Heart disease is one of the leading causes of death in all countries. The increasing occurrence of diabetes, high Blood Pressure, high cholesterol and high rates of smoking contribute towards this. Smoking alone contributes to 30% of heart disease worldwide. Lack of exercise and change in dietary habits also contribute to increased heart disease. According to conservative estimates, at least 2.7 crore Indians have heart disease and 4000 people die every day due to heart disease.
This World Heart Day, keeping the theme ‘Use Heart to connect’ in mind, ESSCAPE can be a simple mnemonic to educate the public regarding the key components of the prevention of heart disease. This starts with eating healthy and ends with exercising regularly.
This also includes sugar, blood pressure and cholesterol control and the extra ‘S’ in ESSCAPE is to attract attention to smoking cessation. Considering the epidemic of heart disease in India, it is worth teaching this simple mantra to the next generation as well to prevent heart disease in the coming years.
E – Exercise regularly
S – Smoking cessation
S – Sugar control
C – Cholesterol control
A – Aspirin for select people
P – Pressure control
E – Eat healthy
Follow the ESSCAPE mantra to escape heart disease
The ESSCAPE mantra is a 7-point strategy to prevent heart disease, and reach the World Heart Federation’s goal of creating more heart-healthy environments. This can be easily remembered to prevent or slow down the epidemic of heart disease in our society.
Exercise is vital for keeping a healthy heart. A daily thirty minutes of moderate-intensity physical activity, primarily aerobic exercise (walking, cycling, jogging, swimming), is necessary to keep your heart fit. These thirty minutes can be done at one stretch or can be split into two sessions. Regular exercise will keep the body weight also closer to ideal levels. Moreover, exercise lowers blood pressure, sugar and cholesterol as well. Even 60-90 minutes of exercise per week has been shown to reduce deaths from heart disease by as much as 50%. Slow walking is also beneficial for the heart.
Smoking is responsible for at least 30% of heart diseases worldwide. Smoking aggravates the build-up of bad cholesterol in blood vessels and increases clot formation in the arteries. Smoking is the most important risk factor for heart attacks in young adults, which is happening more often now than ever before. Hence, saying no to tobacco is important to be inculcated in the younger generation as well if we have to see a decline in heart diseases in the productive age group.
Sugar patients are considered to be at a higher risk for heart disease. Diabetic patients develop blocks that are very extensive and not amenable to treatment, at times, to even angioplasty and bypass. The strict control of diabetes can prevent heart blocks to a great extent. Sugar, BP and cholesterol should all be perfectly controlled in the diabetic, as the risk for heart attack in a diabetic multiplies with the addition of each risk factor.
Cholesterol is the one substance that causes narrowing in blood vessels. LDL cholesterol is the most harmful component. Try to maintain a total cholesterol level below 200 mg%. If this is not possible with a good diet and exercise, then we need to resort to medicines. Statins are the most commonly used agents to lower LDL cholesterol. Still, the uptake of these medicines is not very high in our society, because of the fear of side effects. The side effects which can happen in less than 1% of the population is highlighted, preventing 99% of the population from getting the benefits of lowering cholesterol. Statins have been declared safe to the normal liver.
Aspirin has been used for many decades for the prevention and treatment of heart disease. But some recent reports highlighted the adverse effects of aspirin. Aspirin does irritate the stomach in patients who are prone to gastritis and can cause bleeding in susceptible people. But it is to be remembered that aspirin alone reduced deaths from heart attacks by as much as 33 % when it was first introduced. Aspirin prevents thrombosis and is an integral part of the treatment of patients after heart attacks, stenting and bypass surgery for secondary prevention of heart attack. However, all normal people should not be taking aspirin routinely after a certain age as the benefits are not as high as the side effects that it may cause. Only people at very high risk for heart attacks and who have multiple risk factors should take aspirin for prevention even before a heart attack happens.
Pressure control is very reasonably achieved in most patients with high BP, if treated with the right medicines. However, partial knowledge or ignorance about the complications of high BP results in inadequate treatment of high BP in society. Uncontrolled BP causes strokes, heart attacks and kidney failure. Low salt, exercise and weight reduction contribute towards BP reduction. If these do not work adequately, BP lowering medicines have to be taken. The often-asked question is “Do I have to take these medicines lifelong?”. If you want a healthy long life, it is better to keep the BP under control with or without medicines.
Eating healthy helps in maintaining ideal body weight and goes a long way in controlling blood pressure, sugar and cholesterol. Legally enforcing low salt in processed foods has decreased the occurrence of high BP and heart disease in certain European countries. A healthy diet should be high in fruits and vegetables. It should contain only low-fat dairy products, fish and nuts. The diet should be less on red meat, sweets and sugar-containing beverages.