A heart attack is a condition when the arteries supplying blood to the heart (one or more) are blocked by a clot formation, cutting off the blood supply to part of the heart it is supplying. This results in a shortage of oxygen and other nutrients that lead to the death of the muscle cells of the heart. Actress Mandira Bedi’s husband, filmmaker/producer Raj Kaushal recently passed away after suffering a cardiac arrest, he was only 49. It is pertinent to mention that middle-aged men and women indeed have an increased risk of heart disease, therefore, they should follow a heart-healthy lifestyle. Here, we will discuss how people, who are in their 40s, can prevent heart-related problems.
At 40 years of age one is at the twilight of youth and steps into middle age. There are hormonal changes in both the sexes as a part of ageing which has a complex relationship with the body’s metabolism that is affected leading to several changes in the body.
Forty is an age where most are at an important stage of their professional career along with added responsibilities in their family life. The peer pressures of performance at work along with various other difficulties makes it a very vulnerable period of ones’ life. This is an age where diseases like Type II Diabetes, High BP, dyslipidemia and various other diseases manifest or are detected. The psychological pressures push people into excessive stress resulting in lack of sleep, unhealthy eating, increased alcohol consumption and smoking. Due to scarcity of time, there is a lack of physical exercise too. All these contribute to weight gain, high BP, high blood sugar, high cholesterol which pushes a person into the vicious cycle of bad health with a very high risk of life-threatening heart attack and stroke. 20% of people who have a heart attack are 40 or younger and this rate has risen by 2% every year in the last decade.
SYMPTOMS OF HEART ATTACK
It’s crucial to be aware of the symptoms of a heart attack. Some of these are:
• Chest pain perceived as a feeling of pressure or tightness
• Pain in the centre of the chest with radiation to the left arm, shoulder and jaw associated with sweating
• Shortness of breath
• Excessive unexplained sweating
• Feeling dizzy and fainting
• Pain in the upper abdomen radiating upwards to the chest and back with nausea and vomiting
SMOKING AND HEART DISEASE
Every cigarette smoked makes you more likely to get a heart attack or stroke. Roughly one out of five deaths from heart disease are directly related to smoking. People who smoke are two to four times more likely to get heart disease. The risk is even greater in women who smoke and also take birth control pills.
How does cigarette smoke harm your heart and blood vessels?
1. It causes endothelial activation and dysfunction by reducing vascular NO availability, biomolecule oxidation and endothelial damage. The endothelium is the innermost layer of a blood vessel
2. It causes pathogenic alterations in lipid profile and lipid oxidation
3. It induces a local and systemic proinflammatory status leading to injury to the endothelium
4. It causes a procoagulative environment leading to thrombus formation (blood clotting)
5. Smoking causes the heart rate to rise and also increases blood pressure
There are 7000 toxic substances found in cigarette smoke.
The cardiovascular diseases caused by smoking are: coronary artery disease (arteries of the heart), hypertension, heart attack, stroke (brain), aortic aneurysm (dilation due to thinning of the walls of the vessel), and peripheral vascular disease (affect the vessels of the limbs).
HOW DOES QUITTING SMOKING HELP?
Twenty minutes after you quit smoking your heart rate drops.Just twelve hours after quitting the carbon monoxide level in blood drops to normal, allowing more oxygen to vital organs.Within four years of quitting, your risk of stroke drops to that of lifetime non-smokers.
HOW TO PROTECT YOUR HEART?
Get moving: Aim for at least 30 to 60 min of activity per day. Regular or daily physical activity can lower your risk of heart disease by reducing your weight, blood sugar, cholesterol and BP. It can be 150 minutes a week of moderate aerobic exercise like walking, cycling or jogging or a 75 minutes of vigorous aerobic activity or two or more strength training sessions a week.
Eat a Heart-Healthy diet: A healthy diet will protect your heart by reducing your weight, controlling BP, cholesterol, and diabetes. A heart-healthy diet includes vegetables and fruits, beans or other legumes, lean meats and fish, low fat or fat-free dairy products, whole grains, and healthy fats like Olive oil. Limit the intake of salt, sugar, alcohol, saturated fat (found in red meat and full-fat dairy products), trans fat (found in fried fast food, chips and baked food).
Maintain a Healthy weight: A BMI of 25 and above is considered overweight. Overweight especially around the middle part of the body increases the chance of developing heart disease, hypertension, dyslipidemia, and Type II Diabetes.
Waist circumference is a useful tool to measure abdominal fat. 40 inches for men and 35 inches for women are considered the cut-off point. Reducing your weight by just 3% to 5% can be beneficial as it can decrease certain fats (triglycerides), blood sugar, BP, and cholesterol.
Get good quality sleep: Lack of sleep leads to a higher risk of obesity, high BP, heart attack, diabetes, and depression. Most adults need seven hours of sound sleep. Make sleep a priority in your life by setting a schedule and sticking to it. Thus going to sleep and getting up at the same time every day. If you feel tired throughout the day or have a disturbed sleep where you wake up several times at night then get yourself evaluated for obstructive sleep apnoea, which manifest as snoring, stopping of breath, and waking up gasping. This is treated with a CPAP continuous positive airway pressure and weight reduction. This is one of the reasons for high BP, heart failure, and sudden cardiac death.
Stress management: Cope with stress properly and not by indulging in smoking, eating unhealthy food, and drinking alcohol. Exercise and sports are good ways to reduce stress. Meditation and yoga are the best but getting counselled by a Clinical Psychologist is helpful.
Regular Screening tests: Regular screening help you identify your risk for heart disease, especially if have a strong family history of one.
BP screening should begin from the age of 18 and measured at least once in two years. For people in their 40s, who are not hypertensive, should have their BP screened at least annually.
Cholesterol screening should also begin at the age of 20 and done annually for people with a family history of hypertension or heart disease. Once detected to have abnormal levels, tests should be repeated every six months or else annually.
Screening for diabetes: If one has a strong family history of diabetes or is overweight then screening should begin early. But for those, who have neither, screening should begin at 45.
Electrocardiogram: People with a family history of sudden cardiac death should be screened in their teens. Several familial and sporadic diseases cause a sudden increase in heart rate resulting in cardiac arrest and death. They have certain characteristic ECG by which they are diagnosed. A 24 Hr Holter (ECG) monitoring is also advised to them.
Imaging: Ultrasonographic (Echocardiography) imaging helps identify certain familial and congenital conditions which can cause sudden death. Hence, it is advised for people with a family history of premature deaths.
The writer is Consultant – Senior Interventional Cardiologist, Cardiac Science, HCMCT Manipal Hospital, Dwarka.
