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Health Tips Punjab Institue of Cardiology Lahore

Abdullah gul

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Health Tips Punjab Institue of Cardiology Lahore
« on: August 05, 2009, 01:28:08 PM »
Health Tips Punjab Institue of Cardiology Lahore

Cardiovascular diseases have now assumed the shape of a global pandemic and need special attention:

• Heart disease is the world’s number one killer. It is responsible for one in every three deaths. It affects both women and men with no regard for geography or economics.
• Eighty percent of the 17 million deaths caused by heart disease world wide occur in low and middle income countries. Risk factors linked to cardiovascular diseases are already among the top ten risk factors for the global disease burden in low income countries, and have become the dominant risk factors for death and disability in middle income countries.
• Children are at increasing risk, In particular through tobacco smoking (active and passive), obesity and lack of physical activity.
• Deaths among women due to heart disease are eight times higher than breast or ovarian cancer.
• Cardiovascular death and disability can be reduced by more than 50 % by taking simple and cost effective measures that deal with the risk factors.
• Contrary to popular thinking, heart disease research, prevention and treatment, are not properly funded, particularly in low and middle income countries.
The incidence and prevalence of cardiovascular diseases in the world in general and Pakistan in particular, have registered a significant increase over the past two decades. The cardiovascular diseases have assumed the shape of an epidemic, contributing to a huge proportion of morbidity and mortality throughout the globe. In other words, cardiovascular diseases are no longer a problem of the west alone, but are of an equal, if not greater concern to developing countries like Pakistan. Today our country carries the ‘double burden of disease’ – a combined load of communicable (infectious) and non-communicable (cardiovascular) diseases.
To cut it short, the rapid rate at which cardiovascular diseases are emerging means that the economic, social and emotional costs of this problem are becoming increasingly unbearable for a poor country like Pakistan. Learning from the experience of the west, we must realize that it is important to shift our focus from curative and rehabilitative care towards preventive cardiology
Preventive cardiology constitutes four levels:
• Health promotion: This aims at the prevention of onset of risk factors that may subsequently predispose a person to cardiovascular disease.
• Primary prevention: This aims to prevent the development of cardiovascular disease in a person who is at risk for it, i.e., one who has already developed risk factors but has yet to show symptoms of disease.
• Secondary prevention: This attempts to prevent recurrent events from occurring in patients who have established cardiovascular disease.
• Tertiary prevention: This primarily focuses on the palliative management of a patient suffering from cardiovascular disease.
The most important aspect of preventive cardiology is to change the lifestyle, behavior and attitude of the people. That in turn is only possible by creating awareness regarding the risk factors and subsequent effects of cardiovascular diseases. Emphasizing and applying the principles of preventive cardiology is the responsibility of the health care system of our country and the health care workers.
Elements or characteristics that predispose a person to a disease are termed as risk factors for that particular disease. The risk factors for cardiovascular disease are diabetes, hypertension, hyperlipidemia, smoking, family history, obesity and stress. Following is a brief explanation of all these factors to help create awareness about them:

Diabetes Mellitus is an independent risk factor for cardiovascular disease, increasing its risk by about two to three times for men and three to five times for women. Cardiovascular disease is the leading cause of death in diabetic patients and approximately 25 percent of heart attack survivors have diabetes. Diabetes is a more potent risk factor in women as compared to men since diabetic women have twice the risk of a second heart attack compared to diabetic men.

Hypertension (high blood pressure):
Hypertension remains one of the major risk factors for cardiovascular disease even if the systolic/diastolic (upper/lower, normal = 120/80) blood pressures only slightly fall into the hypertensive range. The risk imposed by hypertension is substantially heightened if other risk factors are present.

Cholesterol in blood can be divided into two portions: bad cholesterol and good cholesterol. Bad cholesterol (LDL cholesterol) is harmful in the sense that it gets deposited in the blood vessels and subsequently blocks it. This compromises the blood flow to the heart or the brain if that particular vessel supplies any of these two organs. Good cholesterol (HDL cholesterol) is beneficial for the circulatory system since it prevents the cholesterol deposition into the vessels and in fact returns it to the liver for proper metabolism and excretion. It is therefore important that the levels of bad cholesterol be kept below a certain value while the good cholesterol should be above a specific level in the blood.

Cigarette smoking increases the risk of cardiovascular disease by about two to three fold. The risk is amplified by several times if the smoker carries other risk factors of cardiovascular disease. Smoking remains the leading cause of preventable mortality, most of it due to cardiovascular disease. Cessation of smoking causes a precipitous fall in cardiovascular events. It is estimated that if a 35 year old quits smoking, he extends his survival by as much as 3 to 5 years. This is primarily due to a reduction in cardiovascular related events.

Family History:
If the first degree relatives of a person suffer from cardiovascular disease, the chances of that person getting the same problem increase manifold. It becomes all the more important for that person to make specific target oriented efforts to avoid the development of other risk factors.

Obesity has also shown a strong correlation with the risk of cardiovascular disease. While latest research also indicates that obesity might be an independent risk factor for cardiovascular disease, its major effects are through the changes it causes in the metabolic pathways. It does so by increasing the chances of getting diabetes, hypertension and hyperlipidemia.

Physical Inactivity:
Physical inactivity roughly doubles the risk of cardiovascular disease. Even regular moderate intensity exercise causes significant reduction in risk. The potential ways in which physical activity reduces the risk of cardiovascular disease include an increase in good (HDL) cholesterol, decrease in blood pressure and reduction in obesity. In other words, it acts and lessens the extent of numerous other factors that can lead to disease.


Continuous stress on a person causes increased production of catecholamines (certain hormones) which in turn puts greater load on the heart and can lead to increased blood pressure and predisposing to atypical cardiovascular events.
Unbalanced Diet:
An unbalanced diet consisting of high fat and cholesterol can lead to plaques in the coronary arteries. This can cause disruption of blood flow to the heart muscle, culminating in the death of the cardiac tissue. Lack of dietary fiber in the diet increases absorption of cholesterol from the gut resulting in a high blood cholesterol level. Some useful information regarding a balanced diet is given below:
• Eating fruits and vegetables three times a day or more reduces the risk of stroke and of dying from heart disease.
• A diet rich in pulses, such as lentils and chickpeas, significantly reduces the risk coronary heart disease.
• Eating fish regularly reduces heart disease risk in women with type 2 diabetes. Fish contains Omega-3 fatty acids which are good for the heart.
• Eating foods rich in folate decreases the risk of stroke and cardiovascular disease.
• Drinking eight or more glasses of water a day leads to a decreased risk of dying from heart disease-but drinking other liquids such as coffee , juice or soft drinks increase the risk.
• And of course the bottom line is: Eat to live; don’t live to eat.
Some useful tips for a healthy heart:
• Exercise - even moderate exercise is better than nothing.
• A better and balanced diet can improve or maintain your health.
• Control your weight.
• Try to stop smoking or at least decreasing the number of cigarettes smoked daily.
• Avoid stress as much as possible.
• Have your blood pressure monitored regularly.
• Check if you have diabetes. If yes, keep it controlled and undertake special precautions.
• Get your cholesterol level monitored regularly if you feel you are at risk.
• An overall checkup is recommended.