'World Heart Day-2005' is being celebrated under the auspices of World Heart Federation (WHF), which is an international body engaged in prevention of heart diseases in various parts of the world, including Pakistan, on September 25 with a pledge that efforts for creation of a healthy society by checking spread of cardiac diseases through creating awareness among people about healthy lifestyle would continue to be made.
This year the Day is observed with the theme of 'Healthy Weight, Healthy Shape'. The selection of this theme reflects the need to increase awareness among the people about necessity of maintaining body weight to avoid heart diseases.
The 'World Heart Day' takes place on September 25 each year with the aim to raise awareness of healthy heart on a global scale. It has now firmly established itself as an international day and is recognised across the world.
To mark the day, walks, seminars, scientific sessions, symposiums, awareness camps, and special functions will be held across the country. It also calls attention to the pressing need to promote enlightened public policy, increase availability of treatment services, and develop as well as implement effective preventive strategies to reduce the sufferings of those facing cardiac problems, which have now assumed the shape of a global pandemic and need special attention.
The growing rate at which cardiovascular diseases are emerging means that the economic, social and emotional costs of this problem are becoming increasingly unbearable for a poor country like Pakistan. Learning from the experience of the West, we must realise that it is important to shift our focus from curative and rehabilitative care on preventive cardiology, which has three levels ie health promotion, primary prevention, and secondary prevention.
Leading cardiologists told Business Recorder here on Saturday that the most important aspect of preventive cardiology is to change the lifestyle, behaviour and attitude of the people, which is only possible by creating awareness regarding the risk factors and subsequent effects of cardiovascular diseases. The risk factors for cardiovascular disease are diabetes, hypertension, hyperlipidemia, smoking, family history, obesity and stress, they said.
About diabetes mellitus, they said it is an independent risk factor for cardiovascular disease, increasing its risk by about two to three times for men and three to five times for women. The cardiovascular disease is the leading cause of death in diabetic patients and approximately, 25 percent of heart attack survivors have diabetes. Diabetes is a more potent risk factor in women as compared to men since diabetic women have twice the risk of a second heart attack compared to diabetic men.
Talking about hypertension, they said it remains one of the major risk factors for cardiovascular disease even if the systolic/diastolic (upper/lower, normal = 120/80) blood pressures only slightly fall into the hypertensive range. The risk imposed by hypertension is substantially heightened if other risk factors are present.
About hyperlipidemia, experts said: "Cholesterol in blood can be divided into two portions: bad cholesterol and good cholesterol. Bad cholesterol (LDL cholesterol) is harmful in the sense that it gets deposited in the blood vessels and subsequently blocks it. This compromises the blood flow to the heart or the brain if that particular vessel supplies any of these two organs. Good cholesterol (HDL cholesterol) is beneficial for the circulatory system since it prevents the cholesterol deposition into the vessels and, in fact, returns it to the liver for proper metabolism and excretion.
It is, therefore, important that the levels of bad cholesterol be kept below a certain value, while the good cholesterol should be above a specific level in the blood.
Regarding smoking, they said that cigarette smoking increases the risk of cardiovascular disease by about two to three folds. The risk is amplified by several times if the smoker carries other risk factors of cardiovascular disease. Smoking remains the leading cause of preventable mortality, most of it due to cardiovascular disease, they added.
They warned that the incidence of heart diseases would increase manifold if present trends of smoking were not checked through coercive measures. About family history, the experts said if the first-degree relatives of a person suffer from cardiovascular disease, the chances of that person getting the same problem increase manifold. It becomes all the more important for that person to make specific target-oriented efforts to avoid the development of other risk factors.
About obesity, the experts said it has also shown a strong co-relation with the risk of cardiovascular disease. While latest research also indicates that obesity might be an independent risk factor for cardiovascular disease, its major effects are through the changes it causes in the metabolic pathways. It does so by increasing the chances of getting diabetes, hypertension and hyperlipidemia, they said.
"Obesity itself has become a life-long disease, and it is becoming a dangerous epidemic, as it joins other major risk factors, including smoking, high blood cholesterol, high blood pressure and a sedentary lifestyle. The link between obesity and heart disease isn't new to doctors, who have known for years that those who are overweight have increased health risks."
They also said that physical inactivity roughly doubles the risk of cardiovascular disease. Even regular moderate intensity exercise causes significant reduction in risk. The potential ways in which physical activity reduces the risk of cardiovascular disease include an increase in good (HDL) cholesterol, decrease in blood pressure and reduction in obesity. In other words, it acts and lessens the extent of numerous other factors that can lead to disease.
To a query, they said that continuous stress on a person causes increased production of catecholamines (certain hormones) which in turn puts greater load on the heart and can lead to increase blood pressure and predisposing to atypical cardiovascular events.
They said that an unbalanced diet consisting of high fat and cholesterol can lead to plaques in the coronary arteries. This can cause disruption of blood flow to the heart muscle, culminating in the death of the cardiac tissue. Lack of dietary fiber in the diet increases absorption of cholesterol from the gut resulting in a high blood cholesterol level, they added.
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