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Heart Care

The Risk Factor

Risk factors are the reasons, which lead to or aggravate the deposition of cholesterol or fat in the coronary arteries. If one desires to know the total number of risk factors responsible for the development of Coronary Heart Disease these will amount to hundreds. Williams in 1981 identified 246 risk factors that directly or indirectly lead to the development and onset of heart diseases.

To give you a rough idea, the distribution of these risk factors is
mentioned below:

  • Habits and Lifestyle, Psychosocial              54
  • Physical and Biochemical                            16
  • Serum / Blood Measurements                    44
  • Medical conditions or Diseases                  45
  • Dietary deficiency (inverse association)`   23
  • Dietary excess (negative association)       21
  • Constitutional, demographic                      16
  • Blood Clotting (Platelet) Disorders             16
  • Environmental                                             5
  • Drugs                                                          6

Healthier Lifestyle

Heart and blood vessel diseases are our nation's number one killer. More than 2,600 Americans die each day from them! Meanwhile, over 60 million people are living with them. Many are struggling to recover from heart attack or stroke, while others at high risk are getting the care and making the changes necessary to lower their risk.

The fact is, you can do plenty to get your heart in shape, even if you've had a bad experience. Healthy changes will help you feel and look better! Death rates from heart attack, stroke and other heart diseases are going down. Healthy lifestyles play a big part! Now's the time to make up your mind to take some control over your future. You'll find that
once you make one change, the next comes easier. Here are the steps to take:

  • Don't smoke.
  • Improve your eating habits.
  • Be more active.
  • Take your medicine to control your blood pressure.

How do I stop smoking?
  • Make an agreement with yourself to quit.
  • Ask your health care professional for information and programs that may help.
  • Fight the urge by going where smoking isn't allowed and staying around people who don't smoke.
  • Reward yourself when you quit.
  • keep busy doing things that make it hard to smoke, like working in the yard, washing dishes and being more active.
  • Remind yourself that smoking causes many diseases can harm others and is deadly.
  • Ask your family and friends to support you.

How do I change my eating habits?
  • Ask your doctor, nurse or licensed nutritionist for help.
  • Avoid foods like egg yolks, fatty meats, skin-on chicken, butter and cream.
  • Cut down on saturated fat, sugar and salt.
  • Substitute skim or low-fat milk for whole milk.
  • Bake, broil, roast and boil - don't fry foods.
  • Eat fruit, vegetables, cereals, dried peas and beans, pasta, fish, skinless poultry and lean meats.
  • Limit alcohol to one drink a day, and if you don't drink, don't start.

What about physical activity?
  • Check with your doctor before you start.
  • Start slows and builds up to 30 minutes, 3 to 4 times per week.
  • Physical activity reduces your risk of heart attack and makes your heart stro nger.
  • It helps control your weight and blood pressure; helps you relax, and can improve your mood!
  • Look for chances to be more active. Take 10-15 minute walking breaks during the day or after meals.

Non-Modifiable Risk Factors

AGE
The incidence of Heart Disease increases with advancing age but today we are seeing people getting heart attack at a younger age.

SEX
Men are at a greater risk of heart attacks as compared to women but due to excessive stress more women are getting prone to heart diseases.

HEREDITY
People with a strong family history of heart disease are at a greater risk as one cannot change one's parents. Early prevention can surely decrease the risk.

Modifiable Risk Factor

HIGH BLOOD CHOLESTEROL
Recognized as one of the first three risk factors leading to heart disease. A fat particle with a complex structure, if present in more than adequate quantity in blood gets deposited to create blockages. A diet rich in cholesterol source is a major culprit.

HIGH BLOOD TRIGLYCERIDES
Increased level of Triglycerides or fat in food is another factor for heart disease. A level of 160 mg/100ml is associated with increased incidence.

HIGH BLOOD PRESSURE
A "silent killer", High Blood pressure puts an extra strain on the heart and is also a major cause for deposition of cholesterol and fat in the coronary arteries.

OBESITY
Lack of physical exercise & wrong food habits will make a person obese and increases their chances of getting a heart disease.

STRESS AND MENTAL TENSION
Psychological stress is recognized as most important risk factor for heart disease. In absence of other risk factors people can still have angina, if stress is not controlled as it leads to spasm of coronary arteries.

SEDENTARY LIFE STYLE
Modern mechanization makes everything available easily, as a result physical activity of people is almost nil which predisposes them to many disease.

INTAKE OF ALCOHOL
Alcohol owing to it's structural similarity with glycerol is associated with major risk. It is a source of empty calories and leads to diseases of liver, gastritis etc.

LOW HDL CHOLESTEROL
HDL also called "good cholesterol " can be another factor for CHD as it binds cholesterol and remove it from blockages.

SMOKING OR TOBACOO CONSUMPTION
Smoking or Tobacco Consumption studies have proved that smoking substantially increases the risk of heart attack. Consuming tobacco in any form is equally hazardous as both are bad for health.

DIABETES MELLITUS
Uncontrolled blood sugar levels associated with obesity, high blood pressure and high cholesterol levels are responsible for CHD.

What to Do after Heart Attack

  • Chest pain not relieved by rest or sub lingual Sorbitrate: The victim of a heart attack often complaints of an excruciating pain in the left part of the chest , radiating to the left arm. The pain is not relieved by taking rest or sorbitrate (or other nitrates) below the tongue.
  • Sweating : This pain often is accompanied by a profuse sweating. Even in a cold atmosphere the patient perspires.
  • Feeling of intense weakness: In many patients there is a feeling of intense emptyness or giddiness following a heart attack. Some of the patients often feel like having a low blood pressure and low blood sugar.
  • Suffocation: Choking, sense of constriction in the chest. There may be feeling of breathlessness in some patients. Those who already have angina, would find an acute aggravation of the symptoms.
  • Burning sensation in the chest: This feeling occurs specially in people having heart attack for the first time. This uncomfortable feeling, accompanied with a gastric or acidity problem, many times confuse heart attack victims. They consider this as a gas problem and take some antacid tablets, which also relieve the feeling to some extent.

Parameters for Reversal

Causative Factors

Usual Cardiology Recommendation

SAAOL Recommendation

1

Serum Cholesterol

130 - 200 mg/dl

Less than 130mg/dl

2

Serum Triglycerides

60 - 160 mg/dl

Less than 100 mg/ dl

3

Serum HDL Cholesterol

30 - 60 mg/dl

More than 40 mg/dl

4

Cholesterol: HDL

4 - 5

Below 4 
Ratio

5

Serum LDL Cholesterol

30 - 130 mg/dl

Less than 70 mg / dl

6

Blood Pressure (systolic)

120 - 140 mmHg

120 mmHg or less

7

Blood Pressure (diastolic)

70 - 90 mmHg

80 mmHg or less

8

Blood Glucose (Fasting)

80 - 110 mg/dl

70-100 mgs %

9

Blood Glucose (PP)

120 - 160 mg/dl

Less than 140 mgs %

10

Smoking/Tobacco

To be reduced

Banned

11

Exercise/Walk

Should be done

Must do, at least one hour

12

Weight

20 - 30% extra (from any chart)

Only 2 - 3 Kg extra allowed permitted from Indian Chart

13

Fiber intake

Not specified

Plenty everyday

14

Stress

Not defined, Not available

Clearly defined, optimal

15

Total fat intake

10 - 30% Calories

10% of total Calories

16

Visible-fat intake

PUFA, MUFA etc.

Banned

17

Cholesterol intake/day

Not defined

10 mg/day

 

Prevent Heart Attack

The simple message is "Do not create more blockages. If you can reduce it, heart attack would never occur." It is like a bundle of notes being guarded by a rubber band. If you keep on putting more and more notes inside the rubber band one day the rubber band has to shap. This is the situation of a heart attack where the membrane also breaks off. Now if you stop putting more notes, the rubber band will never break. Further, if you start taking out one or two notes from the bundle everyday, the rubber band will never break.

The same principle applies in prevention of heart attack. Control of all the risk factors of heart disease by adequate change in the lifestyle can prevent heart attacks. The following are the expected parameters to prevent heart attacks :

  • Cholesterol below 130 mg/dl.
  • Triglycerides 60 to 100 mg/dl
  • HDL Cholesterol 40 to 60 mg/dl.
  • Blood glucose (Fasting) 70 to 100 mg/dl.
  • Blood Glucose(PP) below 140 mg/dl.
  • Blood Pressure 120/80 mmHg.
  • Maximum permissible exercises.
  • Body weight in proportion to height.
  • Stop smoking completely.
  • Control stress.
  • Oil/Ghee in food is banned completely.
  • Consume salads and fruits in plenty.
  • Restrict consumption of milk and milk products.
  • Avoid meat of any kind.

NON-MODIFIABLE:

AGE: The incidence of Heart Disease increases with advancing age but today we are seeing people getting heart attack at a younger age.

SEX: Men are at a greater risk of heart attacks as compared to women but due to excessive stress more women are getting prone to heart diseases.

HEREDITY: People with a strong family history of heart disease are at a greater risk as one cannot change one's parents. Early prevention can surely decrease the risk.

MODIFIABLE:

HIGH BLOOD CHOLESTEROL: Recognized as one of the first three risk factors leading to heart disease. A fat particle with a complex structure, if present in more than adequate quantity in blood gets deposited to create blockages. A diet rich in cholesterol source is a major culprit.

HIGH BLOOD TRIGLYCERIDES: Increased level of Triglycerides or fat in food is another factor for heart disease. A level of 160 mg/100ml is associated with increased incidence.

HIGH BLOOD PRESSURE: A "silent killer", High Blood pressure puts an extra strain on the heart and is also a major cause for deposition of cholesterol and fat in the coronary arteries.

OBESITY: Lack of physical exercise & wrong food habits will make a person obese and increases their chances of getting a heart disease.

STRESS AND MENTAL TENSION: Psychological stress is recognized as most important risk factor for heart disease. In absence of other risk factors people can still have angina, if stress is not controlled as it leads to spasm of coronary arteries.

SEDENTARY LIFE STYLE: Modern mechanization makes everything available easily, as a result physical activity of people is almost nil which predisposes them to many disease.

INTAKE OF ALCOHOL: Alcohol owing to it's structural similarity with glycerol is associated with major risk. It is a source of empty calories and leads to diseases of liver, gastritis etc.

LOW HDL CHOLESTEROL: HDL also called "good cholesterol " can be another factor for CHD as it binds cholesterol and remove it from blockages.

SMOKING OR TOBACOO CONSUMPTION: Smoking or Tobacco Consumption studies have proved that smoking substantially increases the risk of heart attack. Consuming tobacco in any form is equally hazardous as both are bad for health.

DIABETES MELLITUS: Uncontrolled blood sugar levels associated with obesity, high blood pressure and high cholesterol levels are responsible for CHD.