Heart disease is a big killer but only because we let it be. Awareness of the risks, a change in diet and lifestyle and appropriate screening can have you living out a long life — in good health. Dr Jamieson explains more.
Here in Hong Kong heart disease is the second most common cause of death, however it is increasing in prevalence. In the US heart disease is the most common killer, with Americans suffer a ‘coronary event’ every 25 seconds, one dying per minute. It’s a hot topic, with over a million Americans having a coronary yearly, and an additional 195,00 suffering from ‘silent’ ones — without pain or symptoms — but leading to weakening of the heart. In the past heart disease has been more common in men, however now women are rapidly catching up.
Preventing this common disease has become one of the ways that modern medicine can increase life expectancy. If we add strokes in to the pot, we find that as many as one third of Americans are dying of cardiovascular disease (heart attacks and strokes).
As a doctor it’s my job to screen everyone, even those coming with a sore throat, as if caught early, risk factors can be controlled or eliminated. Also, education is everything, and even in these days of Internet access, patients still don’t realize what they are doing to their bodies by bad eating habits.
How does ‘heart disease’ kill you?
So, how do we actually die of heart disease? Coronary heart disease and the subsequent heart attack is caused by ‘furring up’ of the blood vessels supplying the heart, so that the heart muscle becomes starved of oxygen—a vital nutrient. This often happens on exercising, as the heart’s blood requirement is more at that time. Lack of blood supply leads to the death of the heart muscle tissue downstream from the blockage, and hence the characteristic chest pain or discomfort. People also suffer an ‘arrhythmia’ where the electrical activity of the heart is disrupted, causing malfunction and blood not being pumped to the brain, which will quickly cause death.
The ‘furring up’ of the coronary arteries is like lime scale on a kettle and newer screening tests for heart disease, CT scans, measure calcium in these arteries and this is related to cholesterol deposits and blockages. Everyone has experienced the pain of aching tired muscles and this is not so different from the pain caused by this dying heart muscle. However this heart attack pain may vary in severity from a similar mild achiness, to a stabbing pain, or in a few cases, no pain at all.
Know your risk
The increase in Hong Kong’s heart disease over the years has been blamed by many sources on an increase in fatty, sugary western foods over traditional Chinese foods; smoking; and sedentary lifestyles amongst others. Looking at statistics and risk factors in other countries such as the UK is helpful in giving us insight into this:
- Two thirds of adults have borderline or high cholesterol,
- A third have high blood pressure (half untreated!),
- A third of men and women exceed the recommended alcohol allowance,
- One third of children are obese.
For some reason these risk factors appear to happen in ‘thirds’.
Other risk factors for heart disease are lack of exercise, diabetes, gout, thyroid disease, stress (this is scientifically proven) and family history — the genes are the genes!.
The really good news about all of this is that 90% of these risk factors can be modified, and hence coronary disease and also strokes prevented.
Screening starts at…
Men should start check ups at 40, women later at 50, as before menopause their hormones protect them against heart disease. Patients can see their GPs for yearly checks of risk factors such as blood pressure and cholesterol as well as an assessment and advice on exercise, diet and stress. Screening tests such as exercise ECGs and calcium CT of coronary arteries can then be ordered if appropriate.
