" Key to your Health is in your hands. "

Which are the RISK FACTORS?

MODIFIABLE RISK FACTORS

• Tobacco abuse (smoking, chewing)
• High Lipid levels
• Obesity
• High BP
• Diabetes
• Stress

NON MODIFIABLE RISK FACTORS

• Advancing Age
• Sex
• Heredity

EMERGING RISK FACTORS

• Homocysteine
• Apolipoprotein a
• Fibrinogen
• Metabolic Syndrome

TOBACCO ABUSE

THE FACTS:

• In 2020, 12.3 % of all deaths (total 10 million) in the world would be due to tobacco related disease.
• 55 % males in India are consuming tobacco.
• Smoker dies on an average three years earlier than non smokers.
• Smoker dies 10 years earlier if more than one risk factor present.
• Family members of smokers also inhale smoke and are affected. They carry 20-30% higher risk of getting heart disease. This is called as Passive Smoking.
• 80 % smokers suffer from Heart Disease.

LIPIDS – FATS (CHOLESTEROL)

Types of Cholesterol

HDL Cholesterol (High Density Lipoprotein)
This is referred to as good Cholesterol as it scavenges cholesterol from arteries.

What are the ideal levels of Cholesterol?

What elevates lipids? - Smoking, High fat Diet, Stress, Sedentary lifestyle

What reduces lipids? - Weight loss, Exercise, Diet, Medicines,

Please note that 1 % fall in Cholesterol leads to 2% reduction in risk of Heart Disease.

OBESITY

BMI = Weight in Kgs / (Height in m)2

< 25: Normal 25 –30: Overweight 30 -35: Obese > 35: very obese

Obesity Health Risks

• Over 80% of people with diabetes are overweight or obese.
• Overweight people are twice as likely to develop type 2 diabetes
• Can lead to premature death, heart disease, kidney disease, stroke, and blindness.
• The truncal obesity is associated with increased incidence of Heart disease.
• 300,000 deaths a year are attributed to obesity.
• Obese (more than 30% of their ideal body weight) have a 50% to 100% increased risk of premature death.
• Obese women at higher risk of getting Cancer of the uterus, gallbladder, cervix, ovary, breast, and colon.
• Obese men have a higher risk of developing cancer of the colon, rectum, and prostate.
• For every 2-pound increase in weight, the risk of developing arthritis is increased by 9 to 13%.
• Six fold increase in the incidence of symptomatic gall stones.
• One of the most common breathing problems associated with obesity is sleep apnea.
• Sleep apnea may also cause daytime sleepiness and even heart failure.

One must understand that Obesity is more of a health problem than an image problem.

HIGH BLOOD PRESSURE (HYPERTENSION)

Blood Pressure Classification

• The BP relationship to risk of CVD is continuous, consistent, and independent of other risk factors.
• Each increment of 20/10 mmHg doubles the risk of CVD across the entire BP range starting from 115/75 mmHg.
• Prehypertension signals the need for increased education to reduce BP in order to prevent hypertension.

• Stroke Reduction – 35 -40%
• Heart Attack Reduction – 20-25%
• Heart Failure Reduction – 50%

• For 10 kg weight loss the reduction in BP is 5 -20 mm of Hg.
• Dietary Sodium Restriction causes 2-8 mm of Hg reduction.
• Regular exercise leads to reduction by 4-9 mm of Hg.

• Uncontrolled Diabetes increases the risk of Heart Disease three fold.
• In addition to Heart Disease, Diabetes can cause stroke, kidney failure, loss of vision, gangrene, foot ulcers.
• Many Diabetes patients may not get the typical chest pain of HEART DISEASE. This is referred to as silent heart disease. The screening for heart disease even in absence of symptoms in all Diabetes patients is imperative.

ADVANCING AGE

With advancing age the atherosclerosis is also well advanced to cause heart disease.

SEX

Women are well protected from heart disease till they are menstruating. They are benefited because of the protective effect of estrogen. Post menopausal women lose this protective advantage of estrogen coverage.

HEREDITY

If any of the immediate family members have died before the age of 40 due to Heart Disease; the risk of getting heart disease increases.

EMERGING RISK FACTORS

Some new risk factors are emerging.

HOMOCYSTEINE

High Homocysteine levels (> 15 mcg) are associated with increased incidence of heart disease and stroke. This is due to increased coagulability of blood.

APOLIPOPROTEIN A

High Apolipoprotein A levels are found in Indians. They are also associated with high incidence of Heart disease.

FIBRINOGEN

High fibrinogen levels are also found to have correlation with heart disease.

METABOLIC SYNDROME

After several studies, the definition of METABOLIC SYNDROME has been established.

A person is said to be suffering from Metabolic Syndrome if he/she has any three of the following features.

• Waist circumference : > 40 inches in men, > 35 inches in women
• Triglycerides: > 150 mg/dl
• HDL Cholesterol: < 40 mg/dl in men, < 50 mg in women
• Blood Pressure: > 130/85 mm of Hg
• Fasting Blood Sugar: > 110 mg/dl

• Stop consuming tobacco in any form. It will reduce the risk of Heart disease by 10%.
• Bring your cholesterols to ideal levels as mentioned before. Ideal levels of Cholesterols will reduce the risk of Heart disease by 20 – 30%.
• Do regular exercise. Regular walk of 30 to 45 minutes per day for 5 days a week can be effective. You can also walk for 10 minutes three times a day. Regular exercise as mentioned can reduce the risk of heart disease by 10%.
• You must keep Diabetes, Blood Pressure under tight control as per the advice of your doctor.
• Watch your food habits. Eat plenty of green vegetables, salads, and fruits. Keep away from fried food, excessive salt and sugar.
• Resort to meditation, prayer, and positive attitude to conquer your stress.

• When a person gets symptoms, the disease is already advanced. The correct approach should be to prevent the heart disease from occurring by taking care of all the risk factors mentioned.
• 30% of patients of Heart disease, Diabetes & High BP do not get any symptoms. These are more dangerous people as if not found earlier, the disease attacks the patient with catastrophic outcomes. A comprehensive health check up after the age of 35 is absolutely necessary.
• Apart from well known symptom of chest pain ; Heart disease can also present with many atypical symptoms viz. gastric troubles, toothache, jaw pain, arm pains, giddiness etc. Do not waste time at home in giving household remedies. Rush to doctor immediately.

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