Risk Factors of Heart Attack

Risk factors for Heart attack:

Age:

  • Men age > 45
  • women age > 55

Family history of heart attack:

If your siblings, parents or grandparents have had early heart attacks (by age 55 for male relatives and by age 65 for female relatives), you might be at increased risk. In this condition prevention and early detection of heart disease is useful and safe. Risk factors like high cholesterol, diabetes and high blood pressure can be detected early and managed with life style modification or medications. If patient develops coronary artery disease then by screening tests like ECG, Echocardiogram and TMT followed by Coronay angiogram can detect the disease process and extent to plan further treatment course.

Smoking:

Smoking and long-term exposure to second hand smoke.

High blood pressure:

High blood cholesterol or triglyceride levels:

Obesity:

Obesity is associated with

Losing just 10 percent of your body weight can lower risk of heart attack.

Diabetes:

  • Less insulin hormone secreted by pancreas
  • Body cells not responding to insulin properly

This causes increased blood sugar levels to rise.

Diabetes increase risk of heart attack.

Metabolic syndrome:

This occurs when you have

People having metabolic syndrome has twice likely to develop heart disease than if you don’t have it.

Lack of physical activity:

Being inactive contributes to high blood cholesterol levels and obesity.

People who exercise regularly have better cardiovascular fitness, lower high blood pressure.

Stress:

You might respond to stress in ways that can increase your risk of a heart attack.

A history of preeclampsia.

If you have high blood pressure during pregnancy then it increases the lifetime risk of heart disease.

Which are the risk factors of heart attack particularly in women?

Endometriosis has been found to raise the risk of developing CAD in women under age 40.

Why more men get heart attack than women?

  • Men are at risk for heart attack much earlier in life than women.
  • Estrogen offers women protection from heart disease.
  • Estrogen stop blood cells sticking to the walls of arteries and forming potentially blockages.
  • After menopause  estrogen levels drop.
  • After menopause as estrogen level drops and risk of heart attack increases for women.
  • After menopause > 50 years they have almost equal risk like men.

Family History of heart Disease

If  one of your parents experienced cardiovascular disease at a young age (before 55 or 65), your risk of developing heart disease is 60 to 75 percent higher than it would be otherwise.

Prevention –

  • Early and comprehensive testing
  • Targeted  therapies – control particular risk factors if identified like High cholesterol or diabetes.

Avoid other risk factors also – high blood pressure, high blood cholesterol, diabetes and prediabetes, smoking, obesity or being overweight, physical inactivity and an unhealthy diet.

Non-Modifiable Risk Factors for Women

Factors cannot be changed –   

Modifiable Risk Factors for Women

Smoking

Cigarette smoking increases the risk of heart attack or stroke.

Good news is that no matter how long or how much someone has smoked, smokers can immediately reduce their risk of heart attack by quitting.

It is never too late to stop smoking.

High blood pressure

Hypertension is a silent disease.

High blood pressure cannot be cured, it can be controlled with diet, exercise, and, if necessary, medicines.

Cholesterol

LDL, HDL, and fats called triglycerides relate to each other and to your total cholesterol level.

High LDL – Increase the Heart attack risk

Higher HDL level – Reduce risk of a cardiovascular event such as heart attack or stroke.

Female have high HDL so protected against heart disease but after menopause, HDL levels tend to drop, increasing the risk of heart disease.

HDL and LDL cholesterol levels can be improved by diet, exercise.

In some serious cases, statins or other cholesterol-lowering medicines may be taken as advised by doctor.

Obesity

It is a strong predictor for heart disease.

What is Waist Hip Ratio?

Even you are overweight or obese where fat settles on the body is also an important predictor.

Who have a lot of fat around the waist are at greater risk than those who have fat around the hips.

Body Types?

People with “apple-shaped” bodies (more weight around the waist) face more health risks than those with “pear-shaped” bodies (more weight around the hips)

Obesity is defined as a waist-hip ratio above 0.90 for males and above 0.85 for females

Diet and Exercise is the best way to lose weight.

What is BMI?

Body mass index (BMI) is a simple index defined as a person’s weight in kilograms divided by the square of his height in meters (kg/m2)

•             Overweight is a BMI greater than or equal to 25

•             Obesity is a BMI greater than or equal to 30

Diabetes

Most diabetic patients tend to be overweight and physically inactive, have high cholesterol levels, and are more likely to have high blood pressure. Proper management of diabetes is important for cardiovascular health.

Physical inactivity is a significant risk factor for heart disease.

Many studies shows exercise reduces the risk of –

Exercise has also been shown to reduce mental stress as well.

You can benefit from exercising even it is only for 30 minutes a day, at least three times a week, but more will reap better benefits.

Oral contraceptives (birth control pills)

Increased cardiovascular risk for women.  

Excessive alcohol intake

Contribute to –

Some studies have shown that the risk of heart disease in people who drink moderate amounts of alcohol is lower than in non-drinkers, this does not mean that non-drinkers should start drinking alcohol or that those who do drink should increase the amount they drink.

Stress

Contributing risk factor

leads to other risk factors such as smoking and overeating.

What are the symptoms of heart pain and how to distinguish it from acidity?

  • Chest pain, chest tightness, chest pressure and chest discomfort (angina) radiating to left arm.
  • Breathlessness.
  • Pain in the neck, jaw, throat, upper abdomen or back

Acidity – pain is related with food but cannot be distinguished clearly from anginal or heart pain. We can not take chance in case it is a Heart attack.

Many cases reported in specialised hospitals where heart attack is misdiagnosed as gastritis. Always it is better to take ECG and see a doctor particularly specialist.

Why non-alcoholic people, normal weight people and people with good physical activity develop heart attack?

Multiple risk factors are involved in heart disease. Some non-modifiable risk factors are also there which should be carefully evaluated and managed.

Use of Sorbitrate in heart attack? Is it helpful to prevent heart attack?

  • Only helps to prevent the chest pain of cardiac origin. Sometimes it is useful reduce intensity of chest pain in mild cases.
  • This can be taken while waiting for help during emergency chest pain of cardiac origin expected due to coronary artery blockage.
  • Taking aspirin during a heart attack could reduce heart damage by helping to keep your blood from clotting.

There are instances when on health check it is advised for immediate stent? Is there a check?

What is done in health check.

  1. Find risk factors
  2. Find existing heart disease.
  3. If changes in ECG, Echocardiogram or TMT are present suggesting blockage in heart blood vessels then patient is advised for Coronary angiogram.
  4. If angiogram shows blocks then it will be shown to patient or attenders. Patient can appreciate the block, percentage and seriousness of the problem.
  5. Then it is planned for stenting.
  6. In some cases, if block is highly critical of causing heart attack it is advised to go for early stenting procedure.
  • In Health check TMT Positive cases advised angiogram.
  • Stent placement only can be advised after angiogram.
  • Only cases having critical block in blood vessels.

You can ask the cardiologist about the % of blocks in arteries. That will give an idea about seriousness of the blocks.

Why majority male suffers from heart attack?

Oestrogen in women < 50 years protects heart. High HDL Levels in females protective.

Heart attack and heredity

Patient with family history of heart attack has higher risk of coronary artery disease than the average person.

When you are considered to have a family history of cardiovascular disease ?

  • Your father or brother was under the age of 55 when they were diagnosed with cardiovascular disease or
  • Your mother or sister was under the age of 65 when they were diagnosed with cardiovascular disease.

Which cardiac exercise we should do to on regular basis?

Recommended exercise

  • 60 minutes a day for children
  • 150 minutes spread through the week for adults. That is 30 mins per day at least 5 days in week.
  • Add moderate- to high-intensity muscle-strengthening activity (such as resistance or weights) on at least 2 days per week.

Types of Exercise

  • Brisk walking  
  • Aerobics
  • Dancing  
  • Gardening
  • Tennis (doubles)

Target Heart Rate

Your maximum heart rate is about 220 minus your age

Target HR Zone 50-85% of the above value. During Exercise heart rate increases. As we exercise we can target this zone by monitoring the heart rate.

Can a person with low or normal weight have high cholesterol?

Yes, that is decided by other factors like cholesterol metabolism in body.

This can be in family. 

Diet for healthy life.

  • Vegetables
  • Fruits
  • Less animal fat
  • Less ghee, butter
  • Less baked item
  • Less rice
  • Fish
  • Whole grains
  • Eat plenty of vegetables and fruit
  • Eat total fat <  30% of energy intake.
  • Sugars < than 10% of your total energy intake.
  • High sodium consumption (>2 grams/day, equivalent to 5 g salt/day) can cause high blood pressure and increase the risk of heart disease and stroke.
  • Most people consume too much salt—on average 9–12 grams per day, or around twice the recommended maximum level of intake.

       5 g salt is nearly equal to or less than a teaspoon of salt per day.

AVOID OR LESS

Consume –  less

  • Salt,
  • Sugars
  • Saturated fat
  • Trans-fats – cakes, biscuits and bakery items
  • Ghee, butter

Reduce weight –

  • Avoid total fats and sugars.
  • Reduce calories
  • Avoid or limit calories from sugar and fat.
  • Increase consumption of fruit and vegetables, legumes, whole grains and nuts.
  • Engage in regular physical activity.
  • –  2000 calories per day to maintain,

                     1500 calories per day to will start to decrease weight

                     2000 or less per day will start to decrease weight

  • Can restrict to 1000 – 1200 cal per day for good results
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