Dr Sushil K Sharma
World Heart day
Every year World Heart Day is celebrated on last Sunday of September month to spread awareness among the masses regarding the burden of CVD in this world .
CVD accounts for approximately 30% of death world wide however there is a great variation in regional CVD mortality rates.
Heart Disease Risk Factors
Some conditions as well as some lifestyle factors can put people at a higher risk for developing heart disease. All persons can take steps to lower their risk of heart disease and heart attack by addressing these risk factors. Control of risk factors is especially needed by people who already have heart disease.
” Blood Cholesterol Levels
Cholesterol is a waxy substance produced by the liver or consumed in certain foods. It is needed by the body, and the liver makes enough for the body’s needs. When there is too much cholesterol in the body-because of diet and the rate at which the cholesterol is processed-it is deposited in arteries, including those of the heart. This can lead to narrowing of the arteries, heart disease, and other complications.
” Some cholesterol is often termed “good,” and some often termed “bad.” A higher level of high-density lipoprotein cholesterol, or HDL, is considered “good,” and gives some protection against heart disease. Higher levels of low-density lipoprotein, or LDL, are considered “bad” and can lead to heart disease. A lipoprotein profile can be done to measure several different forms of cholesterol, as well as triglycerides (another kind of fat) in the blood.
High Blood Pressure
High blood pressure is another major risk factor for heart disease. It is a condition where the pressure of the blood in the arteries is too high. There are often no symptoms to signal high blood pressure. Reducing BP by pharmacological means reduces CV morbidity and mortality in clinical trials an anti-hypertensive therapy has been associated with reduction in stroke incidence of 35 to 40% in MI of 20 to 25% and in development of CHF of more than 50%.
Diabetes Mellitus
Diabetes Mellitus is caused by in absolute or relative insulin deficiency .The frequency of diabetes increases with age it is a major determinant of heart disease and stroke.
Together with smoking and physical activity dietery habits form the foundation for the causation, prevention and treatment of most cardiovascular and metabolic diseases including coronary heart disease, stroke and type 2 diabetes mellitus and sudden cardiac death , atrial fibrillation , heart failure and cognitive decline. Higher intake of dietary salts and industrial trans fat and lower intake of omega 3 fatty acids , fruits and vegetables are some of major modifiable causes of both total death and death from cardiovascular diseases.
Physical Inactivity
Physical inactivity is one othe most common modifiable risk factor for CHD. Engaging in sustained physical activity for at least 30 mins for 5 days a week is the current recommendation for prevention of heart disease. An exercise prescription might include walking , jogging , cycling , swimming or other aerobic physical activity for 30 to 60 mins on most days of the week supplemented with an increase in daily lifestyle activities such as walking upstairs when possible .Common potential barrier include lack of time energy , desire or a safe and convenient place to exercise .
Obesity
Although clearly associated increased risk of CVD much of the risk posed by obesity may be mediated by other cvd risk factors including hypertension , diabetes and lipid profile imbalances .
Alcohol
Excessive alcohol use leads to an increase in blood pressure, and increases the risk for heart disease. It also increases blood levels of triglycerides which contributes to atherosclerosis.
Heart Disease Heredity
Heart disease can run in the family. Genetic factors likely play some role in high blood pressure, heart disease, and other vascular conditions. However, it is also likely that people with a family history of heart disease share common environments and risk factors that increase their risk. The risk for heart disease can increase even more when heredity is combined with unhealthy lifestyle choices, such as smoking cigarettes and eating a unhealthy diet.
Treatment
Medical Therapy with antiplatelet agents, Lipid lowering therapy and anti anginal agents is the mainstay of treatment in patients with stable ischemic heart diseases . The goal of revascularization are to improve survival and to provide relief of ischemic symptoms .In patients with ongoing angina , LV dysfunction immediately intervention is warranted in other subset of coronary artery disease. There are steps you can take to lower your risk for having a heart attack or worsening heart disease. Your doctor may recommend lifestyle changes such as eating a healthier diet, exercising, and cessation of smoking.
What You Can Do
Live a Healthy Lifestyle
* Eat a healthy diet. Choosing healthful meal and snack options can help you avoid heart disease and its complications. Be sure to eat plenty of fresh fruits and vegetables.
*Eating foods low in saturated fat and cholesterol and high in fiber can help prevent high blood cholesterol. Limiting salt or sodium in your diet can also lower your blood pressure.
* Maintain a healthy weight. Being overweight or obese can increase your risk for heart disease. To determine whether your weight is in a healthy range, doctors often calculate a number called the body mass index (BMI). Doctors sometimes also use waist and hip measurements to measure a person’s excess body fat.
* Exercise regularly. Physical activity can help you maintain a healthy weight and lower cholesterol and blood pressure. The best heart friendly exercises are jogging, swimming , running and cycling.
* Don’t smoke. Cigarette smoking greatly increases your risk for heart disease. So, if you don’t smoke, don’t start. If you do smoke, quitting will lower your risk for heart disease. Your doctor can suggest ways to help you quit.
* Limit alcohol use. Avoid drinking too much alcohol, which causes high blood pressure.
( The author is Interventional Cardiologist and Head Deptt. Cardiology , GMC Jammu).
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