A stitch in time saves nine”. These proverbial words by Ben Franklin were first used in 1723 by Thomas Fuller. It was first referred to repairing sails on a ship. This concept can also be applied to prevention of heart attacks, which are becoming not only common but also being seen at younger ages.
The commonest cause of a “Heart attack” is blockage of an artery by a clot which suddenly stops blood from flowing to the heart muscle. This clot formation occurs on a partially blocked artery which has a build-up of fatty deposits on the inner wall of the blood vessel that supplies the heart with blood.
There are a number of risk factors associated with heart attacks such as tobacco use, high blood pressure, diabetes mellitus, and high levels of bad cholesterol, unhealthy diet, obesity and physical inactivity.
This build-up of cholesterol deposit is called atherosclerosis which hardens the arteries. A similar build up in the arteries supplying blood to the brain leads to brain strokes.
When atherosclerosis affects the arteries and builds up slowly, it leads to problems like angina. A symptom of chest discomfort or shortness of breath on variable degrees of effort like walking or climbing stairs. The degree of limitation is often related to the severity of blockade.
A sudden blockade leads to a heart attack, which can be rapidly fatal if not recognised and managed in time. It can also lead to very unstable or chaotic rapid beating of the heart, a condition called ventricular fibrillation which leads to instantaneous death unless managed within a few minutes by an effective cardio pulmonary resuscitation.
Prevention of a heart attack needs a control on the process of atherosclerosis. It has to start early in life and the measures are to be observed for the long term. For this identification of the modifiable risk factors is essential.
These risk factors are smoking and use of tobacco, raised levels of cholesterol (especially bad cholesterol, LDLc), high blood pressure, diabetes, psycho social stress, lack of adequate intake of fresh fruits and vegetables, sedentary lifestyle.
These risk factors explain at least 90% of the heart attacks in all geographies and races. Persons having presence of more than one of these risk factors are at a risk which is several folds higher.
Regular check-ups and taking measures if any of these risk factors is present is an essential preventive strategy. Preventive health check-ups which are available in many medical centres in the country have not been promoted energetically in the valley. We at Gauri heart Centre have made it a regular feature. In spite of that, people are hardly availing of it.
Atherosclerosis is preventable to a large extent for which a disciplined life consisting of regular exercise, eating a heart healthy diet consisting of plenty of fresh fruits and vegetables, no smoking, maintaining a healthy weight and early detection of high blood pressure and diabetes are essential. These measures go a long way to minimize the chances of getting a heart attack or a stroke. A tablet of aspirin a day used to be promoted as a preventive measure till 2018.
However, 3 large studies negated this concept and showed that whatever benefit accrues is offset by the increased bleeding. This showed that it has no role in primary prevention. Aspirin, however, is still advocated in people who have had a heart attack, a thrombotic brain stroke, bypass surgery or an angioplasty.
This is called secondary prevention. On the other hand, a group of drugs called Statins (atorvastatin, rosuvastatin etc) given under medical supervision are very useful in preventing vascular events like heart attacks and strokes.
The number of deaths in India due to cardiovascular diseases in 2020 were around 4.75 million and in J & K an estimated number of 14 lacks. In addition, we also see a large number of deaths occurring in young people below the age of 40 years.
This is very concerning and needs preventive measures. These measures have to come from all of us which include, voluntary bodies, panchayats, the media and NGOs besides the administrators.
Heart attacks are being seen frequently and are on a rise at all ages, including the younger population. The risk factors of these are well known: smoking, high blood cholesterol, high BP, diabetes, stress, bad food habits and lack of exercise. Preventive measures which include periodic checks and treating the risk factors is the key.
Dr Abid Hussain, Senior Consultant, Gauri Heart Centre
Dr Upendra Kaul, Founder Director Gauri Kaul foundation
Disclaimer: The views and opinions expressed in this article are the personal opinions of the author.
The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.