In order to raise awareness about overall Cardiovascular health and wellbeing, World Heart Day is observed annually on 29th September all across the globe. Despite phenomenal developments in the field of medical sciences, cardio-vascular diseases still 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, commented Prof Rajesh Vijayvergiya, from the Cardiology department, PGIMER, Chandigarh.
This year the theme of World Heart Day is USE HEART for EVERY HEART and 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, commented Prof Vijayvergiya.
The good part is that, unlike many other chronic illnesses, Cardiac diseases can be well prevented to great extent by simply incorporating a couple of healthy lifestyle-related changes. Prof Vijayvergiya emphasized that by getting involved in regular physical activity, reducing salt intake, regularizing sleep, minimizing psychological stress and regular meditation, cardiac risk could be cut down significantly. Each one of us should come together to motivate one another by adopting a healthy lifestyle and also take proper medical consultation in case of any heart health-related issue is suspected rather than delay it.
There is a concern about cardiac death and heart attacks in young people also, although they were doing regular gym activity and having a strict low calories diet. Regarding this, Prof Vijayvergiya commented that certain cardiac risk factors such as smoking, strenuous physical exercise or excess of mental stress and a family history of heart disease can also lead to acute cardiac events such as death or heart attack in a seemingly healthy individual. To avoid such incidents, he stressed screening of all healthy populations after the age of 40 years. Those with risk factors like overweight, smoking, diabetes and hypertension may require a screening after the age of 30 years and this screening should be repeated every 2-5 yearly, or in between if any abnormal cardiac symptoms appear in an individual.
There is also a concern about COVID infection and increased incidence of heart attack, for which he replied that due to the pandemic there was a surge in cardiac risk factors such as smoking, increase body weight, physical and mental stress, and discontinuation of cardiac drugs, which leads to increase 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.
Regarding screening for early diagnosis of heart disease in the general population, he advised following points: –
• 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 5 years; if risk factors are present, every 2 years).
• After the age of 40 years, each individual should be evaluated for heart disease— ECG, Echo and TMT. It should be repeated 2-5 yearly depending upon the underlying risk. Those with the risk factors such as smoking, diabetes, obesity or having symptoms of heart pain should be screened from the age of 30 years.
For the prevention of heart disease, following actions are to be taken by an individual: –
Actions to be taken for the prevention of heart disease.
Have healthy food style. Increase uptake of vegetables (>200gm), fruits (>200gm), cereals and fibers (> 20gm/d) in daily diet. Salt intake should be < 5 g/d. Food with high saturated fat contents like Red meat, Dairy products, Coconut and palm oils; with high trans-fat contents like Deep-fried fast foods, Bakery products, Packaged snack foods, Margarine should be avoided.
All healthy adults should do 30 – 45 minutes of moderate to vigorous exercise every day, at least five days a week.
Treatment of abnormal lipids by exercise, weight reduction and drugs.
Stop smoking and tobacco chewing.
Have the blood pressure <140/90 mmHg. Those with diabetes and renal failure should have strict control of high blood pressure. Control of blood pressure is achieved by low salt intake, appropriate body weight maintenance and medications.
Have the fasting blood sugar <110 mg%. Control of blood sugar can be done with diet modification, appropriate body weight maintenance and drugs.
Be physically active. Have a Body Mass Index (BMI) of <25 Kg/m2. The ideal weight can be calculated by height in cm – 100. Reduction of body weight can be achieved by an appropriate balance of physical activity, caloric intake and formal behavioural programs when indicated.
Psychological stress at home and at the workplace can be modified by yoga, exercise, changing the workplace environment, and psychological counselling.
Compliance to the drugs prescribed by the physician for heart disease. Drugs like aspirin and statin should not be taken without physician advice.
Prof Dr Rajesh Vijayvergiya
Department of Cardiology
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