Stay heart healthy

Tips to prevent and lower the risk of heart disease

First, the bad news: By a very conservative estimate, India has at least 50 million heart patients. Says Dr. Upendra Kaul, director, Cardiology, Fortis hospital, New Delhi.

And Indians have a genetic propensity to heart disease, given the abnormally high rates noted in NRIs too. It’s estimated that by 2010, nearly 60per cent of the world’s heart patients will be Indian. Worse, the patients in India are getting younger with nearly 40 per cent of our heart patients being around 35yrs old or younger. And three decades ago, only about five percent of heart patients were below 40. And the first heart attack in young patients in generally more massive since their body has not developed natural collateral mechanisms, reveals cardiologist Dr.C.N.Manjunath, director, Sri Jayadeva Institute of cardiology. Bangalore.

Now, the good news: Heart disease can be prevented by healthy lifestyle habits-exercise, diet, attitude…

Risk factors

These guard against the major risk factors – high BP, abnormal cholesterol levels, diabetes, overweight especially abdominal fat, physical inactivity, inadequate intake of fresh fruit and vegetables, family history, smoking, and alcoholism.

Give up the sedentary lifestyle. Exercise combats two major risk factors – diabetes and obesity. It works by increasing blood flow stimulating the release of a chemical that lowers BP by relaxing artery walls. Also, an enzyme which increases the good (HDL) cholesterol and reduces bad (LDL) cholesterol, is released. Exercise for at least an hour daily five times a week.

Gyms and regimented workouts seem tough? A brisk walk for 45 minutes to one hour is also effective. Heart specialists say walking is one of the cheapest, safest and most effective forms of exercise. No need to buy gym membership, expensive equipment and clothes, or commute to fitness centres. And if you can’t walk/exercise continuously for one hour, split that into two capsules of half an hour spaced by a small interval, advises Hyderabad-based cardiologist Dr.B.Somaraju.

Diabetes seriously increases the risk of heart disease. And we’re again more prone – every fourth diabetic in the world is Indian. Dr.V.mohan, MV Diabetes specialities centre and Madras diabetes research foundation, says that though the genetic factor matters, a combination of regular exercise and weight reduction goes a long way in comatting diabetes.

Stop smoking

Cigarettes are deadly for all vital organs including the heart. One to five cigarettes a day increase the risk of heart attack by nearly 40 per cent while a pack(20) increases the risk four times. Smoking also destroys the protective effect of cholesterol-lowering drugs and augments diabetes and its resulting damage.

Maintaining ideal weight or BMI is vital, as obesity and overweight are major risk factors especially abdominal obesity, the kind of fat most associated with heart attacks. However, being slim shouldn’t make you complacent, warns Dr.Manjunath, since even slim people have a tendency to heart disease if they have other risk factors like diabetes, smoking, hypertension and family history.

An important factor is diet. And the bad words here are fat, calories, cholesterol, oil and non-vegetarianism. Dr.B.Sesikeran, director, national institute of nutrition, Hyderabad says, “It is total calorie intake from all sources – rather than fat calories alone-that are bad. The major bad sources of fat – deep fried foods, snacks with plenty of salt and fat, sweets, high-fat diary products like cheese and butter, and bakery products with high transfat content. Visible fat intake should be 15gm per head per day.”

And which are the bad oils. “There’s nothing like bad oil. We overindulge and make it bad. Ideally, combine oils like groundnut, safflower soya, mustard or rice bran by using them sequentially and in limited quantities instead of sticking to one oil. Safflower alone won’t benefit since fats contain fatty acids of various types and we need a bit of each variety.” Sesikeran adds that if cholesterol levels are 2000 or more, diet control doesn’t alone do much and stains are needed to lower chances of a coronary event.

Vegetarianism is a healthy choice but only if the diet is a low-cal, low-fat, high fibre one, and balanced in all nutrients. The typical equating of vegetarianism with good health is simplistic and makes us forget this vital distinction. Many traditional Indian vegetarian thalis and snacks contain loads of sugar, oil and ghee. So eat ‘Healthy Veg’. Ensure intake of vitamins and antioxidants. Eat lots of fresh fruit and vegetables; cooked food which has used minimum oil/ghee; adequate pulsed, unrefined cereals with fibre and low glycemic index.

If you can’t do without non-veg, eat lean meats with less fat like fish. Finally, disciplined eating matters, especially eating in moderation.

Go for yoga

Long ago, yogis and rishis discovered the power of mind over matter and, by implication, how mental control leads to body fitness. The science of yoga and medication is a product of this realization. Experiments prove that yoga and meditation are tremendous breath control mechanisms, have a calming effect on the nerves and brain, help control pulse and heart rate, and aid anger-management and emotion-control. And prolonged harbouring of negative emotions like hatred, frustration and resentment exacerbate heart disease. So, heart specialists endorse yoga and meditation as both preventive aids, and disease-management tools. Besides, say psychiatrists, laughter, optimism, setting realistic targets, learning to face failure/frustration with equanimity , cultivating psychological-support systems both within and outside the family, go a long way.

Despite all this, you never know what exactly is happening inside your body – hence, the need for regular check-ups. Dr.Kaul’s recommends that everyone above 30 undergo annual tests for BP measurement, blood-sugar estimation, and serum cholesterol. The high-risk group-those with family history of heart disease especially at a younger age, diabetics, high-cholesterol levels, high BP-is advised a more extensive check including ECG, TMT, stress Excho, multislice coronary CT angiograms.