A Heart that Protects All, Needs Care

A woman, a "care giver", whose health is often neglected by her or by others, is always on the edge of health disorders. She tends to forget about looking after herself, while taking care of others. Consequently, she becomes more susceptible to several health hazards. A woman's health differs from men's in numerous ways, and the biolgoy has all the explanations for this. WHO defines “health” as "a state of complete physical, mental & social well-being, and not merely as the absence of disease or infirmity". This indicates that health needs a holistic approach: in terms of taking care as many factors affect it directly or indirectly.

Now coming to heart health, as someone has correctly said, "Heart health is at the heart of all health." A study says that Indian women are more prone to heart attacks due to high-stress lifestyle, and the symptoms are often ignored or misconstrued. Susceptibility to heart attacks for women is mostly due to ignoring the symptoms and fast-paced lifestyle.

We read somewhere about a study by a diagnostic chain, SRL Diagnostics, which stated that 48 percent women in the age group of 46-60 years had the highest level of abnormality in the lipid profile tests. A lipid profile test measures the amount of cholesterol present in lipid-carrier proteins like LDL (low-density lipoprotein), HDL (high-density lipoprotein) and fats (triglyceride) present in the blood and determines the risk of cardiovascular diseases (CVD). It is based on more than 3.3 million lipid profile tests performed at SRL diagnostic labs present across India between 2014 and 2016. The same survey also stated that nearly 50 per cent of women in India live with an abnormal cholesterol level, which is an alarming indicator of the risk of their being prone to cardiovascular diseases (CVD).

The World Heart Federation (on the occasion of the World Heart Day), has mentioned that the cardiovascular disease (CVD) is the world's number one killer today. It has also mentioned that CVD is the leading cause of death and disability in the world, killing 17.5 million people a year. This is a third of all deaths on the planet and half of all non-communicable-disease-related deaths. Around 80% of these deaths are in low- and middle-income countries where human and financial resources are least able to address the CVD burden.

When it comes to looking after heart, it indicates at doing all the things right. Right from eating, drinking and exercising well to choosing a lifestyle, including quitting smoking: everything needs to be done at a good pace so one is able to enjoy the life to the fullest since it is just one life we have.

To generate awareness on hearth health, every year on 29th September, we celebrate World Heart Day. World Heart Day is quite integral to our life as it challenges all the things that we do in our daily life, so we can understand how to start leading a healthy life thereon. We need to encourage people to do the same and encourage others to follow as well. Collectively, we can eradicate the burden and deaths due to heart problems.

The team Saturday Fare checked with Dr. Parvatagouda C, Consultant, Cardiology & Cardiac Surgery, Aakash Healthcare Super Specialty Hospital to understand the common heart problems. She shared that the Hypertensive heart disease; Coronary artery disease (Blockage in arteries leading to heart attack); Valvular heart disease; (Rheumatic heart disease leading to stenos is & regurgitation of valves); and Arrhythmia like atrial fibrillation (irregularly beating heart with increased rate) are different types of heart diseases.

We further checked with her about the factors that can possibly lead to heart problems, and she mentioned about these: physical inactivity; unhealthy dietary pattern; overweight and obesity; smoking & tobacco use; high blood cholesterol; high blood pressure; and diabetes mellitus.

Sometime back while discussing about health, we had asked Dr. Parinita Kaur, who was then serving as the Consultant, Internal Medicine, Aakash Healthcare - Super Specialty Hospital, about general yet important medical symptoms that women should not ignore. She said, "General weakness is the most common symptom we encounter. It could mean anything from a nutritional deficiency to chronic infections, anaemia, cardiac disease, malignancy to even psychological disorders like Depression. Other common symptoms and signs to watch out for are prolonged fever, menstrual irregularities, post-menopausal or post coital bleeding, new onset headaches, any swelling or lumps on the body, etc."

Did you know? High blood glucose or blood sugar can also be indicative of diabetes. CVD accounts for the major deaths in people who have diabetes. Here goes the clue: if it is left undiagnosed and untreated, it can put you at increased risk of heart disease and stroke. High BP, one of the factors of CVD, is called the "silent killer" as it usually gives no warning signs or symptoms, and many people don't even realize that they have it. In fact, cholesterol has caused around 4 million deaths per year. Your weight and body mass index (BMI) also plays an important role.

Dr. Parvatagouda talked about the early signs of heart risks: chest pain on exertion; breathlessness on exertion; easy fatigue-ability & weakness; and palpitations.

Stress is one of the major causes of heart risks, especially in women. Fast paced life has some benefits and many demerits as well. We spend nearly one-third of our time working in the office, home or somewhere else. Working tirelessly and for long hours, causes exhaustion and stress.

Women, unsurprisingly, are more prone to stress. They utilize all of their neurons and energy looking after miniscule of things, and worrying about all. We tried to understand this from Ms. Pritika Singh, CEO and Planning and Strategy, Director of Prayag Hospital, about how stress impacts a woman's health. "According to many studies women differ from men not only in their emotional responses to stress, but also in their physical and mental health, particularly their acute and chronic stress may take a greater toll. Women may face many problems due to stress that includes irregular periods, acne breakouts, hair loss, poor digestion, depression, insomnia, weight gain, and many more."

If you refer the descriptions mentioned above, you would realize that most of these resultants are directly or indirectly, responsible for a heart's health.

On the same line, we asked Dr. Ranjana Sharma, Senior Consultant, Obstetrician & Gynecologist, Indraprastha Apollo Hospitals, New Delhi, if stress in pregnant women can lead to the birth of an abnormal child or cause problems in delivery. She shared, "stress can lead to problem regarding delivery. When the mother goes into labour, if she is stressed then it is not good for a normal delivery. The labour lasts for hours, if the mother is stressed out, it may interfere with a normal delivery. But there is no evidence to suggest that if the mother is stressed then the baby will be abnormal."

Stress leads to incorporating deadly habits in one's lifestyle like smoking. Dr Gaurav Thukral, COO, HealthCare at Home, mentioned, "It depends from region to region & varies from one individual to others. However, most common addictions are chewing tobacco and smoking cigarettes. Both have the same consequences & adverse effect on health which leads to multiple problems including lung cancer, bronchitis, anxiety and irritability, constricted blood vessels, heart disease & cervical cancer etc.

Further, Ms Shamantha K- Counselling Psychologist-Fortis Hospitals, Bangalore, explained how smoking and stress are related to a woman. "Women tend to reach out for a smoke more likely than men when in a stressful situation, but this only adds to the problem. The reason why one feels calm after smoking is because nicotine is a mood-altering drug, in other terms dopamine is released. Fact is it increases the levels of stress in one's body by increasing the blood pressure, heart rate, constrict blood vessels, decrease the flow of oxygen to the brain and restrict healthy coping skills to the individual."

In fact, "the chemicals in the tobacco enter our bloodstream and expose the whole body to the risk of several diseases like lung cancer, colon cancer, mouth cancer, throat cancer, hypertension, risk of heart diseases, chronic obstructive pulmonary disease, asthma, reduced fertility and the list goes on", says Dr. Walia Murshida Huda, Senior Medical Officer, Healthians - a health test at home service provider. Dr. P K Thomas, Consultant Pulmonologist, Fortis Malar Hospital, Chennai, clarified about the doubts that whether a baby born to a smoker woman, have abnormalities. "We have enough literature to say that maternal smoking is very clearly associated to birth related defects. It could lead to a wide range of defects including cardio vascular abnormalities in the baby and various other defects. So, maternal smoking is an absolute NO." Dr. Thukral, added another dimension that "Second hand smoking" impacts a woman's health. l Smoking causes coronary heart disease, cancer, and stroke-the first, second, and fourth leading causes of death for women in the United States.

l Smoking cigarettes causes chronic obstructive pulmonary disease (COPD). People with COPD have trouble breathing and slowly start to die from lack of air. Women who smoke cigarettes are up to 40 times more likely to develop COPD than female non-smokers.

l Life expectancy for smokers-both male and female-is at least 10 years less than for non-smokers.

Ms Shamantha added to this, "The list may include heart diseases, lung cancer and other gender-specific health risks involving their reproductive health. To stress on a few issues would be: problems with menstrual cycles and early onset of menopause. Also, smoking during pregnancy has adverse effects like low birth-rates babies, still births, anomalies of the brain and Sudden Infant Death Syndrome (SIDS) to start with a few. It could also lead to the female employee picking up the habit due to peer pressure or work-stress. Another fact is that women have more difficulty quitting smoking than men, focus being on the relationship between depression, stress and smoking behaviour. Preventive measures to ban smoking in public places acts as a catalyst for those who've been wanting to kick the habit of smoking."

Well, climate havoc can also cause havoc on the heart health of women. Dr. Taruna Dua, Consultant, Obstetrics & Gynecology, Aakash Healthcare Super Speciality Hospital, enlightened us with it. "A change in the climatic conditions does significantly affect health of women and pregnant women in particular. A change in the climatic conditions is associated with a rise in the prevalence of infective agents enhance occurrences of infectious diseases, particularly vector borne diseases. The pregnant women being the vulnerable group tend to get more affected. There is also an increase the incidence of lung cancer, asthma, Heart attack, and strokes and dementia in older women. While these are the direct impacts there are also indirect impacts like occupational impacts, Under Nutritional Impacts and also mental stress."

All of this, collectively, indicates that proper care is needed to be incorporated in the lifestyle.

l To start with a good, thorough and a regular check up. Visit a healthcare center to get a few simple checks done.

l Check your blood glucose levels as CVD accounts for 60% of all deaths in people with diabetes. If it is left undiagnosed and untreated, it can put you at increased risk of heart disease and stroke.

l Check your blood pressure, cholesterol levels, weight and body mass index (BMI).

l Understand the signs and symptoms of a heart attack. Dr. Parvatagouda mentioned about some of the silent signs of heart attack. They are: dizziness; pain at atypical sites like jaw, arms, back & upper abdomen; sudden appearance & disappearance of chest pain; fatigue, shortness of breath; sometimes heart burn (Gastritis), and GI discomfort (Loose stools, vomiting)

l If possible, talk about local cardiopulmonary resuscitation (CPR) courses, so you can become able to help someone in the event of a heart attack. In case of a family member is having a heart attack or stroke, seek medical help immediately.

A few more changes in the eating habits need to be done. We asked Dr. Parvatagouda about the five high risk foods for heart. She said processed foods like pastries, pizza, biscuits, etc.; full cream dairy foods; butter; animal products like chicken skin, beef, lamb (Red meat); Cold drinks should be avoided.

She mentioned that three cooking oils are good for heart:

a) Peanut oil, olive oil, Rice brand oil are relatively better for cardiac health; b) No oil is 100% safe, advantages & disadvantages of oils are marginal over each other; and c) Best thing is to avoid re- heating of oils & keep on changing the oils.

While talking about heart health, Kavita Basak, Co-Founder, The Yoga Chakra said, “the practice of Yoga is known to improve many risk factors for heart diseases. Yoga is a physical exercise that brings awareness of the body, mind and emotions, allowing a practitioner to become more in tune with their physical and mental health. She suggested a few Yoga postures and Pranayama that will keep heart diseases at bay.”

Big Toe Posture (Padangushthasana): How to perform: Step the feet hip width apart, parallel. While exhaling, fold forward and grip the big toes with the index and middle finger of each hand, palms facing inward. Bend the knees as much as you need to, holding onto the toes firmly. Extend the spine forward to lengthen. Stay for a few breaths. To release, while inhaling, let go of the toes and slowly come back to standing.

Bridge Pose (Setu Bandhasana): How to perform: Lie down with your back on the floor. Draw your feet inwards towards the hips. Your feet should be parallel to each other. Now lift yourself up with your stomach going towards the ceiling, along with your back, hip and thighs. Chin and chest should be locked. You can either keep your hands sideways or engage them in supporting your back. You can also clasp them under your back and stretch. Inhale while going up, hold, and exhale while coming down.

Pranayama Bandha- Maha Bandha: How to perform: At first feel the diaphragm move down, allowing the lungs to expand and forcing the abdomen out and feel your chest expand with your collar bones rising at the end? Exhale forcefully and use your stomach and diaphragm to push air from your body. Now, touch chin to your chest and suck in your stomach completely though comfortably. You need to do this because the main reason is to leave a hollow below your ribcage, making it look like the front muscle wall of your abdomen is pressed against the back. Hold this position with your breath as long as you can do it. Now lift your chin and breathe in slowly and allow your lungs completely fill with air. You can repeat this process 4-5 times.

Kavita further explained that the breath has a strong influence on the rhythm of the heart through the connections in the central nervous system. Slow and deep breathing is something that is practiced in Yoga. And this smoothing and lengthening of the breath slows the heart rate, regulates the heart rhythm and oxygenates the blood. Practicing Yoga overall builds the cardiovascular health, lung capacity and also Yoga not only improves respiratory functions, but also boosts the blood circulation, builds muscle and decreases inflammation.

This World Heart Day, ladies, lets make a resolution to care for out heart, because only then we can care for others.