Dr Sushil K. Sharma
World Heart Day is an annual event which takes place on 29 September every year. Each year’s celebrations have a different theme, reflecting key issues and topics relating to heart health. This year our theme is creating heart-healthy environments .
This year, World Heart Day’s theme is creating Heart-Healthy environments. The places in which we live, work and play should not increase our risk of cardiovascular disease (CVD). But individuals frequently cannot make heart-healthy choices due to environmental factors, such as the availability of healthy food or smoke-free zones.
What are cardiovascular diseases?
Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels and they include:
* Coronary heart disease – disease of the blood vessels supplying the heart muscle;
* Cerebrovascular disease – disease of the blood vessels supplying the brain;
* Peripheral arterial disease – disease of blood vessels supplying the arms and legs;
* Rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria;
* Congenital heart disease – malformations of heart structure existing at birth;
* Deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge and move to the heart and lungs.
Heart attacks and strokes are usually acute events and are mainly caused by a blockage that prevents blood from flowing to the heart or brain. The most common reason for this is a build-up of fatty deposits on the inner walls of the blood vessels that supply the heart or brain. Strokes can also be caused by bleeding from a blood vessel in the brain or from blood clots. The cause of heart attacks and strokes are usually the presence of a combination of risk factors, such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol, hypertension, diabetes and hyperlipidemia.
What are the risk factors for cardiovascular disease?
The most important behavioral risk factors of heart disease and stroke are unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. The effects of behavioral risk factors may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity. These “intermediate risks factors” can be measured in primary care facilities and indicate an increased risk of developing a heart attack, stroke, heart failure and other complications.
Cessation of tobacco use, reduction of salt in the diet, consuming fruits and vegetables, regular physical activity and avoiding harmful use of alcohol have been shown to reduce the risk of cardiovascular disease. In addition, drug treatment of diabetes, hypertension and high blood lipids may be necessary to reduce cardiovascular risk and prevent heart attacks and strokes. Health policies that create conducive environments for making healthy choices affordable and available are essential for motivating people to adopt and sustain healthy behaviour.
There are also a number of underlying determinants of CVDs or “the causes of the causes”. These are a reflection of the major forces driving social, economic and cultural change – globalization, urbanization and population ageing. Other determinants of CVDs include poverty, stress and hereditary factors.
What are common symptoms of cardiovascular diseases?
Symptoms of heart attacks and strokes
Often, there are no symptoms of the underlying disease of the blood vessels. A heart attack or stroke may be the first warning of underlying disease. Symptoms of a heart attack include:
* Pain or discomfort in the centre of the chest.
*Pain or discomfort in the arms, the left shoulder, elbows, jaw, or back.
In addition the person may experience difficulty in breathing or shortness of breath, feeling sick or vomiting, feeling light-headed or faint, breaking into a cold sweat, and becoming pale. Women are more likely to have shortness of breath, nausea, vomiting, and back or jaw pain.
The most common symptom of a stroke is sudden weakness of the face, arm, or leg, most often on one side of the body. Other symptoms include sudden onset of:
* Numbness of the face, arm, or leg, especially on one side of the body.
* Confusion, difficulty speaking or understanding speech.
* Difficulty seeing with one or both eyes.
* Difficulty walking, dizziness, loss of balance or coordination.
* Severe headache with no known cause and fainting or unconsciousness
People experiencing these symptoms should seek medical care immediately.
The majority of risk factors for CAD can be improved by lifestyle modification. Goals for “optimal” levels continue to decrease with each new guideline version. The gap between “average” and “optimal” will continue to widen unless lifestyle modification is adopted more successfully. Remember that modest changes in diet, weight, and exercise can have a big impact on cardiac risk. A heart-healthy lifestyle should be encouraged from youth, but even changes later in life lead to important benefits.
(The author is Head Department of Cardiology GMC, Jammu)
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