USE HEART, KNOW HEART

World Heart Day-2023

Dr Sushil .K. Sharma

About World Heart Day

The main aim of celebrating this day is to raise awareness about cardiovascular disease, its prevention and the impact it has on people across the world. CVD including heart disease and stroke bear a huge mortality and socioeconomic burden. Given this fact, the day highlights the actions that individuals can take to prevent and control CVD. The day is celebrated every year with a theme.World Heart Day is a reminder to everyone around the world to take care of their hearts. This year’s campaign focuses on the essential step of knowing our hearts first.In a world where knowledge about heart health is limited and policies are insufficient or lacking, aim is to shatter barriers and empower individuals to take control of their well-being.
To fight against cardiovascular diseases and to raise awareness about them, we celebrate World Heart Day every year on 29 September. Since a healthy heart is the gateway to a healthy life, it is important to ensure the health of your heart. With the growing number of heart patients worldwide, it has become a cause of concern of late. As per reports, millions of people die of heart diseases every year, which is an alarming scenario. Thus, to create awareness against heart diseases and to prevent heart diseases by giving it a tough fight, the World Heart Day is celebrated on the 29th of September each year. This year, the organizers have captured a beautiful World Heart Day 2023 theme – “Use Heart Know Heart”. World Heart Day is an opportunity for everyone to stop and consider how best to use heart for humanity, for nature, and for you. Beating cardiovascular disease (CVD) is something that matters to every beating heart.
Use Heart means to think differently. To make the right decisions. To act with courage. To help others. To engage with this important cause. The heart is the only organ you can hear and feel. It is the first and last sign of life. It is one of the few things with the potential to unite all of us as people.

USE HEART, KNOW HEART IS OPEN-ENDED: It is not limited to a specific theme or topic. Instead, those who activate the campaign can choose their area of focus – i.e., the environment, healthcare access, mental health or priority risk factors – and provoke their audiences with questions that are relevant and interesting to them.
USE HEART TO EAT WELL: Cut down on sugary beverages and fruit juices – choose water or unsweetened juices instead. Swap sweet, sugary treats for fresh fruit as a healthy alternative.
Try to eat 5 portions (about a handful each) of fruit and veg a day – they can be fresh, frozen, tinned or dried, Keep the amount of alcohol you drink within recommended guidelines, Limit processed foods that are often high in salt, sugar and fat – unpack and unwrap less, peel and cook more!

USE HEART TO GET MORE ACTIVE : Aim for at least 30 minutes of moderateintensity physical activity 5 times a week. Or at least 75 minutes spread throughout the week of vigorous-intensity activity. Playing, walking, housework, dancing – they all count, Be more active every day – take the stairs, walk or cycle instead of driving.

USE HEART TO SAY NO TO TOBACCO : It’s the single best thing you can do to improve your heart health, Within 2 years of quitting, the risk of coronary heart disease is substantially reduced, Within 15 years the risk of CVD returns to that of a non-smoker, Exposure to secondhand smoke is also a cause of heart disease in non-smokers. By quitting/not smoking you’ll improve both your health and the health of those around you. If you’re having trouble stopping, seek professionaladvice .
About CVD
Cardiovascular disease (CVD) is the world’s number one killer, causing over 20.5 million deaths per year. CVD is a class of diseases that affect the heart or blood vessels. More people die from CVD worldwide than from any other cause. Of these deaths, 85% are due to coronary heart diseases (e.g heart attacks) and cerebrovascular diseases (e.g. strokes) and mostly affect low- and middle-income countries.
Heart attack warning signs
Some heart attacks are sudden and intense, where no one doubts what’s happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren’t sure what’s wrong and wait too long before getting help. Here are some signs that can mean a heart attack is happening:
4Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

• Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
• Shortness of breath with or without chest discomfort.
• 4Other signs may include breaking out in a cold sweat, nausea or lightheadedness.

There are three Components of Acute Coronary Syndrome

Unstable Angina: Typical ischaemic symptoms without ST Elevation on ECG and without elevated Bio Markers of Necrosis.

NON STEMI : Typical ischaemic symptoms without ST Elevation on ECG but with elevated Bio markers of Necrosis
STEMI : Typical ischaemic symptoms with ST elevation on ECG and with Bio markers of Necrosis
Risk factors for Coronary Artery Disease:
There are many risk factors associated with coronary heart disease and stroke. Some risk factors, such as family history, cannot be modified, while other risk factors, like high blood pressure, can be modified with treatment.

Modifiable risk factors include:
A) Diabetes- Diabetes is a major global health threat. It affects 1 in 11 adults… 425 million people in the world. People living with diabetes are twice as likely to develop and die from cardiovascular disease. Diabetes is a major global health threat. It affects 1 in 11 adults … 425 million people with the overall figure predicted to rise to 629 million by 2045. Type 2 diabetes accounts for approximately 90% of all people with diabetes. All of those living with diabetes are at heightened risk of CVD making the prevention of CVD onset a major priority.
B) Cholesterol – Raised cholesterol is estimated to cause 2.6 million deaths and is implicated in heart diseases and stroke
C) Tobacco Use – Globally, tobacco causes some 6 million deaths a year and poses a major risk for developing heart disease-it is also a highly preventable risk. Around 1.2 million deaths are due to exposure to second-hand smoke.
D) Physical Inactivity – Around 150 minute of moderate physical activity per week reduces the risk of heart disease by 30% and risk of diabetes by 27%.
Non-modifiable risk factors include:

Family history

• Age: Simply getting old is a risk factor for cardiovascular disease; risk of stroke doubles every decade after age 55.
• Gender: Your gender is significant: as a man you are at greater risk of heart disease than a pre-menopausal woman. But once past the menopause, a woman’s risk is similar to a man’s. Risk of stroke is similar for men and women.
• Ethnicity: Your ethnic origin plays a role. People with African or Asian origin are at higher risks of developing cardiovascular disease than other racial groups.
• Socioeconomic status: Being poor, no matter where in the globe, increases your risk of heart disease and stroke. A chronically stressful life, social isolation, anxiety and depression also increase the risk.
  Diagnosing cardiac ailments:
  The tests you’ll need to diagnose your heart disease depend on what condition your doctor thinks you might have. No matter what type of heart disease you have, your doctor will likely perform a physical exam and ask about your personal and family medical history before doing any tests. Besides blood tests and a chest X-ray, tests to diagnose heart disease can include:
  4Electrocardiogram (ECG). An ECG records these electrical signals and can help your doctor detect irregularities in your heart’s rhythm and structure. You may have an ECG while you’re at rest or while exercising (stress electrocardiogram).
• Holter monitoring. A Holter monitor is a portable device you wear to record a continuous ECG, usually for 24 to 72 hours. Holter monitoring is used to detect heart rhythm irregularities that aren’t found during a regular ECG exam.
• Echocardiogram. This non-invasive exam, which includes an ultrasound of your chest, shows detailed images of your heart’s structure and function.
• Stress test. This type of test involves raising your heart rate with exercise or medicine while performing heart tests and imaging to check how your heart responds.
• Cardiac catheterization. In this test, a short tube (sheath) is inserted into a vein or artery in your leg (groin) or arm. A hollow, flexible and longer tube (guide catheter) is then inserted into the sheath. Aided by X-ray images on a monitor, your doctor threads the guide catheter through that artery until it reaches your heart.
• The pressures in your heart chambers can be measured, and dye can be injected. The dye can be seen on an X-ray, which helps your doctor see the blood flow through your heart, blood vessels and valves to check for abnormalities.
  Methods to assess Coronary Micro vascular Function are :
  Non-Invasive: PET Scan, SPECT Scan, MRI, CT Scan, Doppler Echocardiography, Myocardial Contrast Echocardiography.
  Invasive: Doppler Flow Wire, Temperature and Pressure Sensor tripped Coronary Wire, TIMI Frame Count and Myocardial Blush Score.
  With the advent of latest advancements both on the practical and technological side viz., refinement of intervention techniques , increasing operator experience , changes in stent technology, devices for heart failure , advances in adjunctive pharmacotherapy, coupled with mechanical circulatory support devices have greatly enhanced the safety and effectiveness of intervention in people with heart disease.
  Prevention of CVD –
  According to the World Health Organization, as many as 80% of all heart attacks and strokes are preventable. The majority of deaths due to CVD are precipitated by risk factors such as high blood pressure, high cholesterol, obesity, or diabetes, which can, to a large extent, be prevented or controlled through the consumption of a healthy diet, regular exercise and avoiding tobacco. Keeping an eye on your blood pressure, cholesterol levels and blood sugar levels is also very important.
• Eat a healthy and balanced diet- Eating a healthy, balanced diet is crucial to maintaining a healthy heart and circulation system. A healthy diet should include a wide variety of unprocessed and fresh foods, including plenty of fruit and vegetables (at least five portions every day), whole grains, nuts and foods low in saturated fats, sugars and salt. Be wary of processed foods, which often contain high levels of salt, and drink lots of water!
• Exercise regularly-It only takes 30 minutes of moderate-intensity physical activity, five days a week, to improve and maintain your health. Adults (aged 18-65) and seniors (65+) should aim to do at least 150 minutes of moderate-intensity physical activity, or at least 75 minutes of high-intensity physical activity, every week. Children and adolescents should do at least 60 minutes of moderate- to vigorous-intensity physical activity every day. Try to make exercise a regular part of your life: use the stairs instead of the lift, get off the bus a few stops earlier and walk the rest of the way. Being active is also a great way to relieve stress and control your weight, which are both risk factors for cardiovascular disease.
• Maintain a healthy body weight – Lowering your risk of overweight and obesity normally involves reducing the number of calories consumed from fats and sugars, increasing the portion of daily intake of fruit, vegetables, whole grains and nuts, and exercising regularly. At least 60 minutes of exercise most days a week will help you maintain a healthy body weight.
• Avoid tobacco use- If you stop smoking, your risk of coronary heart disease will be halved within a year and will return to a normal level over time. Avoid smoke-filled environments: exposure to second-hand smoke significantly increases the risk of heart attack. All forms of tobacco are harmful, and there is no safe level of exposure to tobacco. If you’re having trouble quitting tobacco, talk to your doctor about developing a tailored plan to suit your needs.
• Avoid alcohol-As with tobacco, there is no safe level for drinking alcohol, and the detrimental effects of alcohol far outweigh any potential protective benefits. While drinking less may reduce your risk of CVD, evidence shows that the ideal situation for health is to not drink at all. Even moderate drinkers notice health benefits when they stop drinking alcohol.
• Know your numbers- Knowing your numbers is an important part of keeping your heart healthy. Checking your blood pressure, cholesterol levels and blood sugar levels on a regular basis is important to help determine and control your risk of developing cardiovascular disease.
  Take your medication as prescribed
  If you have a higher risk of developing heart disease or stroke, you may need to take medication to reduce your risk. These can include statins to lower blood cholesterol levels, low-dose aspirin to prevent blood clots, insulin for diabetes and tablets to reduce blood pressure. Take the medication that your doctor has prescribed and make sure you stick to your regimen.
  (The writer is Head Deptt. of Cardiology, GMC Jammu).