Coronary heart disease is increasing in our country, and the disease is affecting young people as well as older people, starting from 20 years of age and onwards. Approximately half of the patients with heart attack die within one hour. Therefore, everyone needs to know about what is a heart attack, what causes heart attack, how to prevent heart attack, and in case of a heart attack, what is the best treatment available.
The basic problem in coronary disease is the deposition of fat within the walls of the blood vessels which manifests as angina - chest discomfort which usually is under the center of the chest, spreading commonly to the left hand, and sometimes to the right hand, throat, jaws, back or upper abdomen; may be associated with shortness of breath, sweating, giddiness. Sometimes even though the blockages are not advanced, it may rupture and cause a heart attack.
Factors responsible for blockages
Non-modifiable: Family history of coronary heart disease, gender, and age
★ High blood pressure
★ High blood sugar
★ High blood cholesterol
★ Sedentary lifestyle
★ Psychosocial factors
With changing lifestyles, the incidence of coronary heart disease is increasing these days. One important change from the previous pattern is that we see patients of younger age groups – 2nd, 3rd decade and premenopausal women suffering from heart attacks.
Why diet is important
Diet plays a major role in the development of risk factors for heart attacks. For example, people who overeat are prone to develop obesity. They develop other comorbid diseases like high blood pressure, high blood sugar, and high cholesterol.
One may gradually reduce the body weight and aim to reduce half to 1 kg per week. If one burns 500 calories daily, they may reduce half kg weight in a week. Exercises that should be done include regular walking, jogging, running, swimming, etc. Weight lifting is not a good exercise for heart patients.
A person is called diabetic if his blood sugar is >126 mg% after 12 hours fasting or if it is >160 mg% 2 hours after meal or HbA1C is above 7. The only way to confirm diabetes is by a blood test. Persons with diabetes need to have strict diet control and do regular exercises. They may need to take drugs and sometimes daily insulin injections.
Cholesterol is the other important risk factor. There are four types of cholesterols – LDL, VLDL, TG, and HDL. The total cholesterol should be less 200mg% and LDL should be <100 mg% and if diabetic or previously has heart blockages <70 mg%.
Triglycerides also called TG should be less than 150 mg%. HDL is called good cholesterol and should be more than 45 mg% in men and > 35 mg% in women.
How to control diabetes, cholestrol
To control diabetes and cholesterol, one should avoid fatty foods. The cooking oil should be changed to non-saturated oils, like canola or palm oil. Per person usage of oil per month should be approximately 1 kg.
Eating a lot of vegetables is good for the heart, especially leafy vegetables. Similarly, the usage of nuts like almonds, cashews, and walnuts once or twice a week is good for the heart.
High blood pressure
High blood pressure is another important risk factor for heart attacks, heart failure, paralysis, and kidney disease. Blood pressure should be less than 140/90 mm Hg and in diabetics <130/80.
Low salt intake, avoiding smoking and alcohol, regular exercise, and a diet rich in fruits and vegetables will help lower blood pressure. In case it is not controlled, one should start using medications.
Alcohol consumption should be avoided. If someone is alcoholic, she should curtail drinks to one beer, or a few glasses of wine, or one peg of hard liquor. Smoking is very injurious and should be discouraged.
Psychosocial factors such as depression, anger, and competitive behavior are also important factors that cause heart attacks. If these measures are initiated at an early age, the benefits will be long-term, even for those who have already suffered with cardiac issues.
(Dr. Pramod Kumar K, Consultant Interventional Cardiologist, Yashoda Hospitals, Hyderabad)
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