TM RY A H EE H A RR UT, O Y

TM RY A H EE H A RR UT, O Y

“Prevention is better than cure”

Prevention is by one rupee whereas cure is by one Lac rupees in Heart Disease (by Stent & Surgery)

This World Heart Day, we ask you to share how you power your heart and inspire

millions of people around the world to be heart healthy.

Cardiovascular disease (CVD), which includes heart disease and stroke, is the

world’s number one killer. Each year, it’s responsible for 175 lakhs premature

deaths and by 2030 this is expected to rise to 230 lakhs.

But the good news is that such Cardiovascular disease can be prevented by small

changes in lifestyle.

like...

World Heart Day

01

PROMISETO EAT WELL AND DRINK WISELY

PROMISETO SAY NO TO SMOKING

PROMISETO GET MORE ACTIVE

Risk Factors for Heart Disease

• • • Abnormal lipids Smoking Hypertension

• • • Diabetes Abdominal obesity Psychosocial stress

• Decreased consumption of fruits and vegetables

• • Moderate consumption of alcohol Physical inactivity

• • • Smoking / Tobacco Sedentary lifestyle Stress

• Type - A Personality

• • • High Blood Pressure Diabetes Dyslipidaemia (Bad Cholesterol)

Obesity Metabolic Syndrome Improper & High fat Diet• • •

• • • Lipoprotein (a) Hyper Homocys�nemia Hyper Uricemia

Hyper Fibrinogenemia HS-CRP An�phospholipid • • •

An�body Syndrome)

Oral Contracep�ve Pills Apolipoproteins• •

• • Gender-Male Post menopausal women

• Heredity (Family history of Heart Disease, Male < 55 years and

Female < 65 years)

• Collectively, following nine risk factors accounted for 90% of the population

attributable risk (PAR) in men and 94% in women in India.

02

Modifiable Risk Factors (by Lifestyle)

Non – Modifiable Risk Factors

New factors

03Know your ideal goals of Important Risk Factors for Prevention of Heart Attack

< 50 mg/100ml.

04

Abnormal lipids

• It increases the risk of Heart attack by 56%.

• LDL is the best established risk factor of Heart Attack.

• Total cholesterol to HDL ratio is also a very strong risk predictor for Heart Disease.

• For general population LDL>160 (mg/dl), TG>150 (mg/dl) and HDL<40 mg/dl are considered as abnormal.

• For people with risk factors of Heart Diseases mentioned before, LDL>100 is considered as abnormal.

• 1 unit(1 mmol/litre) reduction in LDL level reduces major coronary events and stroke by 25%.

• Target LDL should be less than 100 mg/dl (for general population) & less than 70 mg/dl (for heart patients).

• Low calorie, low fat diet

• Avoid fried foods and junk food.

• Consume more fruits and vegetables.

• Do Physical activity (Walking, Jogging, Cycling, Swimming etc.

• Lipid Lowering Drugs-Statins (only according to doctors advice).

Preventive Steps for Abnormal lipids

05

• It increases the risk for heart attack by 49%.

Prevention of Hypertension

Hypertension

• In addition, it also causes cerebrovascular stroke, Kidney failure, Peripheral vascular

diseases and retinal damage.

• Out of all diagnosed of Hypertension, 47% remain uncontrolled.

• Prehypertension also increases the risk of Heart Attack and Stroke.

• Research showed that lowering of the blood pressure by 5-6 mmhg results in 56%

reduction in the risk of heart attack.

• Symptoms of Hypertension :

- Headache

- Giddiness

- Blurring of vision, etc.

• Although majority of the patients are asymptomatic.

Grade Systolic (mm of Hg) Diastolic (mm of Hg)

Normal < 120 < 80

Pre-Hypertension 120 to 139 80 to 89

Stage-1 140 to 159 90 to 99

Stage-2 > 160 > 100

MedicationPhysical activityWeight ControlLow Salt Diet (DASH Diet - Dietary

Approach to stop Hypertension)

06

Diabetes

Preventive Steps of Diabetes

MedicationMonitoring of Fasting Blood

sugar/HbA1C levels

Low calorie, low fat diet

Weight Control

Physical activity

• In India, 61.3 million people are affected (largest proportion in world).

• >50% are undiagnosed (Silent killer).

• Every 1 of 10 heart patient has Diabetes.

Fasting Blood Sugar (FBS) > 126 mg/dl

Post Prandial Blood Sugar (PPBS) > 200 mg/dl

Random Blood Sugar (RBS) > 200 mg/dl

HbA1c > 6.0%

• Symptoms of Diabetes :

- Increased appetite and thirst,

- Increased frequency of urination,

- Weakness,

- Unexplained weight loss.

• Although majority of patients have no symptoms.

• In addition to Heart Diseases, it also increases the risk of Kidney failure, Peripheral Vascular Diseases, Retinal Damage, Stroke, Neuropathy etc.

Criteria for Diabetes

07

Obesity leads to high blood pressure, diabetes, High cholesterol, Heart diseases, Stroke,

Arthritis, Gallstones and Cancer etc.

• It increases the risk for heart attack by 20%.

Definition of Obesity

• Waist circumference > 90 cm (men), >80cm (women)

• BMI= [Weight (kg)/Height (m2)] = ≥ 25 denotes a person as Over Weight

Preventive steps for obesity

• Low calorie diet

1. 1200-1500 kcal/day for women and 1500-1800 kcal/day for men.

2. Avoid high carbohydrate foods and high fat foods.

3. Take high fiber food, fruits and vegetables.

• Do physical activity (Walking, Jogging, Cycling, Swimming etc.)

: 30 minutes for 5 day / week

• Practice Yoga & Shavasana

Obesity

08

Smoking / Tobacco

Intake of tobacco or smoking increases the possibility of heart diseases by 20-30 times.

• Among smokers/ tobacco users 35 years of age or older who die of smoking related

causes, 35% die due to heart disease.

By the consumption of tobacco and smoking...

• Nicotine in Tobacco is injurious to Heart & Other Organs.

• It Increases Vasoconstriction, Sympathetic tone and Endothelial dysfunction.

• It causes Oxidation of LDL.

• Decreases the good cholesterol (HDL) and increases the bad cholesterol (LDL).

• Increases the heart rate and blood pressure.

• Also increases the risk of oral and lung cancer.

• It increases the Blockage & Thrombus Formation in the arteries of leg.

What is Indirect (Passive) Smoke ?

• Cigarette smoke exhaled by smoker and inhaled by non-smoker is called passive

smoking.

• Others Exhaled smoke is also Hazardous.

• It increases the risk of heart attack 30% more, also the chances of lung cancer with

more than 30 times.

09

Advantages of stopping smoking

• Smokers/ tobacco users who quit, Reduce their excess risk of heart disease by 50%

within first 2 years after suggestion.

• 1 year : Risk of heart attack is decrease to 50% compared to smoker.

• 10 years : Risk of lung cancer decrease to 50% compared to smoker.

• 15 years : Risk of heart attack becomes Equal to a normal person.

Help to quit the smoking...

• Patient’s Willingness to quit.

• Strong Will power.

• Positive support of the family members.

• Awareness of diseases and its consequences.

• Behaviour counselling.

• You can use the alternatives :- Nicotine Patch, Chewing gum, lozenges, Micro tablets,

Inhaler, Bupropion Spray.

10

Physical inactivity

• It increases the risk for heart attack by 21%.

Exercise

• Reduces diabetes and heart attack by 52%

Exercise Programme

• Aerobic activity – walking , cycling, swimming etc.

Frequency-5 days /week

Duration- average 30 minutes

• Stretching and relaxation exercises leading to progressive deep relaxation

• Yoga and Meditation

• Padmasan

Siddhasan •

Halasan •

Shirshasan •

• Virasan

Janu shirasan •

Supt vajrasan •

Ardha matsyandrasan•

• Dhanurasan

Shavasan •

Pashchinotasan •

• Decrease bad cholesterol, high blood

pressure.

• Increase good cholesterol.

• It controls the diabetes & obesity.

• It can increase the enthusiasm,

Activeness and prolong healthy life.

• It increases the spirituality and happiness.

• We can also get sound sleep.

• It decreases mental stress and depression.

• It can prevent ageing.

Benefits from yoga and exercise...

11

Stress Control...

• Yoga, Meditation, Prayers

• Relaxation techniques, deep breathing

Regular Adequate & Sound sleep...

• Sleep for 6 to 8 hours at night time.

• Try to rest one hour in day time.

• Take dinner 2 to 3 hours before you

sleep.

• It increases the risk for heart a�ack by 15-20%.

Stress increases blood pressure and the viscosity of blood. It also increases bad

cholesterol and Blood sugar. Hence Increases Heart a�ack.

• Stress, anxiety and depression can contribute to coronary heart disease.

Psycho - Social Stress

Type-A Type-B

Type-A & Type-B Personality...

• Patience

One task at a time •

Enjoys peaceful eating•

Peaceful nature •

Competitive attitude only if required •

Works without time limit•

Jolly nature•

Value success as per circumstances•

Relaxes at proper time•

• Impatience

Multiple tasks at a time•

Fast eating & talking while eating•

Aggressive nature•

Always competitive attitude •

Always works time bound•

Pertinacity and malevolent nature•

Tries to quantify success•

No relaxation in the life•

P unctuality and Perfectness•

• Don't bother too much. Learn to say 'No'.

• Get peace of mind e.g. listen light music

12

Have Healthy Food

By Research, Following facts about diet are established

• Coconut oil

Palm oil •

Butter •

Ghee •

Cheese •

• Vanaspati

• Fatty food 83% Saturated harmful fat-avoid it

Healthy Eating Plan

Diet recommendations

• • Carbohydrates - Refined < 30% Whole grains - 50%

• • Proteins - > 15 % Fruit and vegetables-> 400gm /day

• • Poly unsaturated fat - > 15% Salt < 1gm /day

• • Saturated fat - < 5% Fiber - 30 - 45gm

• • Fast and Fried food - < 5% Dry fruit - 30gm /day

• Total calorie - 1500 -1800/day

Heart Attack can be prevented by taking a Balanced Diet About various fats

Poly unsaturated fat (PUFA) :Reduces LDL cholesterol

Example :Sunflower oil, corn, soybean, Cotton Seed oil and sesame seeds

Example :Olive oil, Peanut oil, Canola oil

Mono unsaturated fat (MUFA) : Can lower LDL (Bad) cholesterol and maintain HDL (good) - cholesterol

Saturated Fats (SAFA) :

Increases the cholesterol levels in the

blood (Total & LDL cholesterol)

Example : Butter, ghee, coconut oil, palm

oil, cheese, yellow portion of egg, meat,

full fat milk & yogurt, pastries

Trans Fat or Hydrogenated Fat (TFA) :

Raise total and LDL (bad) cholesterol

Example :Margarines, cookies, snack foods made with or fried in partially hydrogenated oil.

HeartHealthy

HeartHealthy

Avoid

Avoid

13

• Commercial, Fried, Ready packet

• • Ganthiya, Fafda Fast food

All have high saturated fat and vanaspati So avoid it.

Recommendation - (100 gm/week)

• Oil - take 1 teaspoonful only.

Cereals

• Raw rice and whole grain must be consumed.

• Polished rice, maida, white flour-less nutritious-avoid it.

• Take fruits- ≥ 4-5 cups/day

(1 medium size fruit )

• Take vegetables -

1 cup raw vegetables /day

Half cup cooked vegetables /day

Fruits and Vegetables

Nuts

- like Akhrot, badam etc.

30 gm /week

“Akhrot”- high good cholesterol. Take more.

Dairy products

Recommendation

- 1 cup of milk/day,

- 50gm of cheese/week)

• Avoid Cold Drinks and Sugar Sweetened beverages.

7 Steps for Healthy Heart

1) Have Healthy Food Saturated fat (Fish, Meat, Ghee, Bu�er, Cheese,

Coconut oil, Palm oil, Vanaspa� oil ) leads to stasis of blood cell. 1 unit (1 mmol/litre) reduction in LDL level reduces major heart attack and stroke by 25%. avoid fa�y food. Take more fruits and vegetables.

2) Reduce Weight Obesity leads to high blood pressure, diabetes, high

cholesterol and heart a�ack. It is advisable to reduce weight.

3) Stop Smoking / Tobacco chewing Smoking causes constric�on and spasm of blood

vessels as well as increases cholesterol level. Hence, intake of tobacco or smoking increases the possibility of heart diseases by 20-30 �mes.

4) Exercise Exercise controls the weight gain, diabetes level, high

blood pressure and also makes your heart healthy. Minimum 30 minutes of exercise per day for at least 5 days per week is recommended.

7) Adequate Sleep Sleep for 6 to 8 hours daily. If possible try to rest or nap in

the day�me and avoid sleeping late at night. Sound sleep is essen�al for good health, so sleep before midnight.

5) Reduce stress Stress increases blood pressure and the viscosity of

blood. It also increases cholesterol. So reduc�on in stress is advised and this can be achieved by different methods like yoga, Art of Living, Medita�on etc.

6) Live happily The situa�on of loneliness leads to heart problems.

Social ac�vi�es can reduce the possibility of heart problems.

14

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Civil Hospital (Medicity Campus), Asarwa, Ahmedabad - 380 016Mobile +91 90991 08108 Phone : (079) 22684220, 22684200,Fax : (079) 22682092

U. N. Mehta Institute of Cardiology & Research Centre(Affiliated to B. J. Medical College, Ahmedabad)

For Registration email : itsupport@unmicrc.org

“ Redefining... Quality Cardiac Care”

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