How to reduce your risk of getting heart attack, stroke

Today is World Heart Day, observed annually since September 2000. A joint effort of the World Heart Federation (WHF) and the World Health Organisation (WHO), the aim is to increase public awareness of heart and blood vessel diseases, including their diagnosis, treatment, prevention and the impact on world populations. Heart and blood vessel diseases, usually referred to as cardiovascular disease (CVD), remain the leading causes of death and disability worldwide and are a major contributor to health expenditure. An estimated 20.5 million people died of CVDs in 2021. This represented 32 per cent of all global deaths. This is just one set of conditions of about 10,000 known human diseases worldwide. Further, 85 per cent of these deaths due to CVD were due to two conditions: heart attacks and strokes. Another remarkable fact is that despite heart attacks and stroke being perceived to be diseases of the developed world, 80 per cent of these deaths occurred in middle- and low-income countries such as ours. A heart attack occurs when an artery supplying part of the heart muscle narrows and blocks resulting in damage to that part, which could lead to heart failure or death if not treated in time. A stroke is when a similar thing happens to the brain threatening to cause damage to that part of the brain. Bleeding into the brain due to high blood pressure also causes stroke. Non-communicable diseases such as diabetes, high blood pressure, high blood cholesterol, overweight and obesity are precursors of CVD. It is estimated that by 2030, death from heart attacks and stroke will overtake other causes in our region due to high incidence of non-communicable diseases. Most of these deaths, particularly in low- and middle-income countries such as Kenya, occur between the ages of 30-70 when people are at the peak of their productivity and responsibility. The cost of caring for heart attacks and strokes, the infrastructure needed and the human resource training required for diagnosis and treatment are very high. Many families are left on the verge of bankruptcy when a heart attack or stroke strikes. Heart attacks and strokes are known to be largely caused by cardiovascular risk factors. These conditions and behaviours increase one's chance of developing a heart attack or stroke. The most significant behavioural risk factors are unhealthy diets, physical inactivity, tobacco use and harmful use of alcohol. These behavioural trends also lead to conditions such as diabetes, raised blood pressure, raised blood cholesterol, overweight and obesity. When these latter conditions are uncontrolled for a long time, they slowly narrow the arteries, eventually causing heart attacks and strokes. The safest and least expensive way to deal with CVD as an individual is to take measures to avoid developing these diseases, and for the country it is to institute health related policies that make heart healthy choices affordable and available. This would include reduced taxation of healthy foods such as fruits, vegetables, whole grains, healthy oils and at the same time discouraging use of harmful products such as smoking and excess alcohol. Mandatory accurate food labelling to offer citizens informed choice on what they consume would also be helpful. Risk factors that impact development of heart attacks and strokes or prevent recurrence if the conditions have already occurred include diet. Diet is important as it is a risk factor to which everybody is exposed, when compared to other factors which may be present in some people but not in others. A heart healthy diet contains vegetables, fruits, beans or other legumes, whole grains and their products, moderate use of dairy products or use of low-fat dairy products, animal products such as fish, lean meats and moderate use of chicken, use of unsaturated healthy oils is also recommended. Saturated fats and trans fats are to be avoided. These are usually solid at room temperature, while the better unsaturated fats usually flow. One should reduce excessive salt and sugar intake, as well as foods and drinks that go through complex processing. Diet will impact your development of overweight and obesity status, high blood cholesterol, high blood pressure and diabetes. These, over time, lead to heart attacks and strokes when not diagnosed early and controlled. Smoking is a major risk for damaging arteries, but fortunately, once one quits, within a year, the risk of heart attacks and strokes falls by over 50 per cent and continues to fall over time. Physical activity such as brisk walking for about 150 minutes weekly, divided into 2 to 5 sessions throughout the week has been shown to reduce risk of heart attacks and strokes. It also helps to control weight and reduce stress. Maintaining a healthy weight is important, as weight gain predisposes one to diabetes and high blood pressure. Weight gain could also be an indicator of an unhealthy diet and lack of adequate physical activity. Maintain a BMI of under 25, a waist circumference of under 102cm for men and under 88cm for women. Other determinants of heart health include adequate sleep. For adults about 7 hours of sleep is desirable, though over time most adults are able to do with slightly less. Inadequate sleep will raise your blood pressure and interferes with metabolism of blood sugar and blood cholesterol. Stress acts as a significant trigger of heart attacks and strokes, as it can impact on all the conditions mentioned above. Being self-aware and therefore managing stress better is critical. Regular medical check-ups to pick up those conditions which build up silently in the body, such as high blood cholesterol, high sugar and high blood pressure need to be done. A simple guideline would be to do formal medical check-ups twice in the decade of 20-30 years, three times in the decade of 30-40 years, four times in the decade of 40-50 years, five times in the decade of 50-60 years, and yearly after the age of 60. Have a healthy World Heart Day. -mathenge001@gmail.com

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