The sooner you identify and manage your risk factors for heart disease, the better your chances of leading a heart-healthy life. Dr. Iftikar Ebrahim, an interventional cardiologist in private practice with a special interest in cardiac resynchronization therapy and renal denervation, explains to Longevity how to understand, prevent and manage heart disease, hypertension and obesity.
You need to understand your risk of heart disease
Dr. Iftikar Ebrahim says there are certain heart disease risk factors that you cannot change. That’s why it’s important to understand what they are. The more risk factors you have, the greater your chance of developing coronary heart disease.
Since you can’t do anything about these risk factors, it’s even more important that you understand how to manage them.
“Children of parents with heart disease are more likely to develop heart disease themselves. Most people with a significant family history of heart disease have one or more other risk factors. Just as you can’t control your age, sex and race, you can’t control your family history. So, it’s even more essential to treat and control any other modifiable risk factors you have,” he says.
If you have a history of heart disease in your family, then you should discuss this with your medical practitioner. There are genetic tests available that can also provide you with a deeper understanding of your own risk.
As you age your risk increases
The majority of people who die of heart disease are 65 or older. While heart attacks can strike people of both sexes in old age, women are at greater risk of dying (within a few weeks).
Dr Ebrahim says for men the risk begins at about 45 years old and for females above 55.
High blood pressure
Hypertension is a major cause of premature death worldwide. You need to understand your blood pressure and if you are at risk. A GP or even your local pharmacy or clinic can help you check your status. Once you know your status, you can begin to manage it.
According to the World Health Organization, an estimated 1.28 billion adults aged 30-79 years worldwide have hypertension, most (two-thirds) living in low- and middle-income countries
An estimated 46% of adults with hypertension are unaware that they have the condition. Less than half of adults (42%) with hypertension are diagnosed and treated.
If you are a man, you are at a greater risk
Men have a greater risk of heart attack than women. They also had attacks earlier in life. A woman’s risk increases after menopause, but still is not as great as their male counterparts.
What you can modify, treat or control
The good news is that there are some risk factors that you can influence, treat and keep under control, says Dr. Ebrahim. Take note of these factors.
Smoking
The risk that smokers will develop coronary heart disease is much higher than for nonsmokers.
Cigarette smoking is a powerful independent risk factor for sudden cardiac death in patients with coronary heart disease. Cigarette smoking also interacts with other risk factors to greatly increase the risk of coronary heart disease. Exposure to other people’s smoke increases the risk of heart disease.
High blood cholesterol
As your blood cholesterol rises, so does your risk of heart disease. When other risk factors (such as high blood pressure and tobacco smoke) are also present, this risk increases even more. A person’s cholesterol level is also affected by age, sex, heredity, and diet. Here’s the lowdown on:
According to the Cleveland Clinic, your lipid panel gives you the following numbers:
- Total cholesterol: This is the total amount of cholesterol that’s circulating in your blood. Here’s the formula for calculating it: HDL + LDL + 20% triglycerides = total cholesterol.
- HDL level: HDL is high-density lipoprotein. This is the “good” cholesterol that moves extra cholesterol from your bloodstream to your liver. Your liver then gets rid of it from your body. When you look at HDL, think of “h” for help. HDLs help your arteries clear out the cholesterol your body doesn’t need. It’s the one number on your lipid panel that you want to be high.
- LDL level: LDL is low-density lipoprotein. This is the “bad” cholesterol that contributes to plaque buildup in your arteries. You require some LDLs because they carry cholesterol to your body’s cells. But having too many can cause problems.
- VLDL level: VLDL is a very low-density lipoprotein. It’s another “bad” form that contributes to plaque buildup. VLDLs carry a type of fat (triglycerides) in your blood. If you have too many VLDLs, the extra fat can build up in your arteries.
- Triglycerides: This is a type of fat. You require some triglycerides. But high levels (hypertriglyceridemia) can put you at risk for atherosclerosis and other diseases.
- Non-HDL cholesterol: This is all the cholesterol in your blood that isn’t HDL. The formula for calculating this number is simple: Total cholesterol – HDL = Non-HDL cholesterol
- The ratio between total cholesterol and HDL: This is your total cholesterol divided by your HDL. In general, you want your number to be below five. Your results may show a chart with more details and desirable levels.
Physical inactivity
An inactive lifestyle is a risk factor for coronary heart disease.
Regular, moderate to vigorous physical activity helps reduce the risk of cardiovascular disease. Physical activity can help control blood cholesterol, diabetes and obesity. It can also help to lower blood pressure in some people.
Obesity and being overweight
People who have excess body fat – especially if a lot of it is around the waist – are more likely to develop heart disease and stroke, even if those same people have no other risk factors.
Overweight and obese adults with risk factors for cardiovascular disease such as high blood pressure, high cholesterol, or high blood sugar can make lifestyle changes to lose weight and produce significant reductions in risk factors such as uncontrolled blood glucose and Type 2 diabetes.
Credit: Thamkc/DepositPhotos
Diabetes
Type 2 diabetes seriously increases your risk of developing cardiovascular disease.
Even when glucose levels are under control, diabetes increases the risk of heart disease and stroke. The risks are even greater if blood sugar is not well-controlled.
At least 68 percent of people with diabetes over 65 years of age die of some form of heart disease. Among that same group, 16 percent died of stroke.
If you have diabetes, work with your doctor to manage it. To help manage blood sugar, people with diabetes who are obese or overweight should make lifestyle changes, such as eating better or getting regular physical activity.
“Blood pressure is easily treated as is diabetes. There are also new drugs that are effective in treating obesity.” says Dr Ebrahim.
Healthy Heart Rate
The normal resting heart rate for adults ranges from 60 to 100 beats per minute. Generally, a lower heart rate at rest implies more efficient heart function and better cardiovascular fitness.
“If you feel your pulse, right, you can simply put your finger on your radial pulse, or you could feel a carotid pulse very easily. You can time it. Take the watch and time for over 60 seconds and count the number of beats that will be your pulse rate. If it’s less than 60, it’s too slow. It’s more than 100. It’s too fast. And then that’s the rate.”
Listen to your heart rhythm
Dr. Ebrahim has previously written in Longevity about the importance of listening to your heartbeat. He explains why you also need to check your heart rhythm.
“Like everything in life, your heart also has a rhythm, like a dance rhythm. Most things in life have rhythms as well. And your heart is supposed to go to rhythm. When your rhythm is out. it has other implications. If you feel your pulse, and it’s beating in an irregular rhythm, it may still be between the normal 60 and 100, however if it’s an irregular rhythm, then you need to have an ECG done and investigated further.”
Other factors that contribute to heart disease risk
Stress
An individual’s response to stress may also be a contributing factor to heart attacks. Some scientists have noted a relationship between coronary heart disease risk and stress in a person’s life, along with their health behavior and socioeconomic status. These factors may affect established risk factors.
For example, people under stress may overeat, start smoking or smoke more than they otherwise would. Emotional stress can also impact your heart.
“When you are stressed, you increase your stress hormones so that your cortisol levels, adrenaline and noradrenaline levels are very high.Takotsubo disease or broken heart syndrome can occur when stress hormones have gone through the roof. And what actually happens, your stress hormones cause a spasm in your coronary arteries”
A healthy diet is critical to your heart health
A healthy diet is one of the best weapons you have to fight cardiovascular disease or alternatively you can consult cardiovascular specialists of central maryland. What you eat (and how much) can impact other controllable risk factors, such as cholesterol, blood pressure, diabetes, and being overweight.
Choose nutrient-rich foods, which have vitamins, minerals, fiber, and other nutrients, but are lower in calories than nutrient-poor foods.
Choose a diet that emphasizes vegetables, fruits and whole grains. A heart-healthy diet also includes low-fat dairy products, poultry, fish, legumes, nuts and nontropical vegetable oils.
Be sure to limit your intake of sweets, sugar-sweetened beverages, and red meats. To maintain a healthy weight, coordinate your diet with your physical activity level, so you’re using up as many calories as you take in.
The do’s and don’ts
Dr. Ebrahim believes diets need to be looked at in their entirety and not as fads.
“The most important thing to remember is that processed food is bad for you. Too much salt in your diet is bad for you. And there’s no debate that refined sugar is bad for you. When it comes to protein diets and carbs and high carbs and low carbs and high protein, yes, there’s a lot of debate. But there’s good protein and good carbs. So refined carbs are bad.”
He goes on to explain that complex carbs are good. However, don’t forget vegetables are carbohydrates.
“Focus on healthy veggies. You must eat complex carbohydrates. Refined carbs like white rice, potatoes, and white bread are simple carbohydrates. On the other hand, sweet potato is good. Protein is good for you. But focus on good protein. Fish, rich in omegas, is the best. I am not saying to leave out red meat completely. But eat it in moderation. Red meat is not only bad for your heart, but it also increases your chance of colon cancer, besides warming the planet.”
You are never too young to worry about a heart attack
You’re never too young to start heart-healthy living. If you’re over 40, or if you have multiple risk factors, work closely with your doctor to address your risk of developing cardiovascular disease.
“Heart attack prevention is critical. It should begin early in life. Start with an assessment of your risk factors. Then develop a plan you can follow to maintain a low risk for heart attack.”
The bottom line
While modern medicine has made great progress in treating heart disease, the risk remains ever-present. And for many people, their first heart attack was disabling or even fatal. Do everything you can to lower your risk.
Listen to the full #WellnessWednesday conversation by clicking the link below
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