Heart Health should be your priority in Life-by Dr Harold Gunatillake

My electrician came to replace the hot plates in my old cooker used for over 10 years. He went to Bunnings to purchase the new plates, but he never returned. Phoned up two days later and the wife said he had chest pain after his visit to our home and now in hospital waiting for angiography.

He has just retired, leading a sedentary life from an active carrier. Quite fit looking though having a slight pot belly.

That would be the common story of heart disease.

Cardiovascular diseases are the number 1 cause of death globally, taking an estimated 17.9 million lives each year.

Heart disease is avoidable unless there is an inherited factor.

Today people live in an environment of pollution, street eating outlets, convenience foods and restaurant foods, hot food joints, that never existed 50 years ago and before. Cultivating an addiction to these foods could be the beginning of building up plaques in your coronaries and other vessels including those in the brain.

Obesity has nearly tripled since 1975 globally, a major factor for heart disease.

Life also have become stressful, with the never ever schemes we need to get into, to keep with the Joneses.

In Sri Lanka, when it was called Ceylon, during the second world war, and immediately after, people had to grow their own vegetables including root veggies like manioca, in their gardens, with subsidiary foods provided by the Civil Defense- headed by Sir Oliver Goonetillake who became our first governor general.

The only food outlets we had were the Ananda Bawans, vegetarian hotels which served South Indian hot foods like thosai and idley and the ulundu wades.

Heart disease was never heard of then, and the worst disease was double pneumonia– you enter hospital and never came home.

Today, most couples do not cook food in their homes, don’t have the time because both work. They purchase convenience street foods on the way home.

These foods are mainly fried foods, heavily salted for palatable taste.

Neglecting your heart health may lead to heart failure. Most common causes are old age, chronic conditions like diabetes, thyroid problems, coronary heart disease and heart attacks, heart valve disease, among others.

Heart failure means that the heart muscle is unable to pump enough blood to meet the body’s needs for blood and oxygen. The left ventricle which pumps the blood into the body becomes thickened first to compensate and with further deterioration becomes weakened.

Approximately 600,000 Canadians have heart failure and is the leading cause of hospitalization in Canada.

In Sri Lanka, the incidence of cardiovascular disease is increasing, much higher than many industrialized nations including the United Kingdom, the United States, Australia and France.

This is associated with many symptoms, including shortness of breath, difficulty breathing and fatigue, exercise intolerance, fluid retention, cough, and weight gain due to fluid retention.

We call this stage as congestive heart failure. This is a serious condition and there is no cure but only temporizing measures.

In the past, at this late stage of weakened heart muscle treatment was with drugs such as digoxin considered as food for the heart, diuretics, and other measures, such as giving drugs that lower the blood pressure.

Today, much advanced therapies help such patients to live longer with a better quality of life.

There are two new drugs approved to treat heart failure: ivabradine and sacubitril.

According to Abbas Bitar, MD , clinical assistant professor, Frankel Cardiovascular Centre at the University of Michigan, states that the addition of the drug Entresto, has reduced hospital visits and death from heart failure.

A few drugs in the pipeline are Omecamtiv mecarbil which helps the heart to pump blood more efficiently.

The FDA is reviewing another new drug- vericiguat specifically indicated for patients having heart failure.

Another drug called sodium-glucose cotransporter-2 inhibitors also shows promising results.

These drugs are specifically mentioned because, if the readers have any relations and colleagues having heart failure, names of these drugs should be notified to the respective medical practitioners for consideration.

Among Sri Lankans diabetes, obesity and uncontrolled high blood pressure seem to be the prevalent conditions for heart disease.

In addition to strict control with therapy and diet, walking for 2 to 3 hours at intervals per day, equivalent to 16 to 24,000 steps would help to control any chronic disease, including most cancers.

The author has got rid of coronary plaques, controlled diabetes with minimum therapy, reducing visceral fat and having a normal blood pressure, aging to 92 years.

The key to managing heart failure is to get diagnosed and start treatment early. That allows you to make informed decisions about your treatment before your heart failure becomes too severe.

ABBAS BITAR, MD

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