Almost every Indian would know a family member who has met with a heart attack. Wouldn’t it be nice to see the big picture and learn how to avoid one?
So, I have laid out my five commandments on how to avoid a heart attack and if you ever meet with one how to survive it.
1. Cook less, eat less: Sounds impossible in the era of Zomato and Uber eats. We love our biriyani and love to feed our kids the same. It is hard to change eating habits. But, we have to accept the fact that most people in Urban India now had gross fatty liver and many have cirrhosis and liver disease. The way out is to make at least 1 meal a low-calorie meal. Ideally start dinner. Have 2 or 3 portions of raw cut vegetables and one portion of baked meat/fish/vegetarian protein. Avoid rice completely from your dinner. Initially you would feel hungry after the meal, but constantly experimenting with online low-calorie recipes would help you ultimately. The best thing is that children gets used to it if introduced at a very young age. And, it is worth investing in a convection oven that can roast meat or vegetable protein. Don’t entirely believe media reports that you can avoid heart attacks by simply eating one thing or the other: media is full of reports as to how garlic or turmeric will help prevent heart attacks. These reports are only partly true. They will not help prevent heart attack by themselves.
2. Exercise, exercise, exercise: Sounds easy! But easier said than done with the current Indian lifestyle. You know what the secret is: peer pressure. There are limited avenues in India to do outdoor activity safely. So, join a walking club or local gym. It is worth every rupee paying for a personal trainer. Central obesity with protuberant abdomen is extremely common among our folks. The idea of core-strengthening is the most important thing. It will help you improve your mobility and stay active as you age. So doing simple things like sit-ups and leg raising while lying down helps a lot. If you can’t find a suitable local gym go online and find a video in Youtube. Just do it, folks!
3. Know your risk: Few doctors are going to do this for you, hence do it yourself. Go online to the following website: http://tools.acc.org/ASCVD-Risk-Estimator-Plus/
Fill in your details including the cholesterol levels. The calculator will tell you what your 10-year risk of heart disease or stroke is. If your risk of having a heart attack on stroke over the next 10-years if more than 7.5% as per the calculator, then you need to consider starting cholesterol drugs in consultation with your doctor.
The problem with Indian patients is that they think doctors are pushing medicines without any appropriate indications. But think for yourself: are you willing to take the risk that there is >7 in 100 chance that you will have a heart attack in the next 10-years?
Also, if you have a family history of heart disease, discuss with your doctor how to prevent heart disease.
4. Call an ambulance if you have chest pain: If you ever experience chest pain call the local hospital that has cardiology services and ask them to send an ambulance. Good hospitals have well equipped ambulances that can carry out all emergency therapies including delivering shocks when required. Do not drive yourself to the hospital. We conducted a study in central Kerala and followed up more than 3000 people for a year after having a heart attack. We realised that lot of patients present late after a heart attack. In Kerala, our studies show that more than 70% of the population live within 1-hour distance from a hospital with a cath lab. But only 1 out of 5 patients reach the appropriate hospital on time. We found that lot of patients think they just have “gas” and visit a local community hospital without cath lab facility. By the time they are referred to the appropriate hospital their heart is already damaged. These labs help to delivery life saving treatment within the initial hours. The most important thing is to directly reach your nearest hospital equipped with a good catheterization lab. Opening the blocked arteries by a procedure known as “primary angioplasty” is your best shot at survival. Even if you think you are having gas and the chest pain lasts >15 minutes, call and ambulance and have an ECK done. This is especially true if you are a diabetic or have high blood pressure. Keep the hospital contact numbers in your phone.
5. Be positive: Can being positive protect against heart disease? Absolutely! Those who are optimistic, happy, having gratitude and purpose in life — have some amount of protection from heart disease. Researchers in the UK looked at psychological characteristics of over 8,000 people and found that those who scored high on optimism and a sense of well-being enjoyed a one-third lower risk of developing heart disease. In India, the best way to do this would be to be helpful towards people around you. Volunteer with your local non-governmental organizations/religious bodies to bring happiness to people around you. Be grateful for the things you have! Stay happy, stay healthy folks!
Dr. Anoop Mathew, MD, DM
Cardiologist, University of Alberta Hospital, Edmonton, Canada.