Matters of the Heart

“The heart is the perfection of the whole organism” — Aristotle

80 beats per minute, 4,000 an hour, 100,000 per day and 35 million per year — the heart beats approximately 3 billion times in our entire lifetime! Perhaps the most efficient machinery known to live, it tirelessly pumps blood to every nook and cranny of our bodies, enriching our cells with the nutrients required for survival. A single flaw in its working can prove to be fatal. Like every machine, the heart is prone to damage and needs to be taken care of. Unfortunately, our lifestyle and habits have promoted negligence towards health, leading to increased cardiovascular disease-related morbidity around the world. To promote awareness towards heart health and heart-related afflictions, World Heart Day was first celebrated on 24 September 2000. It was established by World Heart Federation (WHF), a non-governmental organisation, in collaboration with the World Health Organisation (WHO) and is the brainchild of former WHF President, Antoni Bayes De Luna. It seeks to unite the community in fighting against cardiovascular diseases. Since 2000, it has been annually observed on 29 September. The WHF has undertaken various educational programmes, sponsored and organised campaigns that over 90 countries take part in. With this year’s theme, the WHF calls on people to ‘Use Heart to connect’, with an emphasis on digital health in the global prevention and management of cardiovascular diseases. In a situation like the COVID 19 pandemic, where one on one doctor-patient interactions have decreased, digital health tools, such as mobile apps and wearables (like watches or patches) enable out-of-hospital management of CVD.

Now let us first understand what CVDs are. CVD stands for Cardiovascular Disease, a condition that affects the heart and the blood vessels. These diseases are usually associated with a build-up of fatty deposits inside the arteries, an increased risk of blood clots and damage to arteries in organs such as the brain, heart, kidneys and eyes. There are particularly four main types of Cardiovascular diseases which are — Coronary heart disease, Strokes and TIAs (Transient Ischaemic Attacks), Peripheral arterial disease and Aortic disease. Coronary heart disease occurs due to an inadequate supply of oxygen-rich blood to the heart muscles which puts an increased strain on the heart. Restricted blood flow to the heart muscle causes angina, (commonly known as chest pain) and when this supply is suddenly blocked, one experiences a heart attack. At times when our heart is not able to pump blood around the body properly, it is said to have gone under failure, which is a fatal condition. Acute events such as strokes and ischaemic attacks are mainly caused by no supply of blood to the brain which shows symptoms such as slurring of one’s speech or the inability to lift both arms. Blockage in the arteries of the limbs, usually the legs, is called peripheral arterial disease which leads to cramps, numbness or weakness in the lower extremities of the body. One of the most common aortic diseases is Aortic aneurysm; here, the aorta, which is the largest blood vessel in our body responsible for supplying blood from the heart to the whole body, weakens and bulges out. Other common types of CVDs include arrhythmias; abnormal heartbeats and heart valve problems. While treating these conditions, time plays a very important role.

Cardiovascular diseases account for the most number of deaths globally. In India, one out of 4 deaths is now because of CVDs. The annual growth rate of CVD grossed from 2.26 Million in 1990 to 4.77 Million in 2020. An INTERHEART study (a standardised case-control study of acute myocardial infarction in 52 countries) reported that young Indians are more susceptible to CVD disorders. The Medical Certification of Cause of Death report highlights that 57% of total deaths due to CVD prevails between the ages 25–69. The average predictive age of myocardial infarction for any Indian individual corresponds to 53, while it is 63 for other countries. This is reflective of the country’s inadequate resources to treat the disease. Another peculiar trend to be noticed here is that women are more susceptible to death from CVDs than men.

During the dreadful time of the COVID-19 pandemic, the mortality rate of victims with pre-existing CVD ailments and hypertension increased. In the random order of 20–30% of hospitalized patients, almost 40% of deaths were reported due to pre-existing CVD complications. Findings of ICMR highlight that nearly half of COVID victims encountered myocardial edema. Evidence of myocarditis without direct viral infection stunned the research community where patients ended up with inflammation, hypertension, thrombosis and eventually death.

Sometimes, the causes of cardiovascular diseases may not be explicit. However, certain elements can increase the risk of getting affected. Some of the risk factors include high blood pressure (hypertension) which can be damaging to blood vessels. Smoking can narrow down our blood vessels, restricting blood flow to organs. High cholesterol is a consequence of a sedentary lifestyle and an unhealthy diet. It chokes the arteries with fatty substances. Consuming alcohol can also increase cholesterol levels, blood pressure levels and lead to weight gain. Furthermore, a family history of diabetes and genetic factors also contribute to an increased susceptibility to CVD. Age plays a major role too; the risk of getting CVDs increases after the age of 50, as the walls of blood vessels weaken over time.

It is important to be on the lookout for warning signs of CVD and always be vigilant towards them. There can be a piercing feeling or a heaviness in the chest region. Nausea, indigestion, dizziness, heartburn or stomach pain are common. If the chest pain spreads to the arm, throat or jaw, it should be immediately diagnosed. Other signs of CVD include easy exhaustion and excessive sweating on a cold day. Swollen legs, ankles and feet can indicate that the heart is not pumping blood as efficiently as it should. Often, such warnings are ignored and dismissed, which can only prove to be detrimental. Reporting them at the correct time plays an important role in intervention and treatment at early stages.

It is often said that ‘Prevention is better than cure’. We should try to evade cardiovascular disease with our best efforts so that we never find ourselves in a situation where we have to combat it. It only takes some amount of self-control and discipline in one’s life. Here are a few changes that we can implement in our everyday life.

Eating a heart-healthy diet :

A healthy diet can help protect our heart, improve blood pressure and cholesterol levels, and reduce the risk of diabetes. A heart-healthy eating plan includes vegetables and fruits, beans or other legumes, lean meats and fish, low-fat food, and whole grain. The intake of salt, sugar, processed carbs, alcohol, saturated and trans fat should be limited.

Staying at a healthy weight :

Being overweight or obese can put us at the risk of cardiovascular disease, as it is also linked to high blood pressure, high cholesterol levels and diabetic illness. Weight management can be achieved through a mixture of proper diet and exercise. Exercise also strengthens heart muscles and improves blood circulation.

Quitting smoking and limiting alcohol intake:

Cigarette smoke reduces the oxygen concentration in our blood whereas chemicals in tobacco such as nicotine can damage our heart and blood vessels. Overconsumption of alcohol raises our blood pressure and adds extra calories. Eliminating these things from our daily life can keep our heart healthy.

Managing stress:

Stress is seen across all groups in a population, especially in women, students and people employed in the corporate sector. Stress can raise our blood pressure, while extreme stress can trigger heart attacks. Coping with stress in unhealthy ways, such as overeating, drinking, or smoking can be very detrimental. We should find better alternative ways to manage stress, such as physical activity, relaxation exercises or meditation. It is also important to maintain a healthy sleeping schedule.

Regular health checkups :

Finally, it is important to regularly monitor our heart health. Regular checkups, measuring blood pressure and cholesterol levels and screening for type 2 diabetes should be undertaken.

All these measures sound simple and easy to implement, however, a majority of the Indian population (especially in rural areas) is unaware of these measures. This is where non-governmental organisations play a very significant role. NGOs like the Indian Heart Association (IHA) and Heart care foundation, raise awareness about preventative cardiovascular health, through a combination of online outreach, large scale campaigns, and grassroots advocacy. Child heart foundation deals with child heart disease (CHD) in India and works on providing adequate treatment for the same.

Medical science is also making significant strides in improving healthcare facilities for the quick and efficient treatment of heart disease. A collaboration between individuals, healthcare professionals, organisations and the government will pave the way for a healthier tomorrow. The World Heart Day aims to unite people from every background to fight against cardiovascular complications and promote equal access to healthcare.

Small changes go a long way when it comes to heart health. This World Heart Day, motivate your loved ones to get a heart check-up, while encouraging them to eat healthy, sleep right and live stress free, because ‘Life is more musical when you have a heart that beats right.’

Written by Priyanka Swaminathan, Sarthak Mathur, Aarushi Sultania, Megha Shruti and Chriswin Harris