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Lifestyle, Diet, Exercise tips to keep heart healthy

Post by on Thursday, September 30, 2021

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1.What are probable causes of heart attack at younger age in India?
Indians get heart disease at younger age group. Average age of heart attack in Western men is 63 years; however, average Indian adult gets heart disease at 53 years. Moreover 25% of all heart attacks occurs at ≤40 years of age. Indians are genetically predisposed to heart disease. Barker (hypothesis) tried to explain this as maternal malnutrition related low birth weight and consequent smaller organs at birth. When these individuals are exposed to high caloric diet and urban life style, the organs cannot cope up. Glucose, Sodium and Cholesterol metabolism gets disturbed. Heart disease evolves from the altered biochemical environment( common soil hypothesis). Family history of premature heart disease (<55 years in male first degree relative, ≤65 years female first degree relative) is a strong predisposition. Besides genetic predisposition, smoking and non smoking tobacco consumption, high cholesterol, diabetes, high blood pressure, high caloric diet, overweight (BMI ≥23m/kg2 ) or obesity, low intake of fruits and vegetables, lack of physical exercise, short sleep duration (><6 hours), poor quality of sleep, low vitamin D3, stress, type A personality (time urgency, perfectionist), type D personality (negative view of life and everything around) are important in younger age group. 2. What are the main risk factors of Heart Disease in India? Analysis of Indian patients’, data from a large study involving heart disease patients showed that 90% of the risk in Indian population could be explained by 9 risk factors. They are abnormal lipid (high ApoB/Apo A1 ratio), smoking, high blood pressure, diabetes, abdominal obesity, psychosocial factors, less><55 years in male first degree relative, ≤65 years female first degree relative) is a strong predisposition.
Besides genetic predisposition, smoking and non smoking tobacco consumption, high cholesterol, diabetes, high blood pressure, high caloric diet, overweight (BMI ≥23m/kg2 ) or obesity, low intake of fruits and vegetables, lack of physical exercise, short sleep duration (<6 hours), poor quality of sleep, low vitamin D3, stress, type A personality (time urgency, perfectionist), type D personality (negative view of life and everything around) are important in younger age group.
 
 2. What are the main risk factors of Heart Disease in India?
Analysis of Indian patients’, data from a large study involving heart disease patients showed that 90% of the risk in Indian population could be explained by 9 risk factors. They are abnormal lipid (high ApoB/Apo A1 ratio), smoking, high blood pressure, diabetes, abdominal obesity, psychosocial factors, less consumption of fruits and vegetables, lack of regular physical activity.
Alcohol consumption was not protective in Indian subset of patients. Low vitamin D3 is a strong emerging risk factor for acute heart attack in Indians.
 
3. How can we prevent heart disease?
There are four levels of prevention. They are (1) primordial (2) primary (3) secondary and (4) tertiary. Primordial prevention is avoidance of risk factors. For example, maintenance of ideal body weight, avoidance of tobacco and table salt, taking 600 gms fruits and vegetable daily, regular isotonic physical exercise, avoidance and reduction of stress, adequate sleep (6-8 hours sleep in protective) and sunlight exposure etc.
Primary prevention is done by treating blood pressure, high cholesterol, diabetes, smoking cessation, treating obesity, stress and sleep apnoea etc. Secondary prevention is done by revascularization (angioplasty, CABG), life style changes and several drugs following the heart attack. Tertiary prevention is done by heart failure treatment, surgery in selected patients
and implantable cardiac defibrillators use to prevent sudden death.
By far, primordial and primary prevention is the low cost high yield intervention. Primordial prevention should start at school going age. Because, the child is the father of man. Parents, grandparents and teachers  can act as a role model for the child.
Regular practice of Yoga help prevent heart disease. Yoga is not ‘asanas’ alone. It has 8 (eight) parts. Asana is one of the 8 parts. The essence of Yoga can be described in one sentence “Yoga is control of ones mind”. Yoga has been endorsed by American college of Cardiology guide
lines for prevention of heart disease.
 
4. What are the simple tips to improve heart function?
Best is to follow the primordial and primary prevention tips. Human
heart beats over 2 billion times is ones lifetime! This can give a life span upto 120 years. Tip is to keep the beat ongoing by regularizing ones lifestyle.
This includes diet, exercise for body and mind and mediations in selected
cases. Following a rhythmic lifestyle prevents heart disease. Alcohol has a
negative impact on heart function.
 
5. How covid has impacted heart?
Covid involved the heart of normal persons, heart patients and care
gives also. 25% of the covid patients have cardiac involvements. Covid can cause microvascular dysfunction (angina without heart attack), acute heart attack (due to coronary thrombosis or slow flow), myocarditis and arrhythmias.
This can cause acute heart failure or can cause prolonged heart muscledysfunction. Higher age (>45 years). Blood pressure, diabetes, heart diseasewere the associations in most patients admitted to ICU with Covid-19.
Some developed acute heart attack or lung artery occlusion during follow up. Many had high heart rate (inappropriate sinus tachycardia). By and large, these are treatable, preventable disorders. Most importantly, practicing covid appropriate behavior, mask usage and vaccination are the keys for prevention.
During covid many patients’ blood pressure and glucose level became off target because of obvious unavoidable reasons.
6. Few fun facts for your lovely “Heart”:
a) Your heart is the size of your clinched fist (approx. 450-550 gm)!
b) Heart beats 1,15,000 times a day, 2 billion times in life, and pumps 2000 gallons of blood every day !
c) Heart disease is known to exist in 5000 years old frozen mummy (Otzi).
d) Impact of diet on health was described 5500 years ago by the Indian sages (Bhagawad Gita Chapter 17.3).
e) Most heart attacks occurs on Monday and morning hours 8-10 AM.
f) Sudden psychological stress can give heart attack (broken heart syndrome)
g) Laughter, joke, smile, positive attitude, dance, classical music are all heart healthy.
 
Dr. Tapan Ghose,
MD (Med), DNB (Med), DNB (Cardio), FNB (Interventional Cardiology),
MNAMS, FIMSA, FCSI, FACC, FSCAI
Director and Head, Dept. of Cardiology.
Head, Dept. of Clinical Research
 
 
 
 
 

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