DOC TALK

Matters of the heart

DR. KUSHAGRA KATARIYA

The causes of heart disease are complex. Busting some myths.

Photo: S. Thanthoni

Keeping fit: Make an early start.

It’s always about the heart! Anything remotely related to it has never been spared of speculation and debates. But there is a thin line that separates the myths from the facts.

Myth 1: Heart disease affects only the old/middle aged.

Many people think that heart disease as a problem of middle and older age, because that’s when the manifestations of heart disease, such as angina and heart attack strike. Although the manifestations of coronary artery disease typically occur during the middle and later years of life, the roots of coronary artery disease lie early in life— in childhood.

Heart attacks can even happen to people in their 20’s and 30’s, from unusually high cholesterol levels that are hereditary. High paced, stressful lifestyles with irregular eating habits and lack of exercise are one of the causes of coronary artery disease striking early.

Adopting a healthy lifestyle early in life works much better than changing one’s lifestyle later in life. Ideally one should have their cholesterol and blood pressure levels checked in their 30’s and 40’s, which, if too high, can be early indicators of a heart disease. Moreover, Indians are genetically more prone to and suffer heart disease earlier than their western counterparts.

Myth 2: Heart disease doesn’t really affect women

Heart disease is the leading cause of death in women older than 40, especially after menopause.

Loss of estrogen is a significant cause of heart disease after menopause and therefore the risk for heart disease increases after the age of 50 for women. There are also some unchangeable factors like family history which make one more prone to heart disease.

Lifestyle plays a crucial role. Smoking and fatal heart diseases go hand-in-hand. If a woman smokes, she increases her risk for early heart disease. There are some differences, though, in how heart disease affects men and women. For instance, women usually get heart disease 10 years later than men, but they have a lower chance of surviving a heart attack than men.

They are also more likely to have a second heart attack as compared to men.

Some interesting and educational facts about heart related problems:

Cholesterol deposition in blood vessels begins in the first decade of life. So, good eating habits and regular physical activity should be inculcated from early childhood if coronary heart disease is to be prevented.

One third of patients with coronary heart disease have normal cholesterol levels. Low levels of good cholesterol (HDL cholesterol) increases risk of heart disease even if level of bad (LDL cholesterol) or total cholesterol is normal.

Blood Pressure

Each blood pressure increment of 20/10 mmHg doubles the risk of coronary heart disease across the entire BP range starting from 115/75 mmHg.

High blood pressure originally thought to be a normal occurrence with increasing age is a misconception. Increased blood pressure is harmful irrespective of the person’s age.

Risk of heart attack in diabetics with no prior heart attack is similar to non diabetics with prior heart attack.

Risk of heart disease in “mild” smokers is almost as high as “heavy” smokers. So, for risk reduction smoking should be completely stopped and not merely reduced.

“Physical inactivity” or lack of regular physical exercise is as important and as harmful a risk factor as high blood pressure or diabetes. Regular physical activity is the best preventive effort for coronary heart disease as it prevents all its risk factors.

Clinical benefits of blood pressure, diabetes and cholesterol reduction are similar irrespective of the treatment modality chosen.

The writer is a CEO and Chief Cardiothoracic Surgeon in Gurgaon

From Hindu Magazine