Lessening your chances of a deadly heart attack

February is a heart health awareness month during which the world ought to be sharing information that can help all of us to improve our cardiovascular health.
Cardiovascular disease (Diseases of the heart and blood vessels) abbreviated CVDs are actually the number 1 cause of deaths globally according to the World Health Organization. More people die annually from CVDs than from any other cause. It is estimated that about 17.5 million people died from CVDs in 2015 and of those, about 7 million were due to stroke.

And believe it or not, over three-quarters of deaths from CVDs occur in low and middle-income countries. So, everyone can be affected by these including you and me.

There are many types of cardiovascular diseases but the most common are hypertension (high blood pressure) and coronary artery disease (disease of the blood vessels supplying the heart). These 2 types of problems alone account for 80 percent of all cardiovascular deaths.

And because high blood pressure and coronary artery disease may have no symptoms, unfortunately for some people a heart attack or a stroke could be the first sign. Other potentially life-threatening forms of cardiovascular disease that you should be aware or include clots and abnormalities in heart rhythm (arrhythmias).

It is very important therefore to know whether or not you have any of these problems (since they can exist in your body without symptoms) or whether you could be at risk for any heart-related problems. And the simple way to know this is by going for a health checkup.

Everyone should know the following health parameters that are markers or indicators of cardiovascular health:

Blood pressure – This is a simple quick test that can be done at any health facility or even at home. Aim for a reading of between 90/60mmHg to 120/80mmHg. A blood pressure test could help you prevent a stroke.

Weight and Body Mass Index (BMI) – The BMI is a screening tool that helps you to understand what is the best weight range for you based on your height. Although it has limitations it can easily be done and gives you a wide range usually about 15kg to target.

Body fat percentage. – This is more reliable than BMI but as a test, it may not always be easily accessible. You can do this test at our health facility.

Lipid – This is what many people call a cholesterol test. It includes Total cholesterol, LDL cholesterol (bad type), HDL cholesterol (good type) and Triglycerides (other blood fats). It is a useful screening test to assess how your body is affected by foods rich in unhealthy fats and sugars that can increase your risk for build-up of a fat-like substance that can affect blood flow.

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Blood sugar – A blood sugar screen is used to assess how your body metabolizes sugar. It is a screen for diabetes as well. High blood sugar is linked to cardiovascular disease.
The above are screening tests that help in early detection and are very useful tests that should be done at least once a year. However, you would be surprised how many of us have never done some or even all of these tests. Some of us last did these tests many years ago.

If you have done these tests within the last year, I commend you but if you haven’t, please schedule a time right now to go and get these done. If you don’t make the decision and commitment now, you may never come around to doing them. There is nothing worse than regret and wishing you had taken the very simple step of doing these potentially lifesaving tests. You can come to our Wellcare clinic in Bugolobi and have them done. Call us or email us if you need any help.

The goal is to have normal values for all these tests. If you have any abnormal value please make a plan to have your cardiovascular risk assessed further. I am willing to help you with that.

However, a very important point to note is that, even if all the above tests are normal that does not necessarily mean you have great cardiovascular health or that you have no risk. This is because we now know that before someone’s blood pressure or sugar levels become detectably abnormal they could have had some degree of abnormal dysfunction in your cardiovascular system for many years that is asymptomatic and not detectable by the tests mentioned above. And this could be the case for you as well.

Fortunately, we can now assess for cardiovascular dysfunction at a deeper level and detect any issues many years before they cause high blood pressure. I believe that checking for this additional cardiovascular dysfunction in addition to the above tests is more prudent. Cardiovascular dysfunction tests look mainly for inflammation in your system and looks for deficiencies in markers that determine cardiovascular health. The tests that can be used to assess this additional cardiovascular dysfunction include;

• Creactive protein – A test that looks at inflammation in the body.
• Fasting insulin – A test that measures the hormone that controls blood sugar. This hormone may be out of range long before anyone gets diabetes or even pre-diabetes.
• Vitamin D level – A very important vitamin which is vital for optimal cardiac health function.

Visceral fat – Fat that surrounds the internal organs and viscera. This fat can cause hormonal, cardiovascular and metabolic dysfunction.
Waist circumference.

The waist circumference, in particular, is a very important marker for cardiovascular health. In general (and this is really just for screening purposes) if you are a man with a waist circumference above 37.5 inches and a woman with a waist circumference of 32.5 inches then you are at particular risk for cardiovascular disease, diabetes and complications such as a stroke or heart attack.

A large waist is more dangerous than being overweight when it comes to heart problems. Simply looking at your belly size will give you an indication of your waist circumference.

I would encourage you all to get all these tests and parameters checked. If any of them are abnormal, it could indicate that you are at significant risk for cardiovascular disease even if your blood pressure, blood sugar or cholesterol levels are normal. In fact, we now know that half of the people who get heart attacks have normal cholesterol levels but will always have some level of dysfunction that can be determined by these extra tests or markers.

If your health care provider is not familiar with these tests or is not comfortable interpreting them, please schedule an appointment with myself or at our clinic to help you understand these tests and what they mean for your heart health.

I also want to mention that some people are known to be at particular risk for cardiovascular disease and cardiovascular complications like strokes, heart attacks and even clots. If you have 3 or more of the following then you are one of such people (who are classified as having a condition called metabolic syndrome).

• Have blood pressure above 130/85 mmHg or are on treatment for Hypertension
• Have diabetes (Fasting blood sugar above 100mg/dL or above 5.55mmol/L)
• Increased waist circumference ( > 37.5″ for men and > 32.5″ for women)
• Have a low HDL cholesterol (< 40 mg/dL for men and <50 mg/dL for women) n Have a high Triglyceride level (>150 mg/dL)

If this is you or someone you know, I urge you to take steps to improve your heart health beginning with doing the second line of tests that I mentioned, followed by doing a wellness evaluation and working on reducing your risk factors.
Also, note the following that have been known to increase the risk for heart disease and if you have any of these, you should be more vigilant in assessing your cardiovascular health.

• Smoking
• Excessive alcohol consumption
• Not getting regular exercise
• Consuming large amounts of unrefined white table salt
• Eating unhealthy processed and refined meats and refined carbohydrates
• Having a strong family history of heart disease
• Having a large belly

Like I said earlier, nothing happens until you act. So, for a first step let us evaluate our risk and get screened so that we are aware of our cardiovascular health and know whether we need to pay and extra attention to our hearts and I say extra because we all need to take care of our hearts in the first place. The writer is a health/nutrition expert based at Welcare Uganda

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