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WEDNESDAY
SEPTEMBER 29, 2021

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lifestyle 05

Understanding bad How can regular exercise

influence cholesterol ?
Regular walking, wogging,
jogging, swimming, etc are
excellent for a healthy heart
Busting heart-related myths
if they experience any of
these symptoms.
and heart attack are the
same.

and good cholesterol and to reduce the level of bad

t is vital to understand the
cholesterol and increase the
level of good cholesterol.
Follow these points for good
heart health and to keep your
cholesterol levels in check:
What are some tips for
everyday cardiac care?
How often should a
person visit a cardiologist
for regular check-up?
What are early indicators
of a heart attack?
Pressure, tightness, pain, a
squeezing or aching
sensation in your chest or
supply to the tissues. High What is the relationship l Say no to stress, smoking, Snap out of a sedentary arms that may spread to

I effects of cholesterol. In
fact, cholesterol is just one
of the many substances
created and used by our body
to keep us healthy. It promotes
synthesis of cell membranes
and hormones. Unfortunately,
cholesterol does not get
processed in a beneficial way
every time. In other words,
elevated levels of bad
cholesterol is a major risk
levels of bad cholesterol
and low levels of good
cholesterol HDL (high density
lipoproteins) may be
responsible for premature
between cholesterol and
alcohol/smoking?
Excessive alcohol intake can
raise bad cholesterol,
triglycerides and may cause
sedentary lifestyle, saturated
fat, excess alcohol, salt, sugar
l Practice heart-friendly
exercises for 30 minutes daily
l Do not eat junk or fried food; Dr Aparna Jaswal PHOTO: HTCS
lifestyle, exercise regularly
and consume healthy fats.
Do not smoke, maintain a
healthy weight. Reduce
alcohol intake and have a
your neck, jaw or back.
Symptoms also include
nausea, indigestion,
heartburn or abdominal
pain, shortness of breath,
heart attack in the younger high blood pressure or heart include more nuts, fruits and low salt and low sugar diet. cold sweat, fatigue and
population, especially those attack. Also, tobacco vegetables in your diet ere are some Keep stress under control, lightheadedness or
who are obese with pot belly
(>90cm in men and >80cm in
women), in hypertensives,
diabetics and smokers.
consumption in any form
raises bad cholesterol, even
LDL and triglycerides, lowers
the level of HDL. HDL level
decline is greater in women
l To be cholesterol fit, ensure
you are adequately hydrated
l Manage anger to enhance
heart health. Also, cope with
stress by practising all eight
H important points to
keep in mind, for a
healthy life ahead.

What’s the contribution of

get regular check-ups done.

What are some common

myths related to cardiac
health and age?
sudden dizziness.

How can one take care of

factor for the rising epidemic
of heart attack, brain attack, etc
in our country. Covid-19 is pro-
thrombotic, pro-inflammatory
and pro-immunogenic. These
factors are responsible for
severity and mortality, more so
for those with underlying
comorbidities.
The theme of World Heart
Day this year is ‘Use your heart
to connect to healthy choices
digitally to improve awareness,
prevention and treatment’.
Healthy heart is not by chance,
it is by choice.
What is cholesterol? What
are the types and risks?
Cholesterol is a waxy, soft,
fat-like substance found in all
body cells, and is essential for
life. However, high levels of
bad cholesterol such as total
cholesterol (CH), triglycerides
(TG), low density lipoproteins
(LDL) LPa, remnants
cholesterol, Apolipoprotein A1,
Apolipoprotein B, may lead to
premature hardening of the
arteries in the heart, brain,
peripheral arteries, aorta,
kidney arteries, etc. Narrowing
of the arteries reduces blood
What are the normal and
risk levels of cholesterol?
Normal range of blood
cholesterol is 150-250 mg/dl.
Ideally, blood cholesterol in an
adult should be < 130 mg/dL,
LDL cholesterol levels
< 70 mg/dL, triglyceride level <
130mg/dl, VLDL level < 30 mg/
dl, HDL cholesterol levels > 40
mg/dl in males and > 50 mg/dl
in females. The cholesterol/
HDL ratio should be < 4, LDL/
HDL ratio should be < 3. LPa
level should be < 30 mg/dL,
non-HDL < 130 mg/dL,
Apolipoprotein A1 .89 -.1.86,g/l
Apolipoprotein B .45 -.1.69 g/l
(>LDLC-Non HDLC)
Apolipoprotein < 90 mg/dL,
Remnant Cholesterol .4-.5
mmol/L (total cholesterol-
LDL-HDL). Increase in levels of
these lipoproteins may
increase risk of heart attacks.
How is high triglyceride
level harmful to the body?
The source of triglycerides is
diet. If high, it may be an
independent risk factor for
heart attack and brain attack.
Individuals with high levels of
triglycerides (> 200 mg/dl) are
Dr HK Chopra PHOTO: HTCS
two times more vulnerable to
atherosclerosis than those with
lower levels. Regular exercise,
healthy diet, reduced alcohol
intake, fenofibrate may be
recommended to reduce
triglyceride levels.
What about fats?
Saturated fats are solid at room
temperature. They are found in
fats of animal origin such as
beef, butter, cream. Coconut
oil, though of plant origin, is
solid at room temperature and
has high saturated fat content.
High intake of saturated fat
spikes cholesterol. On the
contrary, unsaturated fats are
liquid at room temperature.
Sources of polyunsaturated
fats are plants such as
sunflower, corn and soyabean.
Consumption of
polyunsaturated fat oils
lowers cholesterol level.
Monounsaturated fats are in
olive, peanut, avocado oil, and
lowers cholesterol levels.
smokers, as compared to men.
How are age and stress
related to cholesterol?
Any kind of stress may raise
bad cholesterol. Also, as age
advances, it enhance vascular
age and raises bad cholesterol.
And after menopause, bad
cholesterol level becomes high
and good cholesterol low.
What is the recommended
protocol for lipid profile
check after the age of 30?
Lipid profile should be checked
on a yearly basis after 30 and
every six months after 55. It
can be individualised on
doctor’s advise and an
individual’s comorbidities.
What is the role of diet in
reducing cholesterol?
Reduce fat intake, so that less
than 10% of total calories
comes from saturated fat and
10% from polyunsaturated fats.
Eat more nuts, vegetables and.
One can have chicken and fish,
no red meat. Avoid egg yolk,
opt for egg white. Ditch junk,
deep-fried food such as
samosa, cutlets, etc.
limbs of yoga and meditation.
l Eat the right food at the right
time, place, in the right dose
and the right environment
l Get annual health check-up
done after the age of 30
l Optimise your heart-mind
connection for a more
healthy heart
l Follow 3Ms (mindfulness,
meditation and medication)
l Please take statins with your
doctor’s advise
The author of the article is
Dr HK Chopra, senior
consultant cardiologist,
Medanta Moolchand Heart
Institute, chairman CME,
Moolchand Medcity, Delhi,
chairman, World Wellness
Foundation, WHA, country
head, AHA, former national
president, CSI and IAE, former
national editor-in-chief, IHJ,
JIAE, editor-in-chief, Top 10
Textbooks of Cardiology,
chief advisor, heath
committee, SCOPE;
Email: drhkchopra@gmail.com
Disclaimer: The veracity of any
health claim made in the above
article is the responsibility of the
concerned hospital/doctor
female cardiologists in the
field of medicine ?
In a field that is typically
dominated by men,
pioneering women have
brought innovation and
diversity to cardiovascular
medicine, enriching heart
health and patient care.
Though half of all medical
students and over 40% of
internal medicine residents
are women, the number of
women in cardiology
remains abysmally low. It is
important to increase
representation of women
in subspeciality.
What are some common
heart-related post-Covid
conditions and
precautions to be taken?
Severe fatigue is common
after Covid-19. Many people
experience shortness of
breath, chest pain or
palpitations. Any of these
problems could be related to
the heart, but they could
also be due to other factors,
including the aftermath of
being very ill, prolonged
inactivity and spending
weeks convalescing in bed.
One must see a cardiologist,
• I am too young to worry
about heart disease.
•I would know if I had high
blood pressure, because
there would be warning
signs. And it’s okay to have
higher blood pressure when
you are older.
•I can lower risk of heart
disease with vitamins and
supplements. If I have heart
disease, I should eat as little
fat as possible.
•I will know when I am
having a heart attack,
because I will have chest
pain. And diabetes won’t
threaten my heart as long as
I take my medication.
•Heart disease runs in my
family, so there is nothing I
can do to prevent it. I do not
need to have my cholesterol
level checked until I am
middle-aged.
•Heart failure means heart
stops beating. My heart is
beating really fast, I must be
having a heart attack!
•I should avoid exercise
after having a heart attack.
•I have smoked for years,
there is no point stopping
now. Heart disease only
really affects men.
•Cardiac arrest
themselves to reduce the
chances of a heart attack?
Do not smoke. Control your
blood pressure and
cholesterol levels. Check for
and manage diabetes. Get
regular physical exercise.
Maintain a healthy weight.
Eat a heart-healthy diet.
Control your stress levels.
Adhere to your medications
and maintain regular
contact with your doctor.
The author of the article is
Dr Aparna Jaswal, MD
(Internal Medicine), DNB
cardiology gold medallist,
Certified Cardiac Device
Specialist (CCDS), Fellow of
Heart Rhythm Society, USA,
Fellow of American College
and Cardiology, IBHRE –
HRS – world ambassador,
director cardiologist, Dept of
Cardiac Pacing and
Electrophysiology, Fortis
Escorts Heart Institute,
Okhla Road, New Delhi;
Call: 9818797594; Email ID:
aparnajaswal@hotmail.com
Disclaimer: The veracity of any
health claim made in the above
article is the responsibility of the
concerned hospital/doctor

Today, on World Heart Day,

experts share tips to improve
A HEALTHY HEART, cardiovascular health and
keep ailments at bay

ILLUSTRATION:
SHUTTERSTOCK

PHOTOS: HTCS

For acute heart attack, Tackling early onset of

best option is complete cardiovascular disease
Why are heart revascularisation ardiovascular disease is one of

problems increasing in cute heart attack or appearance during coronary C the most common causes of
death and disability in India.
We Indians are prone to heart

younger age group? A ST-segment

elevation,
myocardial
infarction remains the
biggest killer on the planet.
angiography. The reason
may be that in the setting of
an acute heart attack, FFR
may be underestimating the
physiological ramifications
disease due to genetic predisposition
and rampant prevalence of risk
factors such as diabetes, high blood
pressure and tobacco consumption.
The disease is characterised by its
he untimely death lung cancer. But, did you More people succumb to an of a blocked artery. premature occurrence; around 50%

T of TV celebrities
in the past few
months has left
everyone in a state of
shock. Heart attack,
cardiac arrest and other
cardiovascular diseases
are a major concern
around the world. But
recently, a rising number
of cardiovascular issues
among the younger
population is being
diagnosed and reported.
Young people these
days start gymming
without a pre-cardiac
check-up. At the gym,
they do weight training,
which increases the
thickness of the heart.
They do treadmill work
out, cross training; some
even take supplements,
which are not good
and can cause damage to
the heart, leading to
arrhythmia. So, it is
always advisable to go for
regular health check-ups
after the age of 35.
However, there are
many other factors also
that cause cardiovascular
diseases, such as
smoking, drinking
alcohol, unhealthy eating
habits and patterns,
stress, family history and
sedentary lifestyle. You
probably know that
cigarette smoking causes
breathing problems and
know it also makes you
more likely to have a
heart attack?
Every cigarette you
smoke makes you more
prone to heart disease.
Roughly one out of five
deaths from heart disease
is directly related to
smoking. People who
smoke are two to four
times more likely to get
heart disease. The risk is
even greater for women
who smoke and also take
birth control pills.
Cigarette smoke is also
bad for the people
around you, as passive
smoking can also cause
heart disease and lung
cancer in people who
don’t smoke.
Around 80% of
premature heart attacks
and strokes are
preventable. Healthy diet,
regular physical activity
and not using tobacco
products are key to
prevention. Checking and
controlling risk factors
for heart disease and
stroke such as high blood
pressure, cholesterol and
high blood sugar or
diabetes is also very
important.
Follow 5 S programme:
l Smoke – No
l Salt – No extra
l Sugar – Control
l Stress – Control
Dr Subrat Akhoury
l Sedentary lifestyle –
Exercise
The author of this article
is Dr Subrat Akhoury,
director — cath lab,
interventional cardiologist
and head (Unit-I), Asian
Institute of Medical
Sciences, Delhi-NCR,
Sec 21 A, Badhkal Flyover
Road, Faridabad;
Call: 0129-4253000;
www.aimsindia.com
Disclaimer: The veracity of
any health claim made in the
above article is the
responsibility of the
concerned hospital/doctor
acute heart attack in a year
than diabetes, hypertension,
cancer or lung disease. More
importantly, Covid-19 isn’t
one of the biggest killers.
In the event of a heart
attack, one artery supplying
blood to the heart is
completely blocked, that is,
100% occluded. There are
usually three coronary
arteries supplying blood to
the heart. The artery that
gets totally blocked is
termed the culprit artery.
The best treatment for an
acute heart attack is to get to
the closest hospital with a
cath lab at the earliest; time
saved is heart muscle saved.
The blocked artery needs
treatment with coronary
angioplasty and stenting to
restore blood flow to the
dying cells.
In some patients, another
coronary artery may also
be blocked. This is the non-
culprit artery. It was
believed earlier that the
union culprit vessel is best
left alone during the index
procedure. But, a large
randomised trial, the
COMPLETE trial, including
over 4,000 patients with
acute heart attack, showed
that opening up both the
culprit and the non-culprit
artery provided significantly
better clinical outcomes
than treating the culprit
Dr Deepak Natarajan
PHOTO: HTCS
vessel alone. The composite
of death and myocardial
infarction was reduced from
10.5% to 7.8% in a follow-up
of three years. The trial was
published in the New
England Journal of Medicine
in September 2019.
The decision to stent the
non-culprit vessel was taken
if it was blocked 70% or
more, and if the blockage
ranged between 50% to 69%,
stenting was done when the
fractional flow reserve (FFR)
was below 0.80. Usage of
FFR in the cath lab confirms
whether a 50% to 69% block
is actually producing
schema in the heart muscle
being supplied by the
non-culprit vessel.
This year, another big
randomised trial from
France that included more
than 1,100 acute heart
patients, documented that
using FFR for a non-culprit
vessel having 50-69% block
did not provide a clinical
advantage over visual
Currently, the take home
message, hence, should be
that stenting of both the
culprit and the non-culprit
vessel should be done either
in the same hospital setting
or within one-and-a-half
months of the heart attack, if
the non-culprit artery is 70%
or more blocked, regardless
of ischemia.
But, in case the non-
culprit vessel has a block of
50% to 69%, the patient
should be assessed for
ischemia by FFR after a
month of the index
procedure. In case there is a
block in the non-culprit
artery of less than 50%,
treatment is medical
management by pills.
Crucially, the patient
must get to the closest
heart hospital as quickly as
possible.
The author of the article is
Prof Dr Deepak Natarajan,
MBBS, MD (Medicine),
DM (Cardiology), chief of
cardiology, principal director,
Cardiac Sciences, Supreme
Hospital, Charmwood
Village, Sector 39, Faridabad,
Haryana - 121009;
Call: 7290021726
Disclaimer: The veracity of any
health claim made in the above
article is the responsibility of the
concerned hospital/doctor for
more information
heart attack patients are less than 50
years old, and 25% are less than 40.
A study says people born after 1970
are more prone to heart disease due
to less sensitive attitude towards risk
factors. India, we say, is a country of
young with 65% population below 50
years of age. But, are we healthy?
Heart diseases, as much as we take
into account all factors, are majorly
because of our bad habits. This
means our poor lifestyle choices,
including diet, smoking, alcohol
consumption, etc. Our urban
youngsters have an irregular lifestyle,
with high stress of meeting targets on
time. They are not giving enough
time to their bodies to recover from
daily stress.
Modifiable reasons for increasing
heart attacks in young include:
l Diabetes: It is one of the biggest risk
factors, majorly caused by dietary
choices such as exposure and
access to ultra-processed food,
sedentary lifestyle and decreased
physical activity
l Smoking
l Hypertension
l Obesity
l Alcohol consumption
l Lack of fruit and vegetable intake
l Too much time sitting at one place
l High cholesterol
SOLUTION
The solution lies in the reasons itself.
Young people are fortunate that if
they can change their lifestyle, the
chances of progression of heart
disease and eventually heart attacks
comes down multifold, compared to
middle-aged and the elderly.
Dr Manoj Kumar PHOTO: HTCS
Certain steps that can help reduce
the chances of heart attacks are:
l Will power: People need to be
strong to make lifestyle changes
l Smoking: Quit smoking; it’s the
biggest risk factor for heart attack
l Right diet: By consuming fresh
fruits, vegetables, nuts and whole
greens, we can reduce the risk of
cardiovascular disease by 62-85%.
Beans, other low-fat sources of
protein and certain types of fish can
also reduce risk of heart disease.
Healthy fats from plant-based
sources such as avocado, nuts,
olives and olive oil can help your
heart by lowering the bad type of
cholesterol.
l Diabetes screening: Keep your
blood sugar levels under control
l Hypertension: Ensure blood
pressure is in the range of 120/80
l Exercise: Workout daily without fail
for at least 30 minutes
The author of the article is
Dr Manoj Kumar, senior director and
HOD – cath lab, Max Superspeciality
Hospital, Patparganj, New Delhi
Disclaimer: This initiative is undertaken in
the public interest. The information is only
suggestive for patient education and shall
not be considered as a substitute for
doctor’s recommendations or advice. Please
consult your doctor for more information