Interheart, a very significant global study answers why Indians are more prone to cardiovascular events such as heart attack
and brain stroke
compared to their western counterparts.
The study identifies nine modifiable risk factors that explain the occurrence of heart attacks in 90 per cent cases. These are divided into two parts: adverse risk factors and protective risk factors
While the adverse risk factors are smoking, bad cholesterol, high blood pressure, diabetes, abdominal obesity, mellitus and psycho-social stress, the protective risk factors are regular intake of fruits and vegetables, regular exercise and moderate alcohol consumption.
Globally, all nine risk factors were very significantly associated with heart attacks except alcohol, which had only a modest statistical significance. The strongest risk predictor globally was found to be dyslipidemia (high level of lipids: cholesterol, triglycerides, or both), followed by current smoking.
The risk associated with lipids and smoking
was particularly marked in the young (below 55 years of age in men and below 65 years in women) versus the older.
over 20 cigarettes
per day increase the risk of heart attack
by five times, 10 to 19 cigarettes
increases the risk by three times and smoking
less than five cigarettes
per day increases the risk by 1.5 times. Smoking
one cigarette shortens life by 11 minutes and people exposed to second hand smoke have 90 per cent excessive rate of heat attacks. Quitting smoking
at any age nullifies this risk in 3 years. It is never too late to give up. Reducing smoking
to minimum also helps.
High levels of bad cholesterol (LDL cholesterol) and low levels of good cholesterol (HDL cholesterol) promote heart disease. One per cent reduction in cholesterol leads to two per cent reduction in heart attacks. High risk individuals with multiple risk factors and even modestly raised levels of LDL cholesterol need the statin group of drugs (simvastatin, atorvastatin or rosuvastatin). All patients with proven heart and vascular disease need these drugs in high doses. These tablets should be taken under medical supervision and once required, need to be continued for long term.
is associated with increased secretion of adrenaline, which raises blood pressure, predisposes people to diabetes. Stress
management programs that comprise of exercises, meditation and yoga are useful in alleviating stress.
These approaches aim at blunting the adrenaline response to stress
and have added advantage of being safe. Drug treatment, if needed, must be under specialised supervision.
Regular exercise as a preventive risk factor is a very useful adjunct in bringing down blood pressure, blood sugar
and bad cholesterol levels. This combined with intake of plenty of seasonal fruits and green vegetables goes a long way in preventing heart attacks and stroke.
Next week: improve your cognitive functions with exercise