Heart disease – Prevention is better than Cure

Heart disease is the number one cause of death for both men and women surpassing the deaths caused by AIDS and Cancer combined together. It is estimated that by 2020 Cardiovascular disease will be the cause of over 40 percent of deaths in India as compared to 24 percent in 1990. Globally, it causes 17.3 million deaths annually. Keeping in view the increasing prevalence of the disease and associated increase in incidence of risk factors, India is all set to be the “Heart Disease Capital of the World” in few years time. The prevalence of Coronary artery disease in rural India is estimated to be up to 7 percent as compared to the urban areas where incidence is up to 12 percent.

There are almost more than 250 risk factors for coronary artery disease that include the non modifiable factors like age, sex, family history, ethnicity and the modifiable ones including high blood pressure, smoking, abnormal lipids, obesity, physical inactivity, diabetes, unhealthy diet, alcohol etc. Not much can be done about the non- modifiable risk factors but the modifiable risk factors need to be periodically checked, assessed, modified and treated so to avoid the long term morbidity and mortality. The more the accumulation of risk factors, the greater is the likelihood of developing the disease unless some prompt measures are taken to alter and/or stop the occurrence of such factors.

The most common symptoms of Coronary artery disease is Angina or Chest Pain. Angina is a discomfort, heaviness, pressure, aching, burning, squeezing, fullness or painful feeling in chest usually mistaken for indigestion or heartburn. The angina pain can be felt in shoulder, arm, neck, throat or back. This pain can be felt from lower jaw up to umbilicus anywhere and is usually a nonlocal sing pain often shown by the hand on chest (Levine’s Sign). Other symptoms of Coronary artery disease includes shortness of breath, Palpitation, Weakness, nausea, sweating, diaphoresis usually called as Angina Equivalent. During heart attack, any of these symptoms typically last 30 minutes or longer and are not relieved by rest or oral medications. Some people, however, have a heart attack without having any symptoms which is known as Silent Myocardial Infarction and occurs more often in diabetics.

It is an old saying, ” Money is lost, nothing is lost: Power is lost, something is lost: Health is lost, everything is lost.” To maintain healthy heart and health we should try to avoid and/or delay the onset of various modifiable risk factors.

Quit Smoking: Heart disease is not related to the quantity of smoke as does the lung disease like COPD, lung cancer etc. Even a single puff of smoking is enough to have a disastrous effect.  The risk of Coronary artery disease reduces to half within six months after one quits smoking and almost comes to a nonsmoker level within 2 -5 years after stoppage.

Healthy Diet: It included more of vegetables and fruits, avoidance of red meat, dairy products, coconut and palm oils, using less salt, avoid added sugars, limit solid fats and refined grains and drinking alcohol in moderation. In short, it is good to fill half of our eating plates with fruits and vegetables.

Physical Activity: It is one of the vital activities to reduce the accumulation of almost all other risk factors. It has been seen that a vigorous walking for about 30 minutes on almost 5 days a week reduces the high blood pressure, improves good cholesterol (HDL), reduces bad cholesterol (LDL), lowers risk of new onset diabetes, improves sugar level in diabetics and shuns the extra weight.

Maintain a Healthy Weight: A Body Mass Index (BMI) of less than 25 kg/m2 and waist circumference of less than 40 inch in male (< 35 inch in female) are the goal for preventing and treating coronary artery disease.

Stress and Good Sleep: A minimum of 8 hours sound sleep during night and a short nap during day is considered to be the beneficial for heart. A sudden surge in extremes of emotions like anger, depression etc should be avoided as it can trigger a heart attack by altering the hormonal balance and causing a plaque to rupture and block the whole vassal. A holistic approach and meditation techniques should be practiced to calm down such extreme emotions.

Blood Pressure: After proper consultation and requisitive investigative tests the medicines prescribed for prevention and treatment of particular risk factors should be followed religiously. A normal or near normal value of the risk factor has a tremendous impact in avoidance of coronary artery disease. Even a few mmHg drops in blood pressure reduces the incidence of angina and heart attacks by manifold.

Diabetes: The stringent control of blood sugar by lifestyle modification, dietary control and medicines is of utmost importance for delaying the onset of CAD. More the duration of diabetes, stricter should be the control.

Dyslipidemia: Proper care should be taken while evaluating the lipid profile of the person with more focus on LDL and non HDL cholesterol and definitive treatment should be started only after a strict lifestyle modification.

Natural Health and natural Heart is the precious possession one can have and it is possible to keep this possession healthy only when we think of our health first, avoid the risk factors for disease and more importantly priorities our health by regular Health Checkups. Whatever we as Interventional Cardiologists do, we only mend the Broken Hearts. Let’s take our best and healthier foot forward, work to prevent our hearts from being broken. Let’s spend on Health rather than Disease because if Health is lost, everything is lost.