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Medicine & Health Education
The Story of Heart Attack
Lifestyle Modifications for a Healthy Body, Mind and Spirit
Bala N. Aiyer, M.D.
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Part - 2
 
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What should be done about the risk factors?

[1]. Family history of heart disease, especially heart attacks prior to the age of 50 years among close relatives and also stroke and other blood vessel diseases is a definite reason for a complete check up. We can not do much about the family history but we can investigate for other risk factors associated and treat, control or prevent them, to lower the probability of heart disease in a person and take efforts for early diagnosis and treatment.
[2]. High blood pressure and Diabetes mellitus contribute to hardening of the arteries, especially in association with high cholesterol. The risk will be reduced very much if these are well controlled with early diagnosis and proper treatment.
[3]. High blood pressure and Diabetes mellitus may remain without any symptoms until very late when complications like a heart attack, stroke or coma occur as the very first sign. Hence, they are called the silent killers. They need to be checked on routine examination periodically, especially if a person has a strong family history of these conditions or has unusual tiredness, loss of weight, frequent headaches, excessive thirst or sudden loss of weight without dieting.
[4]. High cholesterol levels above 190 and high Triglyceride [Fat] levels are well known to be associated with atherosclerotic blockages of arteries causing heart attack and stroke. This is much more correlated with high levels of LDL cholesterol of above 130. HDL cholesterol, called the good cholesterol, helps in removing cholesterol from to the liver and so low levels of this will increase the risk.
[5]. Cigarette smoking causes contraction and spasm of the blood vessels and lead to arteriosclerotic blockages with cholesterol deposits. It also interferes with the clotting mechanisms, causes blood clots, and causes blockages of arteries of heart, brain and legs.
 
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What other conditions can increase this risk?

There are some familial conditions with high cholesterol and high triglycerides and thyroid disorders also can cause the same. These can be controlled by strict diet and medical treatment program. A large majority of problems are due to improper eating habits. Most important factors are a very high consumption of animal fats, red meat, butter, eggs, certain vegetables and vegetable oils and alcohol. A woman who is on hormone treatment or birth control pills who also smokes will have a ten fold higher risk of developing blood clotting problems and heart attacks. If she has diabetes mellitus, the risk is even higher. Similarly, excessive alcohol drinking, over eating and obesity contributes to high cholesterol levels, higher incidence of heart disease, weakness of heart and many serious complications after a heart attack and after heart surgery.

A good exercise program increases blood circulation to the heart and in addition reduces the triglyceride levels. It also increases HDL (good) cholesterol levels which removes the LDL cholesterol from circulating blood. Vegetables and vegetable oils do not contain any cholesterol but many of them contain large amount of saturated fatty acids which will increase the cholesterol levels in blood. A proper diet low fat diet, no cholesterol diet, vegetable oils that are high in unsaturated fatty acids, avoiding alcohol and in some cases, medical treatment are very important.

 

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Who needs check ups and treatment?

Every one in this high risk category or with strong family history needs periodic checkups, risk factor analysis and life style modifications. Individuals can not change their gender [as male gender is a risk factor], genetic characters, family history or past life style. But, by new efforts for proper life style modification, early diagnosis and treatment of diseases that are risk factors, one can minimize the effects of the coronary artery disease. They should avoid smoking and alcohol. Persons with family history of heart disease, high blood pressure, high cholesterol or diabetes and are past the age of 35 years or any one over the age of 45 years will need periodic checkups for these risk factors and will need early intervention with a special low fat diet, exercise and treatment program. General weight reduction is important in all obese people. Persons who are put on a strict low calorie and controlled special diets and exercise program will need a checkup, blood tests and EKG. Persons with risk factors will benefit from a proper diet and exercise plan. Persons over the age of 45 years will require a physical examination, EKG and maximal exercise stress test even if they are not on any exercise program. This will help identify any preexisting coronary artery disease.
 
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Please See : Cholesterol, Hypertension, Diabetes, Stress Test & Diet Plans for Related Information
 
  

Conclusion and summary:

A history of high blood pressure, high cholesterol, diabetes, heavy cigarette smoking and a family history of heart disease in close relatives occurring at an young age are the five important risk factors that indicate a higher than usual probability of coronary artery disease and heart attack in an individual. Sedentary life style, obesity, heavy alcohol consumption and male gender are some of the additional contributing factors. Every person should get a periodic check up for all these risk factors if they are smokers or have a strong family history of heart disease, diabetes or hypertension. Every person with any two of these risk factors, when they reach the age of 45 years, should get a medical check up for coronary artery disease, including a stress test and get a diet and exercise plan. If they have more than two risk factors, they should get these done as early as reaching the age of 35 years. Many of these individuals may have coronary artery disease causing silent ischemia [poor heart circulation without symptoms], with no symptoms of chest pain or a discomfort that might have been ignored. This may lead to a "silent" heart attack. They will need to get an exercise stress test done prior to starting any vigorous exercise program. Persons who are already on a program will also need these evaluation upon reaching the age of 45 years.

 
  
 
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-- This is called Behavior Modification --
Essential Changes -- for a healthy Heart and General Health0
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