By Philip S. Chua, M.D., FACS, FPCS
One person dies of heart attack in the United States every 20 seconds, statistically 3 a minute, 4,320 a day, or 1,576,800 a year! Since most Filipinos, including those in the Philippines, are ‘westernized’ in habits and behavior, especially those in the urban areas, the statistics in proportion to the population ratio could be as significant. Since 1900, heart attack has been the number one killer of man in the European and Asian countries as well. These deaths are included in the global statistics of about 60 million who die each year from various causes around the world.
The number of deaths (2007 study, USA) from the other leading causes are as follows: Cancer: 562,875; Stroke (cerebrovascular diseases): 135,952; Chronic lower respiratory diseases: 127,924; Accidents (unintentional injuries): 123,706; Alzheimer’s disease: 74,632; Diabetes: 71,382; Influenza and Pneumonia: 52,717; Nephritis, nephrotic syndrome, and nephrosis: 46,448; and Septicemia: 34,828.
The highest death rates from heart attack are found in the Soviet Union, Romania, Poland, Bulgaria, Hungary, and Czechoslovakia. Those with the lowest death are Japan, France, Spain, Switzerland, and Canada.
Diseases that increase the risk
The incidence of disease risk factors found in a 2005-2006 study showed lack of physical exercise as the most major one, followed by overweight and others: Inactivity – 39.5 percent; Obesity – 33.9 percent; High blood pressure – 30.5 percent; Cigarette smoking (or exposure to second-hand smoke)- 20.8 percent; High Cholesterol – 15.6 percent; and, Diabetes – 10.1 percent.
Together with the family history of heart disease, those 6 risk factors listed above are the main ones. Added to these heart-attack ‘boosters’ are the following: (1) Lack of sleep, getting only 5-6 hours a night, doubles the risk; (2) Stress at work causes the risk to go up by 40 percent, and unemployment leads to high blood pressure, elevated cholesterol and overweight; (3) Psoriasis, a chronic skin condition that causes inflammation in the body, almost as damaging as smoking; (4) Periodontal disease, bacterial infection of the gums doubles the risk of a fatal heart attack, and unfortunately about 75 percent of people have them without even knowing it, (5) Pre-eclampsia (high blood pressure and protein in the urine among those pregnant) doubles the risk of heart attack later in life, and increases the risk of developing diabetes by 70 percent. Male pattern baldness is also tagged as an incidental risk factor.
The significance and actual effects of those conditions in their impact on the predisposition to heart attack will vary somewhat in their gravity according to the genetic predisposition of the individual.
Example: cigarette smoking could be the most major risk factor, as high as 50 percent, in some people, while obesity could be in others. But there is no question that daily physical exercise, even simple brisk walking, at least 5 days a week, can ward off coronary artery disease and heart attack by 50 percent. Those who do not exercise double their risk of heart attack, compared to those who do.
The cost of heart disease alone in the United States in 2010 was $316.4 billion, which included health care services, medications, and lost productivity and income.
The cholesterol-lowering statins
About 30 million Americans have high blood cholesterol and are on cholesterol-lowering drugs called statins, like Lipitor, Zocor, Crestor, which block a liver enzyme that helps produce cholesterol. It is so effective in most persons taking any of them that their bad cholesterol (LDL, or Lower Density Lipoprotein) goes down by an average of 40 percent. Statins are consistently useful in bringing down cholesterol levels to reduce heart attack and they even lower the mortality rate among those who suffer one.
The side-effects of statins are actually low. Among the 7.5 percent of individuals on statin who might develop muscle pains, mild memory problem, and numbness, these symptoms stop within a few days or weeks after they are off the drug. The great health benefits from statin outweigh these temporary possible side-effects.
Not a vaccine or a panacea.
People should realize, though, that statins or any other drugs used to lower the risk of coronary artery disease or actual heart attack, are not a vaccine that will totally prevent heart attack, or a miraculous ‘cure’ for this cardiovascular disease and other CV conditions.
The medications we have today in the treatment of coronary artery disease and its ultimate end-result called heart attack are not, in themselves, the magic therapy that will make coronary artery blockages and heart attack disappear.
The fundamental strategy must include, not only the work of the attending physician, but greater efforts on our part. Our role, as a person wanting to maintain health and prevent diseases, requires discipline, determination, and sacrifices.
How to reduce the risks
A healthy diet and a lifestyle conducive to health are our greatest weapons against cardiovascular and other illnesses. Our life is literally mostly in our hands. The choices are ours. Children should be appropriately guided by the adults, who are supposed to be more experienced and wiser.
For diet, a lot of fish and some sea foods, a ton of vegetables, especially the green and leafy ones, fresh fruits, nuts, high fiber foods (beans, whole grain, bran, etc) are recommended. In general, low-fat, low-cholesterol, low carb diet is healthier. Red meat, if eaten at all, should be lean, and poultry without skin, prepared without added trans-fat or saturated fat. For dairy products, fat-free, low-fat or 1% fat are healthier. Cut back on carbohydrates (rice, bread, ice cream, candies, and other foods with added sugar) and stay away from soft drinks of any kind, as these pop beverages (cola or uncola, with or without caffeine, regular or diet) all increase the risk for the development of metabolic syndrome (high blood, pressure, diabetes, heart attack, and possibly stroke).
Besides the quality (the kind or type of foods), quantity is essential to maintain or achieve the proper weight, so watch your portion closely.
Read food labels for the calorie, salt, fat, cholesterol, protein contents. Total abstinence from tobacco and moderation in alcohol intake are a part of healthy lifestyle, together with daily disciplined physical exercises. Rest, relaxation, and embracing our faith to achieve inner peace are all vital in the overall scheme for the maintenance of our spiritual, mental, and physical health.
If you think you are at risk, what do you plan to do about it?