Young India's heart health: Cardiologist dispels myths around cardiac activity
Cardiovascular disease in India: A 360 degree overview,
which throws light on how Indians will be affected by CVD ten years sooner than their western counterparts.
WION spoke to Dr Vineet Bhatia, MD, DM, DNB (Cardiology), MNAMS, FESC, Associate Director, Cardiac sciences, Max Hospital, Patparganj, New Delhi, to comprehend young India's cardiovascular health and the reasons behind an increase in heart attacks.
Here are the excerpts.
Q. Firstly, What is the difference between a heart attack and a cardiac arrest?
A. A heart attack also known as Myocardial Infarction occurs when one of the blood vessels (called coronary artery in medical terms) carrying blood to the heart muscle gets suddenly blocked completely.
As we age, the blood vessels on their inner side develop deposits called plaques. These plaques are rich in cholesterol and other substances (notorious to promote clotting when exposed to circulating blood) and are covered by a cap. The plaques gradually increase in size and encroach on the vessel lumen. This process is accelerated by risk factors like diabetes, high blood pressure, deranged lipids, smoking etc.
These risk factors are also associated with a high risk of a phenomenon called plaque rupture in which disruption of the cap leads to the plaque material getting exposed to the blood flowing in the vessel.
This sets into motion a rapid sequence of events which result in the formation of a clot at the site of rupture resulting in a complete blockade of blood flow beyond that point.
Since the blood and oxygen supply is cut off, the muscle cells of the heart begin to suffer damage and start to die. Irreversible damage begins within 30 minutes of blockage.
Prompt recognition of the problem and early aggressive measures to restore blood flow in the occluded vessel help prevent muscle damage. This forms the basis of the popular saying in cardiology that states Time is Muscle- the faster you move the more muscle you can save.
Cardiac arrest on the other hand occurs suddenly and often without any warning. It usually follows an electric malfunction in the heart causing a sudden cessation of electrical activity or irregular heartbeat (referred to as arrhythmia).
With its pumping action disrupted, the heart can not pump blood to the brain, lungs and other vital organs. The individual loses consciousness and is detected to be pulseless and in shock. Unless prompt resuscitative measures are instituted, death may result within minutes. A heart attack may precipitate a cardiac arrest.
Q. What is the most common reason why young Indians are falling prey to heart attacks?
A. The high incidence of heart attacks in India is not of a unifactorial origin but of a multifactorial one. While the prevalence of smoking has declined in the west, there has been a rise in its prevalence among Indian youth.
India has emerged as the diabetes capital of the world and this is a major risk factor for premature cardiac disease. Unhealthy eating habits coupled with lack of exercise have been contributing to it too.
Furthermore, uncontrolled hypertension, reliance on alternative schools of medicine, stress, obesity and air pollution also play a role in the occurrence of heart attacks.
Q. Why are "seemingly fit" people experiencing heart attacks more frequently now?
A. Lately, we have come across several incidences of cardiac arrest while exercising in gyms raising several concerns.
Chronic and monitored exercise training has shown several physical and mental benefits including a healthy heart.
Regular structured exercise regimens help control risk factors like diabetes, blood pressure and high cholesterol levels.
However, research has found evidence that sudden and high-intensity exercises (especially in people who exercise infrequently) can acutely increase the risk of sudden cardiac arrest in individuals with underlying cardiac disease like coronary artery disease (recognised or unrecognised) or cardiac muscle disorders like hypertrophic cardiomyopathy.
Exercise may increase the shear stress in the blood vessel leading to plaque rupture.
Proper warm-up and cool-down periods (pre and post-exercise) and a gradual build-up of exercise time and severity over a period of time may be helpful in preventing unwanted cardiac events.
Hypertrophic cardiomyopathy is a disease in which the heart muscle becomes abnormally thick. In a small number of people (those with certain congenital syndromes like long QT syndromes and hypertrophic cardiomyopathy), exercise can trigger life-threatening cardiac rhythm problems called arrhythmias which may lead to sudden cardiac death.
In-depth research on active gyms and the credentials of supposedly qualified trainers is also essential. The bulk of so-called self-styled trainers lack degrees in physical education and instruct according to their own whims and fancies because there are no guidelines in place.
Q. Can health supplements lead to unusual cardiac activity?
A. Protein supplements are the in thing among gym goers these days. They overlook the fact that a smart diet plan and using existing protein sources can build muscle, strengthen bones and power our body functions.
However, wanting quick and overnight results and most often peer pressure prompts people to use over-the-counter supplements available in an unregulated market.
The manufacturers package what they feel is safe. For the sake of palatability, they may add sugars, artificial flavours, thickeners and calories with detrimental effects. Many protein powders labelled herbal, ayurvedic and safe may in fact contain heavy metals like cadmium, lead, arsenic or mercury) leading to toxic effects.
Fat-burning supplements are popular as they help you lose weight in a short span of time. They contain caffeine plus Afrin which are ordinary ingredients utilised in burning fat.
According to some studies, fat burners can accelerate weight loss. However, they can also occasionally have damaging side effects on our bodies. They may lead to a variety of side effects such as psychological effects (cause nervousness, aggressive behaviour, anxiety and mood swings), loss of appetite, dehydration, and affect heart rate and blood pressure.
These may in turn trigger cardiac events. In fact, many dietitians and nutritionists recommend not taking any fat burner during your phase of weight loss.
Q. COVID-19 and heart attacks: Is there a correlation?
A. The Smidt Heart Institute at Cedars-Sinai recently reported that deaths from heart attacks rose significantly during pandemic surges, including the COVID-19 Omicron surges, overall reversing a heart-healthier pre-pandemic trend.
Prior to the COVID-19 pandemic, heart attacks were the leading cause of death worldwide but were steadily on the decline. However, the new studyrecently published in the peer-reviewed Journal of Medical Virologyshows that heart attack death rates took a sharp turn and increased for all age groups during the pandemic.
The surge in such cases has been seen across surges including the pres
Friday, March 10, 2023 at 12:00 am