Dr. Gurinder

Singh Grewal, M.D.

 In the United States alone, approximately 1.3 million patients suffer myocardial infarction (heart attack) each year and at the present time, a North American man has a 20% chance of suffering either a myocardial infarction or sudden death before the age of 65 years.

The cause of heart attacks in most of these patients is hardening of the arteries secondary to cholesterol deposits inside the muscular wall of the arteries eventually leading to calcium deposits and causing obstruction to flow resulting in decreased blood supply and oxygen supply to the heart muscle when it needs more under stress or with increased physical activity. Results of decreased oxygen supply to a segment of heart muscle for several minutes can cause heart attack which means a portion of the heart muscles dies with the heart attack.

To date, no single cause which initiates arteriosclerosis has been identified; however, several contributing factors called risk factors for coronary artery disease have been identified from epidemiologic studies. Here we will discuss about the risk factors in your background or life

style that may put you at risk for coronary artery disease and what you can do to control them and thus play an active part in preventing a heart attack.

Some risk factors you cannot help ‘‘and therefore cannot change.” Doctors call these modifiable risk factors. If you have these risk factors, you are more likely to develop coronary artery disease;

  1. If you have close blood relatives who have heart attack under the age of 50.
  2. You are male.
  3. You have diabetes mellitus. Diabetes, of course, can be controlled medically, but that does not necessarily effect your risk factor for developing coronary artery disease.
  4. If you are over age 40.

The other risk factors are called modifiable risk factors over which you have some control. They also result from the way you live, the things you eat and things you do in your life. You are more likely to have developed coronary artery disease:

  1. If you have high blood pressure.
  2. If you smoke cigarettes.
  3. If you have a high level of cholesterol in your blood.
  4. If you are overweight.
  5. If you have a lot of stress and tension in your life.

Of course, not everyone with some of or even all of these risk factors will develop coronary artery disease and some people with coronary artery disease do not have any one of them. But, your risk of serious heart problems is much greater if some of these risk factors apply to you. Combining risk factors is not like adding them; it is more like multiplying them. In the last decade, there has been increasing evidence that by modifying the ‘risk factors there is good chance that person can avoid a heart attack. Here we would like to discuss something about modifiable risk factors. High blood pressure pushes against your artery walls with extra force. The artery walls become hard and thick loosing their elasticity and speeding up the hardening and clogging of arteriosclerosis. Your heart muscle must work harder to keep the blood moving from your heart to your tissues. If your arteries are already diseased, high blood pressure increases arteriosclerosis adding wear and tear on your arteries and straining your heart even more. Hypertension is believed to be the most important risk factor leading to coronary artery disease. People with high blood pressure are five times more likely to have a heart attack than those who have normal blood pressure. High blood pressure can almost always be lowered. The principle means of lowering blood pressure is through drugs and reducing salt intake. Note, however, that hypertension is not cured by drugs, it is controlled by drugs. The drugs must be taken regularly. If you are taking medicines for high blood pressure, you may have side effects from the drugs and contact your physician if you have side effects instead of stopping the drugs. Cigarette smoking is especially harmful to people with coronary artery disease and people with high blood pressure. Cigarette smokers are two to three times more likely to have a heart attack than nonsmokers. Smoking stimulates the heart, narrows the blood vessels and makes your heart beat faster. Carbon monoxide in the blood increases which replaces oxygen and decreases the supply of oxygen that gets to your heart, that makes breathing *more difficult and increases the strain on the heart. Smoking also makes your blood more likely to clot. Smoking also causes “extra heart beats’? which at times can lead to serious heart rhythm irregularities. The encouraging news is that as soon as you stop smoking you begin to repair some of the damage. Many smokers, however, believe that because damage has been done, it is too late to quit. It is never too late to quit. Not only does your risk of heart attack stop dropping once you have not smoked for five years but after fifteen years of not smoking, your risks become the same as that for anyone else of your age who has not smoked.

With Guru’s blessing, Sikhs do not smoke, however, if your friends at work or at other places do smoke besides your religious beliefs, you may be able to convince them on a scientific basis and help them quit.

High cholesterol in the blood comes from the food we eat and also is produced by the liver in the body. The higher the cholesterol level in your blood, the more likely you are to develop coronary artery disease and heart attack. There are several types of cholesterol in the blood; one is called “good”? Kind called HDL (for high-density lipoprotein) and ‘‘bad” kind called LDL (for low density lipoprotein). Most people with high cholesterol levels have the bad kind. If you are not aware. Of your cholesterol, you should request your doctor to check it. You should fast at least for fourteen hours before having blood test for cholesterol. If your cholesterol is high, reducing the amount of fat intake, particularly red meats, egg yolk and exercising regularly can improve. A small percentage of people with high cholesterol may need medicines to lower cholesterol which you should discuss with your physician.

Being overweight contributes to coronary artery disease. The heart attack rate for people who are thirty pounds overweight is twice that for people with normal weight. On an average, an extra thirty pounds may decrease your life expectancy by four years. Balanced diet with caloric restriction and regular exercise is the best way to lose weight. People over forty years of age must have physical examination before starting regular exercising. The best exercise is rhythmic and _ repetitive and uses your large muscles, such as your back and lower legs. This type of exercise makes your cardiovascular system work and is called isotonic or aerobic. It includes such activities as walking, jogging, cycling and swimming.

Article extracted from this publication >> DECEMBER-28-1984