease in an individual? Possibility of heart disease can very well be predicted in ones life by looking at the ‘Risk Factors’ in his body. Risk Factors are the disease conditions which facilitates the formation of coronary plaques inside the arteries which ultimately results in Myocardial Infarction or Heart Attack. Age, Sex and Race or Ethnicity are non-modifiable risk factors but more important are the modifiable risk factors like Diabetes, Hypertension, Increased Cholesterol, Smoking, Obesity, Lack of exercise etc which accelerates the plaque formation and creates block in coronary arteries. Presence of these risk factors and lack of control over them makes one prone for heart disease. Effective prevention of heart disease is possible by targeting these lifestyle disease in young and old.
3. Is there a role for heredity in heart disease? In fact, there is strong evidence today to prove that coronary artery disease is genetically designed and determined. There are specific genes which are carried from generation to generation making them prone for early heart attacks and fatalities. If there is a history of heart attacks or sudden deaths in one's blood relations, the possibility of hereditary predisposition for coronary artery disease is very high and this makes one eligible to take preventive actions much earlier in life and in an intensive way.
4. What are symptoms of heart disease and how to recognise them? As I stated earlier, there wont be any symptoms for long period of time and symptoms appear very late in the course of disease. The classical symptoms of Heart Disease are central chest pain precipitated by exertion which may or may not gets radiated to both shoulders or neck and breathlessness on exertion. Both chest pain and breathlessness gets relieved on taking rest. This is called Angina and is a hallmark symptom of obstructive coronary artery disease. This calls for an urgent consultation with a cardiologist so as to prevent a heart attack in the near future.
5. How can we identify the chest pain of heart attack from other causes of chest pain? When a person complains of a severe chest pain mainly in the central part of chest or back which has started abruptly without any precipitating actions and which is not relieved by taking rest is a red light sign to go for immediate medical attention. An ECG test is the only reliable way to differentiate the cause of chest pain and to rule out a heart attack or myocardial infarction. It is important not to waste time with the presumptive ‘first aid’ treatments before taking an ECG to rule out the cardiac origin of chest pain
6. What are the treatments for heart disease in Modern Medicine? There are effective and safe treatment for acute and chronic coronary artery disease in modern medicine. it encompasses medicines, surgical and non-surgical interventions. Primary angioplasty is the most effective treatment for heart attack and if it is performed without wasting much time, mortality of heart attack can be significantly reduced. Chronic coronary artery disease can be effectively treated with medicines, angioplasty or bypass surgery. The preferred mode of treatment varies from individual to individual depending on the severity and status of coronary artery disease
7. What are lifestyle changes recommended for the prevention of heart disease? Small changes in lifestyle can bring in large differences with regard to the prevention of heart disease. Leading an active lifestyle with regular exercise at least 30 minutes a day for five days a week is the most important practice. All kinds of exercise provides benefit for the heart from brisk walking to strenuous exercise. Regular exercise keeps one fit and helps to keep away lifestyle diseases like diabetes and hypertension. Adequate mental and physical rest is equally important with 6 to 8 hours of sleep for a healthy heart. Smoking should be stopped completely and alcohol consumption should be restricted to minimum if it can’t be stopped.
8. What are the essential components of heart-friendly diet? Diet is the key to good health! A heart-friendly diet should contain more green leafy vegetables, fruits and fibres. The proportion of fat intake should be limited and oils containing mono and polyunsaturated fatty acids should be preferably used. Consumption of animal fat and solidified fats should be restricted to minimum as they contain a large amount of saturated fatty acids. Salt and Sugar also should be restricted to the minimum. Total caloric consumption should be matched to the daily level of expenditure in order to avoid weight gain. Coconut oil is not forbidden for heart disease patients but should be used judiciously
9. How frequently I should check for presence of heart disease? Main stay of prevention of heart disease lies in the early detection and treatment of risk factors for heart disease like Diabetes, Hypertension, Increased Cholesterol etc. After the middle age, it is mandatory to undergo screening for these ailments, once in six months. If you are already carrying any of these risk factors, a close monitoring and control is required to check the progression to overt heart disease. Effective control of blood sugar, blood pressure, cholesterol levels and body weight along with regular exercise and diet are the key to prevention of heart disease.
10. How can i start with preventive strategies for heart disease? The preventive strategies should begin from home. Heart-friendly lifestyle habits should be inculcated in family members young and old. This will help us to create a heart-healthy future generation
Dr. Blessan Varghese MD, DM, FACC
Head of the Dept and Chief Interventional Cardiologist
PVS Memorial Hospital, Kochi