Towards a Healthy Heart

Cardiovascular diseases are the leading cause of deaths in the world. Indian ethnicity is a major risk factor for developing cardiovascular problems. People of ethnic Indian origin have the highest incidence of coronary artery disesase (CAD) in the world. Moreover, CAD occurs at least a decade earler and generally involves multiple vessels. Maintaining good heart health is therefore of paramount importance if you are of ethnic Indian origin.

How do I know that I might be at an increased risk for heart attack?

Answer the following questions:

1. Is your blood pressure 140/90 mmHg or higher’ OR, have you been told by your doctor that your blood pressure is too high?

2. Do you smoke?

3. Has your doctor told you that your LDL “bad” cholesterol is too high, that your total cholesterol level is 200 mg/ dL or high; or that your HDL “good” cholesterol is less than 40 mg/dL?

4. Do you have diabetes or a fasting blood sugar of 126 mg/dL or higher; or, do you need medicine to control your blood sugar?

5. For women: Are you over 55 years old? 6. For men: Are you over 45 years old? 7. Do you have a Body Mass Index score of 25 or more?

8. Do you get less than a total of 30 minutes of physical activity on most days?

9. Has a doctor told you that you have angina (chest pains)?

10. Are you suffering from any level of psychosocial stress hampering your lifestyle?

If you answered “yes” to any of these questions, you have a higher risk of having a heart attack. However, this does not mean that you need to take heart medication. There is a lot you can do to minimise the risk of developing heart problems without having to resort to medication.

Why should I exercise?

60% of the population are not sufficiently active. In fact physical inactivity is the 4th leading cause of death worldwide. Just 15 minutes of brisk walking add up to three years in life expectancy: Every additional 15 minutes of daily exercise reduces death rates by further 4%.

What health benefits do I get from exercise?

• Reduce the risk of heart attack by 11%

• Lower blood pressure

• Weight control

• Increase in good cholesterol

• Reduce risk of other non-communicable disease like diabetes

• Improve sleep patterns

• Reduce risk of dementia

• Reduce and alleviate joint and back pain by increasing muscle strength

How much should I exercise?

• Aim for 30-60 minutes of moderate-intensity physical activity on most or at least 5 days a week

• Moderate-intensity physical activity (brisk walking, lowpaced swimming, cycling, gentle aerobics) will cause a slight increase in breathing and heart rate, and may cause light sweating

• The daily dose of exercise can be accumulated in shorter bouts (e.g. three 10-minute walks)

• Consult your doctor before starting an exercise program Who should defer exercise? Those with:

• Uncontrolled blood pressure or symptoms of angina or heart failure (chest pain, shortness of breath)

• Uncontrolled diabetes

• Any acute illness, stress, or surgery

What is the difference between moderate intensity and vigorous intensity physical activity?

If you are doing moderate intensity activity you are still able to talk without pause, whereas in vigorous intensity activity you will not be able to talk without pausing for a breath in between. Remember if you are going out of breath while doing a walk test, you are probably going fast, slow down.

What should be the minimum time of exercise to get benefit?

• You can do the activity all at once or break it up into shorter periods of at least 10 mins each (i.e. walk for 1km in 10 mins).

• Remember some exercise is better than none.

Take healthy steps for a healthy heart: Healthy diet

Food that we eat is the most powerful pill that can make us healthy

1. Can my diet affect my heart?

Healthy food habits can help reduce high blood pressure, high blood cholesterol and excess body weight

2. What is cholesterol? Is it necessary for our body?

Cholesterol is the Structural Backbone of our body. It is important for many body functions. However, its excess can lead to various vascular and heart problems.

3. What is good and bad cholesterol?

LDL = bad cholesterol. It can get deposited in the inner walls of arteries. This leads to narrowing of the arteries and reduced blood flow, a process called atherosclerosis. Blockage of the arteries can cause chest pain and ultimately lead to a heart attack or stroke.

HDL = good cholesterol. It carries cholesterol away from your arteries and back to the liver, where it can be eliminated from the body. A high HDL level in your blood can lower your risk of heart attack and stroke.

4. Should I know my blood cholesterol levels even if I am healthy?

All adults over 20 years: cholesterol levels checked at least once in 5 years. Abnormal cholesterol levels – get the test more often. The recommended test is called LIPID profile. The test is done after a 9-12 hrs fasting.

Your doctor is the best person to advise as to what your results mean.

5. If I have an abnormal cholesterol levels with no risk factors do I still need to take treatment or I might benefit from lifestyle changes?

Whatever may be your cholesterol levels, you benefit from lifestyle changes

• Dietary change: reduced saturated fat, trans fat and cholesterol

• Increase physical activity

• Reduce calorie intake

• Increased soluble intake in diet

• Review with your doctor every 3 months

6. How often should I visit the doctor after starting drug treatment to reduce cholesterol levels?

Every 4-6 months, the frequency depending upon on the results achieved.

In our next article the following month, we will be discussing diet and its effects on your cardiovascular health.

By Dr Ravinder Batra Senior Staff Specialist, Clinical Director Cardiac Catheter Lab Gold Coast University Hospital VMO, Gold Coast Private Hospital