As the new year dawns, it is important that we take a minute to assess our health and understand one of the most common causes of deaths in Sri Lanka—cardiovascular diseases (CVD). There are two types of heart diseases related to a process called atherosclerosis. Atherosclerosis is a condition that develops when plaque builds up in the walls of the arteries. This build-up narrows the arteries, making it harder for blood to flow through. If a blood clot forms, it can stop the blood flow. This can cause a heart attack or stroke.
A heart attack occurs when the blood flow to a part of the heart is blocked by a blood clot. If this clot cuts off the blood flow completely, the part of the heart muscle supplied by that artery begins to die. Most people survive their first heart attack and return to their normal lives to enjoy many more years of productive activity.
An ischemic stroke happens when a blood vessel that feeds the brain gets blocked, usually from a blood clot. When the blood supply to a part of the brain is cut-off, that part of the brain will die. The result will be the inability to carry out some of the previous functions as before, such as walking or talking. A haemorrhagic stroke occurs when a blood vessel within the brain bursts. The most likely cause is uncontrolled hypertension.
CVDs are the number one cause of death globally: people die annually from CVDs more than from any other cause. An estimated 17.7 million people died from CVDs in 2015, representing 31 percent of all global deaths. Of these deaths, an estimated 7.4 million were due to coronary heart disease and 6.7 million were due to stroke. More importantly, over three quarters of CVD deaths take place in low and middle-income countries.
Out of the 17 million premature deaths (under the age of 70) due to non-communicable diseases in 2015, 82 percent are in low and middle-income countries, and 37 percent are caused by CVDs. Most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol using population-wide strategies.
People with cardiovascular disease or who are at high cardiovascular risk (due to the presence of one or more risk factors such as hypertension, diabetes, hyperlipidaemia or already established disease) need early detection and management using counselling and medicines, as appropriate.
No matter what your age, everyone can benefit from a healthy diet and adequate physical activity.
Choose a healthy eating plan
The food you eat can decrease your risk of heart disease and stroke. Choose foods low in saturated fat, transfat, and sodium. As a part of a healthy diet, eat plenty of fruits and vegetables, fibre-rich whole grains, fish (preferably oily fish-at least twice per week), nuts, legumes, and seeds and try eating some meals without red meat. Select lower fat dairy products and poultry (skinless). Limit sugar-sweetened beverages and red meat such as beef, lamb, and mutton. If you choose to eat such meat, select the leanest cuts available.
Be physically active
You can slowly work up to at least 2½ hours (150 minutes) of moderate-intensity aerobic physical activity (e.g., brisk walking) every week or 1 hour and 15 minutes (75 minutes) of vigorous intensity aerobic physical activity (e.g., jogging, running) or a combination of both in every week. Additionally, on two or more days a week, you need muscle-strengthening activities that work all major muscles (legs, hips, back, abdomen, chest, shoulders, and arms). Children should get at least 60 minutes of activity every day.
Looking out for the warning signs
It’s never too early or late tolearn the warning signs of a heart attack and stroke. Not everyone experiences sudden numbness with a stroke or severe chest pain with a heart attack. Heart attack symptoms in women can be different than men.
If you start getting smart about your heart in your 20’s, it will put you far ahead of the curve. “The things you do and don’t are a tell-tale sign of how long and how well you’re going to live,” said Richard Stein, M.D. “There’s no one I know who said: ‘I felt better being sedentary. I felt better eating a terrible diet,’” said Stein, a cardiologist and professor of medicine at New York University School of Medicine further. All these things actually make you feel better while they help you.
Find a doctor and have regular wellness exams
Healthy people need doctors too. Establishing a relationship with a physician means you can start heart-health screenings now.
Talk to your doctor about your diet, lifestyle and check your blood pressure, cholesterol, heart rate, blood sugar, and body mass index. You may also need your blood sugar checked if you are pregnant, overweight or have diabetes. Knowing where your numbers stand early makes it easier to spot a possible change in the future.
Quit smoking and avoid sedentary smoking
If you have been addicted to smoking as a teen, it’s time to quit smoking. Even exposure to second-hand smoke poses a serious health hazard. Non-smokers are up to 30 percent more likely to develop heart disease or lung cancer from second-hand smoke exposure at home or work, according to a U.S. Surgeon General report.
Make heart-healthy living a family affair
Create and sustain heart-healthy habits in your kids and you’ll reap the benefits too. Spend less time on the couch and more time on the move. Explore a nearby park on foot or bike. Shoot some hoops or walk the dog. Plant a vegetable and fruit garden together in the yard, and invite your children into the kitchen to help cook.
Know your family history
Shake down your family tree to learn about heart health. Having a relative with heart disease increases your risk, and more so if the relative is a parent or sibling. That means you need to focus on risk factors you can control by maintaining a healthy weight, exercising regularly, not smoking and eating right. Also, keep your doctor informed about any heart problems you learn about in your family.
Tame your stress
Long-term stress causes an increase in heart rate and blood pressure that may damage the artery walls. Learning stress management techniques not only benefits your body, but also your quality of life. Try deep breathing exercises and find time each day to do something you enjoy. Giving back through volunteering also does wonders for knocking out stress.
If even at 40, heart health hasn’t been a priority, don’t worry. Healthy choices you make now can strengthen your heart for the long haul. Understand why you need to make a lifestyle change and have the confidence to make it. Then, tackle them one at a time. “Each success makes you more confident to take on the next one,” said Stein, an American Heart Association volunteer.
Watch your weight and Body Mass Index (BMI)
You may notice your metabolism slowing down in your 40s. But you can avoid weight gain by following a heart-healthy diet and getting plenty of exercise. The trick is to find a workout routine you enjoy. If you need motivation to get moving, find a workout buddy.
Have your blood sugar level checked
In addition to blood pressure checks and other heart-health screenings, you should have a fasting blood glucose test by the time you’re 45. This first test serves as a baseline for future tests, which you should have every three years. Testing may be done earlier or more often if you are overweight, diabetic or at risk for becoming diabetic.
Don’t brush off snoring
Listen to your sleeping partner’s complaints about your snoring. One in five adults has at least mild sleep apnea, a condition that causes pauses in breathing during sleep. If not properly treated, sleep apnea can contribute to high blood pressure, heart disease and stroke.
Unlike the emergence of wrinkles and grey hair, what you can’t see as you get older is the impact aging has on your heart. So starting in the 50s, you need to take extra steps.
Follow your treatment plan
By now, you may have been diagnosed with high blood pressure, high cholesterol, diabetes or other conditions that increase your risk for heart disease or stroke. Lower your risk by following your prescribed treatment plan, including medications and lifestyle and diet changes.
With your 60’s comes an increased risk for heart disease. Your blood pressure, cholesterol, and other heart-related numbers tend to rise. Watching your numbers closely and managing any health problems that arise along with the requisite healthy eating and exercise can help you live longer and better.
Have an ankle-brachial index test
Starting in your 60s, it’s a good idea to get an ankle-brachial index test as part of a physical exam. The test assesses the pulses in the feet to help diagnose Peripheral Artery Disease (PAD), a lesser-known cardiovascular disease in which plaque builds up in the leg arteries.
The writer holds a B.Sc. in Food Science and Nutrition, a Sp. Applied Nutrition, and is attached to the Wayamba University Livestock Fisheries and Nutrition Faculty’s Applied Nutrition Department.
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