This year’s World Heart Day (September 29) theme was ‘Use Heart for Every Heart’. This puts the onus on every individual not only to adapt to a heart-healthy lifestyle for oneself but also to motivate others so that every single person gets benefits from it.
Despite phenomenal developments in the field of medical sciences, cardiovascular diseases remain the single largest cause of death and illness throughout the globe. A comprehensive well-being approach should be applied so that the overall burden of disease could be significantly reduced, says Prof Rajesh Vijayvergiya.
Unlike many other chronic illnesses, cardiac diseases can be well prevented to a great extent by simply incorporating healthy lifestyle-related changes. Regular physical activity, reducing salt intake, regularising sleep, minimizing psychological stress and regular meditation, cardiac risk could be cut down significantly, says Prof Vijayvergiya, Department of Cardiology, PGI, Chandigarh. The doctor addresses some important issues related to heart health.
Rising heart attacks in young people
There is a rising concern about cardiac death and heart attacks in young people, despite regular gym activity, regular exercise, and a strict low-calorie diet. Certain cardiac risk factors such as smoking, strenuous physical exercise or excess of mental stress, and a family history of heart disease, says Prof Vijayvergiya can also lead to acute cardiac events such as death or heart attack in a seemingly healthy individual. People above 30, with risk factors like smoking, diabetes mellitus, hypertension, taking anabolic steroids or other substance abuse, structural heart diseases like defective valves or chamber enlargement, should not be involved in a high-intensity gym exercise regimen, without consultation or supervision of a physician. Adequate water and salt intake is a must during high-intensity exercise, as deficiency of both can result in dehydration, muscle injury, kidney injury, collapse, and possibly a heart attack. High-intensity exercise increases platelet activity, which results in increased clot formation in the vascular system. Those with underlying blocked arteries of the heart can have a heart attack during exercise, specifically with a high-intensity strenuous workout.
To avoid such incidents, screening of all healthy populations after the age of 40 years is a must and those with risk factors like excess weight, smoking, diabetes, and hypertension may require a screening after the age of 30 years and this screening should be repeated every two to five years, or in between if any abnormal cardiac symptoms appear in an individual.
Symptoms to look out for to prevent heart disease
Symptoms such as chest pain on exertion, relief with rest or after taking a Sorbitrate tablet, undue perspiration, uneasiness, and shortness of breath are prominent symptoms of heart disease. These symptoms required urgent attention and evaluation to make a timely diagnosis and treatment.
COVID-19 & heart disease
Due to the pandemic, adds Prof Vijayvergiya, there was a surge in cardiac risk factors such as smoking, increase in body weight, physical and mental stress, and discontinuation of cardiac drugs, which led to an increase in heart attacks. Covid infection itself can adversely affect the heart by decreasing its pump capacity and acute blockage of coronary arteries, which can lead to adverse events.
Screening for early diagnosis of heart disease
Begin risk factor assessment in adults at age 20.
Assess smoking status, diet, alcohol intake and physical activity at every routine evaluation.
Record blood pressure (BP), body mass index (BMI), and pulse at each visit (at least every two years).
Measure fasting serum cholesterol, and blood glucose according to the person’s risk for hyperlipidemia and diabetes, respectively (at least every five years; if risk factors are present, every two years).
After the age of 40, everyone should be evaluated for heart disease — ECG, Echo and TMT. It should be repeated two-fvie yearly depending upon the underlying risk. All evidence-based advanced treatments of cardiac diseases are available at Cardiac Centre, PGI.
Prevention is the key
Increase uptake of vegetables (>200gm), fruits (>200gm), cereals, and fibre (> 20gm/d) in daily diet. Salt intake should be < 5 g/d. Food with a high saturated fat content like red meat, dairy products, coconut, and palm oils; with high trans-fat content like deep-fried fast foods, bakery products, packaged snack foods, margarine should be avoided.
All healthy adults should do 30 to 45 minutes of moderate to vigorous exercise every day, at least five days a week.
Maintain a blood pressure <140/90 mmHg. Those with diabetes and renal failure should have strict control of high blood pressure, which can be achieved by low salt intake, appropriate body weight maintenance, and medications.
Fasting blood sugar should be <110 mg%. Control of blood sugar can be done with diet modification, appropriate body weight maintenance, and drugs.
Target a body mass index (BMI) of <25 Kg/m2. The ideal weight can be calculated by height in cm minus 100. Reduction of body weight can be achieved by an appropriate balance of physical activity, caloric intake, and formal behavioural programmes when indicated.
Compliance with drugs prescribed by the physician for heart disease. Drugs like aspirin and statin should not be taken without physician advice.
