Tuesday, September 16, 2014

Is your heart in the right place?

India loses about 30 lakh people per year to heart disease. According to WHO, cardiovascular diseases will be the largest cause of death and  disability in India by 2020. If this does not serve as a wake-up call,  then what will?

 If  we take the threat of heart disease seriously, we need to act and act  fast.  It's  important  to trace the problem to its source and tackle it  from  there.  As  a  developing  nation  we cannot bear the huge economic  burden of deadly lifestyle diseases like diabetes and heart problem.    
 The  government is already struggling to tackle the healthcare issues. At  present,  it  spends  just  1  per  cent of its gross domestic product on  public  health  leading to a public health infrastructure which is sorely  deficient.  Apart  from developing world health problems and communicable  diseases,  India  now  has  to  grapple  with  the dual burden of chronic  diseases that accompany unhealthy lifestyles-diabetes and heart disease —  which are eating into the finances of the individuals and the country.

One  can  take heart from the fact that heart disease can be prevented as  it  is  related to the lifestyle of the patient. Some of the risk factors  for  heart  disease  that  can  be  modified  are  diabetes,  high  blood  cholesterol,  consumption  of  tobacco,  high  blood  pressure,  physical  inactivity,  obesity  and  stress. The focus should be on attacking these  risk factors.
A  smoker's  risk  of  having a heart attack is twice more than that of a  non-smoker.  Smoking speeds up the development of plaque in the arteries.  It  also  reduces  the  level of the good cholesterol (known as HDL), and  increases  the  stickiness  of blood cells causing blood clots inside the  arteries. Stubbing out that cigarette can be the first step to protecting  oneself from heart disease.                                            

Diet and exercise are known to play a key role in controlling the menace.  Exercise helps protect against heart disease. It's important to know that  every  extra step one takes during the day builds up the "health balance"  and  helps prevent disease. Incorporating 30 minutes of exercise in daily  life can lead to immense benefits.          
 It  is  also  important  to maintain a healthy weight, according to one's  height.  Studies  have  shown  that  healthy  eating and exercise lead to  improved health parameters, even in the absence of weight loss.        

Eating  right  is  as  important as exercising. One should stay away from  diet  fads  and  stick  to  'sensible  diets' that result in long lasting  benefits.  Several  servings  of  vegetables  and  fruits,  oil lowest in  saturated content and several small meals in a day are ways to eat right.  The  intake  of  simple  sugars  needs  to  be  kept  to a minimum, while  consuming  more  of  complex  carbohydrates.  What  is also required is a  regular  check-up  of  parameters.  Most  of  the  risk factors for heart  disease  are  silent and therefore one needs to keep a regular watch over  weight, glucose levels, blood pressure etc to pre-empt the disease.    
One  can  combat the disease at the grass root level by simply being more  aware  and  cautious  about  the  risk factors and symptoms. But existing  cases  of  heart  disease  and those in the danger zone need governmental  help  as  well.  The population of the country must get an opportunity to  attain   the   highest-possible  level  of  health.  Access  to  quality,  affordable healthcare is absolutely essential especially for the poor and  marginalized population.                                              

Many  lifestyle diseases have their origin in childhood. Unhealthy eating  habits  among children lead to lifestyle diseases like obesity, diabetes,  heart  disease later in life. This calls for the need to educate children  about  the  ill  effects of unhealthy snacking. The Centre recently asked  state  governments  to  ban  sale  of  junk food and carbonated drinks on  schools  premises.  The  Union  health  and family welfare ministry wants  guidelines  to  be  framed  to  serve  good  quality food like dal, roti,  sprouts etc in schools and colleges.                                  

 More needs to be done to curb childhood obesity and related problems like  heart  disease.  People  in the metros are not only hard pressed for time  but  also for open spaces to exercise. A study of 4000 Indian children in  15  cities  indicated  that  23  per  cent  of 5 to 14 year olds in urban  schools  were overweight, while nearly 11 per cent were obese. Overweight  children are at a greater risk of developing diabetes and heart disease.

 Open  spaces  in  the city are few and far between. The existing ones are  getting more crowded than ever, leading to children spending more time in  front  of  their  TV and computer screens. Civic administration of cities  needs  to give heed to the development and maintenance of open spaces for  the citizens.                                                          
A holistic view  of  the  disease would lead to holistic measures being  taken. Programmes to combat NCDs are under-funded in India at present. As  the world discusses this growing malaise at a world forum, India needs to  chalk out its own plan to combat it.                                  

Heart-disease triggers:

Smoking  is the one of the most important preventable causes of premature  death.  A  smoker's risk of having a heart attack is twice more than that  of  a  non-smoker.  Smoking  speeds  up  the development of plaque in the  arteries,  reduces  the  level of the good HDL cholesterol, and increases  the stickiness of blood cells causing blood clots inside the arteries.
High  blood  pressure or hypertension is often referred to as the "silent  killer."  The reason for this is that people often suffer severe problems  related  to  hypertension,  without  being  aware  that their pressure is  high. . It is a common misconception that your systolic BP should be your  age plus 100. This is a myth.                                          
A  high  blood  pressure  has  been  defined as either the higher number,  called  systolic  pressure  being  over  140  or the lower number, called  diastolic  pressure  being  over  90.  However, your ideal Blood Pressure  should be below 120/80.                                                
High Cholesterol
If LDL or bad cholesterol is too high in your blood, some of it sticks to  the walls of blood vessels and is absorbed. The end result is large fatty  deposits  in the blood vessels which cause the vessels to become narrow ,  stiff,  narrow  and  less responsive to triggers to expand and constrict,  reducing  the  blood  flow  to  the heart and other organs. This leads to  heart  diseases and potentially a heart attack. Therefore it is important  to make lifestyle changes, exercise regularly, eat healthy and minimalize  the sources of bad fats.                                              
 Indians  have one of the highest genetic risks for diabetes. It is a very  serious  disease  in  itself  and  leads  to  complications  in the eyes,  kidneys,  and  blood vessels, besides being one of the major risk factors  for  heart  disease.  In clinical practice we are observing more patients  (and  at  younger  ages)  with  Syndrome  X,  also  called the 'Metabolic  Syndrome',  in  which  high  blood  sugar,  high  blood pressure, a large  waistline, and abnormal lipid values are all clustered together.        
Diabetes is diagnosed on the basis of your fasting glucose      levels.  A  level of more than 126 mg/dl indicates diabetes. However,      this should be confirmed by another test done on a different day.  
Normal fasting blood sugar should be 70 -100 mg/dl      
As  India  is  becoming  more  'prosperous'  so are the waistlines of its  citizens.  Obesity  can lead to diabetes, high blood pressure, as well as  other  complications such as arthritis. A sensible diet, combined with an  exercise  programme  is  the  best way to lose weight. Crash diets do not  work in the long term, and may actually be harmful for the body.      
The  role  of  stress  in the development of heart disease is not clearly  defined  as it cannot be 'measured' by any test, but it is advisable that  you keep your stress levels as low as possible.                        

The  triggers  of  heart  disease  can be controlled by leading a healthy  life.  This  should  include  a healthy diet which lowers cholesterol and  blood  pressure and also keep obesity in check. Regular physical activity  of  some  kind  is  also  beneficial in keeping heart disease at bay. One  should  try to maintain the ideal Body Mass Index or healthy weight for a  sustained  period  of  time. Alcohol should be consumed in moderation and  tobacco consumption should be stopped immediately.                      
The key is to stay away from risk factors of heart disease. The more risk  factors  a  person  has,  the greater the possibility of developing heart  disease.                                                                

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