Can we prevent a heart attack?
As you all know, prevention is better than cure.
- May be inherited
- Develop during the course of one’s profession
- May be contracted through contact with a person suffering from a particular disease
We should do all that we can to prevent a heart attack as it is one of the main killers of modern times.
It is estimated that by the year 2030, every 5th Indian will have diabetes, high blood pressure or a heart attack. For this very reason, we should do whatever possible from our side to prevent this dreadful condition.
What Is A Heart Attack?
A heart attack is a condition where a portion of the heart muscle is deprived of oxygen and nutrients. This occurs because a blood vessel that is supplying blood to the heart muscle is blocked.
In medical terms, this is called a ‘myocardial infarction’ (myocardial = heart, infarction = death of).
Quite similar to heart attacks, a brain infarction is called a stroke and tissue infarction is called gangrene.
What Causes A Heart Attack?
There are several causes of heart attacks. The primary underlying reason is the cutting off of blood supply to the heart muscle.
The reason why the blood supply is cut off is due to a condition called atherosclerosis. Atherosclerosis is a process where the inner layer of the blood vessel is damaged due to certain risk factors.
The damaged vessel wall leads to deposition of fat (cholesterol) and inflammatory cells. This in turn leads to narrowing of the blood vessel itself.
The narrowing of the lumen compromises the flow of blood through the vessel. This in turn reduces the circulation to a portion of the heart muscle supplied by that artery.
People who have narrowed heart arteries may experience chest pain on exercise that is relieved by rest. This is called angina.
If the vessel wall is badly damaged, the cholesterol deposition can lead to formation of a ‘plaque’. This cholesterol plaque can rupture and a blood clot can form in this area.
The blood clot can become large enough to block the entire blood vessel, leading to a heart attack.
In a nutshell, a narrowed heart artery causes angina, while a blocked artery causes a heart attack.
What Risk Factors Lead To Narrowing Of The Heart Arteries?
Broadly classified, risk factors are major or minor risk factors.
By identifying the risk factors, the right steps can be taken to prevent a heart attack.
The table below lists these factors.
A person who has a strong family history of heart disease (brother, sister, father or mother have had a heart attack, bypass surgery etc) along with any of the major risk factors is at a high risk of developing heart disease in their lifetime.
In other words, the more risk factors you have, the greater your risk of heart disease.
How Can You Prevent A Heart Attack?
There are many ways you can reduce your risk.
1. Do Not Smoke
If you are a smoker, then it is time to give it up. Smoking can greatly damage the arteries and can increase development of atherosclerosis and heart attacks.
This is because cigarette smoke has a number of harmful chemicals that can damage the vessel wall. By stopping smoking, you can most certainly prevent a heart attack.
2. Control High Blood Pressure
A elevated blood pressure can increase the stress on the vessel wall, resulting in it getting damaged.
High blood pressure causes excessive strain on the heart muscle. This is because the heart has to pump against a high pressure.
Over time, this excessive strain makes the heart muscle thicker than normal. But that’s not all.
The blood supply to the heart muscle also gets compromised to an extent. The blood vessels become hard and thick, leading to reduced circulation.
This in turn causes angina or a heart attack.
3. Control Diabetes
A high blood sugar leads to the early development of atherosclerosis in the small blood vessels of vital organs such as brain, eyes, kidney and the heart. This can start very early in the disease process.
As time passes, the narrowed blood vessels reduce the blood circulated to these vital structures.
In the heart, the progressive decline in the blood flow leads to angina and eventually a heart attack.
In the legs, the reduced circulation and loss of sensation can lead to gangrene.
In the brain, it can lead to a stroke. In the eyes, it could lead to damage of the retina.
Having diabetes is now considered equivalent to having heart disease. Make the right dietary changes as advised by your dietitian or doctor. Combine it with a good exercise plan.
Maintain your average blood sugar value (HbA1c) levels below 7%. This is around 150 mg/dL over a period of 3 months. Keeping your sugar well controlled can help protect the heart, kidneys and other vital organs.
While keeping your sugar levels under control is very important, it is also essential to recognise the dangers of hypoglycemia, or low blood sugar. Make sure your blood sugar level does not drop below 100 mg/dL. This way, you are safe from the effects of hypoglycemia.
4. Reduce Your Cholesterol Levels
Not all cholesterol is bad. Cholesterol is essential for the body as it is required to maintain the integrity of cell membranes and also help in hormone production.
However, high cholesterol levels can have a bad effect on the body.
There are 2 types of cholesterol – good and bad. The good cholesterol, i.e HDL cholesterol has a protective effect on the body. The bad cholesterol i.e. LDL cholesterol is responsible for the development of atherosclerosis.
The lower the LDL cholesterol, the better.
Triglycerides (TG) are also a kind of blood fat that is derived from sugar. They are mainly the energy stores of the body. High TG levels are usually associated with low levels of good HDL cholesterol.
Coronary artery disease is strongly associated with high LDL and low HDL levels. Controlling this therefore becomes very important.
It is currently recommended that LDL cholesterol levels be maintained below 130 mg/dL if you are a healthy person. If you have risk factors for heart disease such as high blood pressure, keep the levels below 100 mg/dL.
However, if you have diabetes or have had heart disease in the past (bypass, stents etc), the LDL should be below 70 mg/dL. Some recommend keeping it even lower, but this is difficult.
Elevated TG levels also carry a risk, and must be reduced through diet and medication if needed.
5. Increase Exercise
Exercise requires energy. This energy is derived from carbohydrates and fats.
By performing regular exercise, you can burn excess carbohydrates and fats. This will reduce atherosclerosis and the chances of developing heart disease.
In addition to this, it makes the heart stronger.
Regular yoga can help you reduce your blood pressure and improve your overall health. Combined with a cardiovascular exercise like walking or running can have added benefit.
The American Heart Association currently recommends 150 minutes of moderate intensity exercise every week. It is best if you could do around 45 minutes a day that includes exercises such as brisk walking, running, swimming, cycling or aerobics.
6. Reduce Weight
Being overweight greatly increases your chances of developing heart attacks.
When associated with conditions like diabetes, the risk increases many-fold.
Exercise and diet is the only (and safest) way to lose weight. It is essential to follow a strict plan to reach your target body weight.
A 10 kg weight loss can reduce blood pressure by around 10 mmHg.
7. Reduce Mental Stress
Our current generation is young, aggressive and overworked. Stress has increasingly become a part of every job.
Type A personalities are high strung and stressed out most of the time. They tend to panic or lose their temper at the smallest issues and challenges. Type A personalities are rarely satisfied with how things are with their life, or find a reason not to be.
On the other hand, type B personalities are less stressed and a lot happier. They tend to have a lower chance of developing heart disease.
8. Eat More Fresh Fruits And Vegetables
Fruits and veggies are rich in vitamins and minerals and low in fat. They also contain anti-oxidants that can fight the development of atherosclerosis.
The current recommendation is 5 portions of fresh fruits and vegetables everyday. Try and eat vegetables of all colors to mix and match the nutrients.
Fruits and vegetables also contain a lot of fiber that can protect the heart and also help in maintaining good bowel movements.
9. Eat More Fish
If you enjoy non-vegetarian food, you will be delighted to know that eating 3 or more portions of oily fish every week can markedly reduce your risk of heart disease.
Oily fish such as salmon, sardines and tuna are rich in omega 3 fatty acids. These have a protective effect on the heart and the blood vessels.
Try your best to avoid eating red meat, as this is high in saturated fats and can be harmful in the long run.
If you are vegetarian, then you can try out supplements that can give you the same benefit to prevent a heart attack.
10. Cut Down Sugar And Salt
Sugar is now considered equally bad as salt.
If you wish to prevent a heart attack, make sure you cut down your sugar and sweet intake drastically.
Keep your total salt intake less than 4 gm a day. Low salt alternatives are high in potassium and can increase the risk of heart beat irregularities. These are therefore best avoided.
There are some factors that cannot be altered –
1. Environmental Factors
There is not much that can be done to alter environmental factors that lead to heart disease.
2. Family History
A strong family history can increase the risk of heart disease significantly. It does not matter if your parent developed heart attacks after the age of 60. You may still be at risk at a younger age.
There is not much you could do to alter your family history – it is what it is.
Males tend to have a higher risk of heart disease. However, these days women are also at a similar risk.
It is important that both men and women get themselves tested for the presence of heart disease annually.
If you follow what is discussed above, you could reduce your risk of heart disease significantly and prevent a heart attack. However, despite your very best efforts, you may still be at risk and develop a heart attack.
Life must be led to the full. Excessive concern about what would happen if you ate certain foods and not doing exercise might just take away the charm of life. Live life in moderation.
- Diabetes – The Dreadful Disease. Dr BG Baliga Writes. - July 29, 2018
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- Can We Prevent A Heart Attack? Dr BG Baliga, Baliga Diagnostics, Writes. - April 15, 2017