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Why do some people get Heart Attacks?
Can one prevent it?
When many lakhs of cars are moving on the roads only a few cars meet with accidents. Cars with defective brakes, gears or non-aligned tyres have increased chances of accidents. Likewise, extensive clinical and statistical studies have identified several factors that increase the risk of coronary heart disease and heart attack.
Major risk factors are those that research has shown significantly increase the risk of heart and blood vessel (cardiovascular) disease. Other factors are associated with increased risk of cardiovascular disease, but their significance and prevalence haven't yet been precisely determined. They are called contributing risk factors.
The American Heart Association has identified several risk factors. Some of them can be modified, treated or controlled, and some can't. The more risk factors you have, the greater your chance of developing coronary heart disease. Also, the greater the lever of ech risk factor, the greater the risk. For example, a person with a total cholesterol of 300 mg/dL has a greater risk than someone with a total cholesterol of 245 mg/dL, even though everyone with a total cholesterol greater than 240 mg/dL is considered high-risk.
Non-modifiable Risk Factors:
- Increasing age: Over 83 percent of people who die of coronary heart disease are 65 or older. At older ages, women who have heart attacks are more likely than men are, to die from them within a few weeks.
- Gender: Men have a greater risk of heart attack than m\women do, and they have attacks earlier in life.
- Heredity (including Race): Children of parents with heart disease are more likely to develop it themselves. Just as you can't control your age, sex and race, you can't control your family history. Therefore, it's even more important to treat and control any other risk factors you have.
Modifiable Risk Factors:
- Smoking: Smokers' risk of developing coronary heart disease is 24 times that of nonsmokers. Cigarette smoking is a powerful independent risk factor for sudden cardiac death in patients with coronary heart disease. Exposure to other people's smoke increases the risk of heart disease ever for nonsmokers. People who stop smoking at 60 years gain 3 years extra life, at 50 years-6 years, at 40 years - 9 years and at 30 years - 10 years. Smoking also totally cancels the actions of Aspirin, a cardiovascular protecting drug and cancels 75% of the actions of Statins.
- High blood cholesterol: As blood cholesterol rises, so does risk of coronary heart disease. When other risk factors such as high blood pressure and tobacco smoke are present, this risk increases even more. A person's cholesterol level is also affected by age, sex, heredity and diet.
- High blood pressure: High blood pressure increases the heart's workload, causing the heart to thicken and become stiffer. It also increases your risk of stroke, heart attack, kidney failure and congestive heart failure. When high blood pressure exists with obesity, smoking, high blood cholesterol levels or diabetes, the risk of heart attack or stroke increases several times.
- Physical inactivity: An inactive lifestyle is a risk factor for coronary heart disease. Regular, moderate-to-vigorous the activity, the greater your benefits. However, even moderate-intensity activities help if done regularly. Exercise can help control blood cholesterol, diabetes and obesity, as well as help lower blood pressure in some people. Doctors have liberalized the physical activity programmes as anywhere and at any time.
- Obesity: People who have excess body fat especially if a lot of it is at the waist are more likely to develop heart disease and stroke even if they have not other risk factors. Excess weight increases the heart's work. It also raises blood pressure and blood cholesterol and triglyceride levels, and lower HDL ("good") cholesterol levels. It can also make Diabetes more likely to develop. Many obese and overweight people may have difficulty losing weight. But by losing even as few as 10 pounds, you can lower your heart disease risk.
- Diabetes mellitus: Diabetes seriously increases your risk of developing cardiovascular disease. Even when glucose (blood sugar) levels are under control, Diabetes increases the risk of heart disease and stroke, but the the risks are even greater if blood sugar is not well controlled. About three-quarters of people with Diabetes die of some form of heart or blood vessel disease. If you have Diabetes, it's extremely important to work with your healthcare provider to manage it and control any other risk factors you can.
- Stress: Individual response to stress may be a contributing factor. Some scientists have noted a relationship between coronary heart disease risk and stress in a person's life, their health behaviours and socioeconomic status. These factors may also affect established risk factors. For example, people under stress may overeat, start smoking or smoke more than they otherwise would.
- Alcohol: Drinking too much alcohol can raise blood pressure, cause heart failure and lead to stroke. It can contribute to high triglycerides, cancer and other diseases, and produce irregular heartbeats. It also contributes to obesity, alcoholism, suicide and accidents.
Dr. P. Ramachandran
Senior Interventional Cardiologist
Apollo Hospitals, Chennai
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