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Tips to prevent heart attacks

Most frequently asked question in my consultation is

Dr. How to prevent heart attack?  The heart attack leaves a devastating effect  on the patient and also on the whole family so they are anxious to know  how to prevent heart attacks.

While  we have decisively controlled epidemics of cholera, plague, small pox, polio, rabies and other infectious diseases we are not so successful in controlling heart attacks which has now assumed epidemic proportion.

Risk factors can be classified as modifiable and non modifiable. The main non modiafiable risk factors are 1. Age, 2. Genetics and major modifiable risk factors are 3. High B.P,  4. High cholesterol, 5.Physical inactivity, 6.Smoking, 7.Diabetes, 8. Stress we have no control over the age and genetics. But we can modify other risk factors by life style modifications. How to modify?

High B.P

Has no symptoms. Normal B.P 120/80 mmHg, though elderly people are likely to have high B.P. A few young people also suffer from high B.P.  So it is better to checkup your B.P at least once a year. If your B.P is 120/80 mmHg it is normal. Consult your family doctor it is above 140/90 mmHg to rule out other causes. Each increase of your systolic B.P 20 mmHg above 115 doubles your chance of heart attack.

Three simple basics to control your B.P.  1. Restrict salt,  2. Reduce weight, 3. Reduce stress.

High cholesterol is incriminated as main risk factor for clogging of the coronary arteries resulting in heart attacks, Your total cholesterol should be below 200 mgs. LDL less than 100.HDL above 50. Cholesterol despite bad publicity, is not all that bad. It is needed for the synthesis of important hormones. Only in high concentrations along with other risk factors like physical  inactivitiy and smoking it  initiates   clotting in the arteries.

Our diet is made up of carbohydrates proteins and fat and micro nutrients cholesterol is derived from saturated fat. Your body makes all the cholesterol it needs even if  itis completely cholesterol free. Intake of cholesterol can be controlled by taking cholesterol free diet. If your cholesterol LDL is high above 100 mgs inspite of strict fat free diet, you need not worry,You have excellent drugs to bring down the cholesterol.  

You may ask how much fat or oil to take ? You need to take 15 – 20 gms vegetable oil to meet daily requirement. Now your next query is which oil is best.  All oil’s have three types of fat 1. Saturated fat, 2.Poly unsaturated fat, 3.Mono unsaturated in different proportions. Saturated fat rises your cholesterol. Unsaturated fat doesnotrise your cholesterol.

How to find out which oil contains more of saturated fat. It is easy, The oil that solidify on freezing is the saturated fat eg. Coconut oil.

There is an impression olive oil and sun flower oil lower your cholesterol level, this is unfortunately not  true, as they also have saturated fat.  So whatever  the oil, restrict it to 15 – 20 gms.

You get 20% of your calories from fat  25 – 30% from proteins, 50 – 60% of carbohydrates   

You may have a genuine doubt.  

If I get most my calories from carbohydrates, will it not lead to diabetes. This happens when your food is loaded with simple sugars like glucose lactose honey and alcohol. If you take complex carbohydrates like rice wheat and cereal, your chances of getting diabetes is less.

What about proteins. Your requirement per day is 1 gm/kg. This is easily obtained from dhal legumes and other pulses. You need not go for eggs or meat.

EXERCISE

Physical inactivity due to our sedentary life style is the major cause of heart attack.

We Indians loathe manual work and we glorify inactivity. We have been brought up with the notion, that doing manual work is below our status. We employ a cook to prepare our food and another to wash the utensil and mop the floor. Richer the person more the number of servants and less physical activity.  

And to add insult to injury we generally do not play games, go for walking or swimming. We assume all these games are to be played by youngsters. Only game we are fanatically mad of is cricket. It is played in a leisurely way and watched by millions of people sitting idly for hours Cricket, our national game does not improve the health of the players and enforces physical inactivity among the viewers.  

You should enjoy your excise, Enjoy your tennis foot ball swimming and walking.

Excise should he fun. If it is fun you will enjoy doing it regularly.  

DIABETES

If you are a diabetic your chances of getting heart attack is double and attack is silent you may not feel the typical pain. You should be beware of the drugs that producess prolonged hypoglycemia and heart attack. 

SMOKING

The next culprit is smoking. A famous cardiologist while participating in a conference was asked to limit his speech on preventing heart attacks in a few sentences for want of time. He got up and addressed the gathering. Stop smoking and start walking and stopped his talk. This is the sacred mantra for a healthy heart. There is warning on every packet of cigarette. Smoking in injurious to health. In spite of this warning young people get addicted to smoking. That is because they see their role models smoking in the movies. Our Government has banned smoking in the movies in the face of heavy opposition from tobacco lobby and cine field. Smoking cigarettes is addictive.

You have to quit smoking on your own, all at once. You should be well motivated.   

STRESS

Next I will deal with stress. Todays life is full of tension and stress, fast and fiercely competitive from L.K.G to M.B.A.  Your B.P shoots up, your pulse races when you touch the road on your way of office. The traffic is so congested and hazardous and in the office also you get irritated as things are not happing as you like. On your dealings with government you encounter corruption at all levels. It is impossible to be unaffected by the conditions prevailing around us. You should follow the old adage, Oh, God give me the courage to change the things which I can and endure things which cannot, and to give me the wisdom to know change. By your out burst and anger will hurt only you. Everyday allot some time morning and evening for meditation. There are excellent centers in your own town. Utilise them. 

Dr. G. Sengottuvelu, M.D.,DM.,DNB.,FMMC., FSCAI., FRCP (London) FRCP (Glasg)., FACP Fellowship in Interventional Cardiology ( France) Senior Consultant & Interventional Cardiologist. Apollo Hospitals main, Chennai. Mobile – 9841430999