The department of medicine celebrated “world heart day” today i.e. the 29th of September, 2018. Dr.Rizwan Aziz Qazi was invited by the head of department Dr.Shajee Ahmed Siddiqui as a chief guest. The participants stressed to identify the risk factors for heart diseases.
Heart diseases are becoming more prevalent owing to the changing lifestyle and the diabetes epidemic in Pakistan. Every one in four persons dies of a heart disease. Participants stressed on the following modifiable risk factors for heart diseases and how to reduce one’s risks for developing heart diseases.
Diabetes is thought to be a coronary heart disease equivalent. This statement is probably an underestimation of the hazards diabetes put a patient in. Diabetes is a strong risk factor for atherosclerosis and kidney diseases. Both the conditions independently are risk factors for heart diseases. Dyslipidemia is also more prevalent in diabetes and so is hypertension which further increases the risk of heart disease.
Another very strong risk factor for heart disease is uncontrolled blood pressure. Hypertension leads to ventricular hypertrophy. This leads to increased oxygen requirements by the heart leading to angina and myocardial infarction.
Obesity has also become an epidemic because of the changing lifestyles. Metabolic syndrome and obesity are recognized as a spectrum of the same disease. Metabolic syndrome requires the presence of three or more of the following
1. Abdominal obesity,
2. Triglycerides 150 mg/dL or higher,
3. HDL cholesterol less than 40 mg/dL for men and less than 50 mg/dL for women,
4. Fasting glucose 110 mg/dL or higher, and hypertension.
High cholesterol, low-density lipid profile, and triglycerides, as well as low HDL, are all associated with increased risk of coronary heart diseases. The 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults suggests the use of statins in four groups of patients. These include patients with
1. Clinical atherosclerotic disease,
2. LDL cholesterol 190 mg/dL or higher,
3. Diabetes who are aged 40–75 years, and
4. An estimated 10-year atherosclerotic risk of 7.5% or more aged 40–75 years.
Importantly, the guidelines do not recommend treating to a target LDL cholesterol. Managing dyslipidemia requires the intake of a healthy diet rich in green vegetables, and fruits and less intake of salt, oil, and carbohydrates.
A sedentary lifestyle leads to obesity, diabetes, and dyslipidemias. All these contribute to atherosclerosis and coronary heart disease. Individuals and especially those at high risk of developing coronary heart disease should exercise for thirty minutes daily or at least five times a week.
stress leads to the release of certain hormones in the body. These include adrenaline and noradrenaline which directly causes narrowing of the blood vessels and increases blood pressure. Takotsubo cardiomyopathy is a term given to stress-induced cardiomyopathy.
Smoking has been ranked as the topmost preventable causative factor of death and illness in the united states. But the good news is that one year after quitting smoking, the risk of coronary heart disease reduces by 50%.