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Bypassing the Bypass - Eight ways to avoid Angina and Heart Attacks

Today, coronary heart disease is racing like a mad horse through most parts of the world. Worried medical scientists are trying their best to find ways to tame it. Their efforts have come ripe with identification of some clear-cut risk factors which increase the likelihood of disease. A curb on them could win you a major battle by averting the disease altogether.

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Can Coronary Artery Disease (CAD) be prevented?
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What are the risk factors significant to CAD?

How far does each risk factor promote the disease?

What is the effect if two or more risk factors co-exist is the influence additive?

What are the factors which raise blood cholesterol and triglyceride levels? Has diet much to do with it?

What kind of diet is culpable? Is all fat bad? What is this talk about saturated and unsaturated fats?

But the older people always seem to be complaining about disappearance of desi khalis ghee from the kitchens?

It is a common belief that dietary regulations and a strict check on body weight need only be observed after the age of 40. Until then caution can be thrown to the wind and dietary excesses can be indulged in without any care. Is this justified?

What are the guidelines for an ideal diet?

What does all this mean?

What are the general recommendations and rules to a rosy heart?

Can Coronary Artery Disease(CAD) be prevented? Top

Largely, yes! If one were to adopt some simple, easy-to-follow recommendations of medical researchers and make suitable changes in living habits, the risk of acquiring CAD could be significantly brought down. This requires a careful, individual, consideration of the risk factors and taking timely steps to check them.

What are the risk factors significant to CAD? Top

There are five of major significance. They are: .(i) increased levels of cholesterol and triglycerides in the blood (hyperlipidaemia), (ii) uncontrolled high blood pressure, (iii) tobacco smoking, (iv) diabetes, and (v) a positive family history of premature atherosclerosis, that is, hardening and clogging of arteries by fat deposits. Other added risk factors are-obesity, physical inactivity, psychic or emotional stress, and anxiety. Ageing and being a man are also contributory, but unlike others, are irreversible.

How far does each risk factor promote the disease? Top

Let us begin with high blood cholesterol levels, or hyper cholesterolaemia*. It is unequivocally associated with increased incidence of premature CAD. However, its importance varies in relation to age. Studies have indicated that the effect is most significant below age 50, but it seems to lose its significance in older individuals. The risk is rated to be three-to-five times higher in individuals between the ages of 30 and 49 years with cholesterol levels greater than 260 mg% when compared to those with cholesterol levels less than 220. The risk rises further as cholesterol levels rise.

With high blood pressure too, the risk is proportionate to the rise in blood pressure. In middle-aged men with blood pressures exceeding 160/95, the risk is five times higher than in men with normal blood pressure (140/90) or less. Unlike blood cholesterol, however, high blood pressure seems to increase the risk of CAD througout life. Thus, after the age of 50, it is a more potent risk factor than hypercholesterolaemia. The risk is significantly reduce~, if blood pressure is controlled.

Again with cigarette smoking too, there is a dose-response relationship. The risk of CAD increases by three-to-fivefold in men who smoke 20 cigarettes a day as compared to nonsmokers. The relationship is less firm in women, though it is considerably more in women who are on the oral contraceptive pill. Such an interaction occurs in diabetics and hypertensive patients too.

In contrast to cigarette smokers, pipe and cigar smokers are at a lesser risk, presumably because they inhale less smoke. But the best news is for those who have stopped smoking, or intend to do so shortly. Such people undergo a prompt decline in risk and by the end of one year of abstention stand as good a chance as non-smokers.

In diabetics, both insulin-dependent and non-insulin-dependent types, there is at least a twofold increase in incidence of heart attacks, compared with non-diabetics. The risk is markedly more in younger diabetics, and diabetic women.

With obesity, the risk rises in direct relation to the degree of overweight beyond 30% of the standard weight. Also, the risk is not singular, as obesity is causally associated with high cholesterol and triglyceride level, raised blood sugar levels, and high blood pressure.

A study of the relationship between CAD and daily physical activity is difficult, because so many variables are involved.

Some prospective studies, however, indicate that the less sedentary an individual is, the less susceptible he is to sudden death from heart attack. Likewise, physical training has been associated with improved exercise performance in patients with CAD.

There is a valid clinical impression that psychic or emotional stress and anxiety are associated with precipitation of CAD and sudden death. Heart attacks are frequently preceded by phases of acute psychological stress. Frustrations at work and/ or at home are a frequent precursor of coronary artery disease. Surgeon John Hunter illustrated the potential seriousness of emotional upset when he said, "My life is in the hands of any rascal who chooses to annoy or tease me." His assessment turned out to be true-he had a fatal heart attack following an argument.

Scientifically, however, it has been very difficult both to define stress as an entity and to spell out the relative importance of individual personality, social and cultural backgrounds in causing CAD.

Probably one of the best-known studies is that of so-called type A individuals who appear prone to CAD. Type A-behaviour men are typically aggressive, extremely competitive, and always in a hurry. They are unable to relax and often try to do more than one job at a time. Up to six times more such individuals have been found to have coronary heart disease than type B personalities, who are able to take life at a more leisurely pace. Type A personalities also face greater difficulty in recovering from a heart attack.

A familial factor in relation to premature atherosclerosis and CAD has also been observed. The risk is increased if one parent has the disease. It is compounded if both parents are afflicted with it.

Atherosclerosis is, also, a part of the normal ageing process. But the current cause of concern is the rising incidence of premature disease, occurring in the 30s and 40s and 50s and 60s.

What is the effect if two or more risk factors co-exist is the influence additive? Top

No. Curiously, there is evidence to suggest that the risk is more than cumulative, that is, the final risk is much greater than simply the expected sum of the individual risk factors.

It is essential to grasp this concept: Adding another risk factor to already existing risk factor(s) may potentially be much more hazardous than you think. But doing away with a risk factor, for the same reason, may equally be more rewarding.

What are the factors which raise blood cholesterol and triglyceride levels? Has diet much to do with it? Top

Yes, in most cases, diet plays a major role. Although there are a number of other factors (see Table I) which can lead to hyperlipidaemia.

Factors which may cause hyperlipidaemia:

I. Disorders to which hyperlipidaemia is secondary:

a. Uncontrolled Diabetes
b. Hypothyroidism (insufficiency of the thyroid gland)
c. Uraemia (high blood urea, usually due to poorly functioning kidneys)
d. Nephrotic syndrome (a kidney disorder which causes marked loss of proteins in the urine)
e. Obstructive liver disease
f. Dysproteinaemia such as in multiple myeloma (bone marrow tumour) and lupus erythematosus (an inflammatory skin disease)

II. Medications producing or aggravating hyperlipidaemia:

a. Oral contraceptive
b. Oestrogens
c. Glucocorticoids (includes cortisone, corticosterone, and hydrocortisone)
d. Antihypertensives (some)

III. Dietary Factors:

a. Caloric intake
b. Content of saturated fats and cholesterol
c. Alcohol intake
d. Genetic disorders

What kind of diet is culpable? Is all fat bad? What is this talk about saturated and unsaturated fats? Top

Excess of total calories, animal fats, dairy and other saturated fat products, sugar, and a low fibre-content diet are all closely linked to coronary artery disease.

Animal fats-meat, eggs, and milk products-are the most culpable, as they have a high cholesterol and saturated fat content in them. They raise the blood cholesterol levels and contribute to obesity. The triglyceride levels are more sensitive to total caloric balance and alcohol intake. Much against the common belief, physical activity, emotional stress, smoking, and intake of coffee or tea have only weak or indirect influences on cholesterol and triglyceride concentrations.

No, not all dietary fat is bad. It is the saturated fats which are the trouble-brewers. Chemically they are those fatty substances which have a high ratio of hydrogen to carbon within the molecules. From a practical standpoint, as has been said before, they are fats that are mainly derived from animal sources. Hydrogenated cooking media, such as 'vanaspati', also fall in this category. The good fats are the polyunsaturated fatty acids, their prime source being vegetable oils such as saffola, corn oil, and groundnut oil. A good measure of the goodness of polyunsaturated fats is that if a healthy young adult, without cutting into his total fat intake, simply switches from a diet containing more saturated fats to one containing equal amounts of polyunsaturated and saturated fats,' his blood cholesterol will show a drop within two weeks, and this benefit will continue as long as such a diet is continued. This is the prime reason why vegetable oils are gaining wide popularity.

But the older people always seem to be complaining about disappearance of desi khalis ghee from the kitchens? Top

Not all old beliefs are true. This is one of them. Further, in the olden days, our forefathers did a lot of physical exercise. This helped them keep their body weight and cholesterol levels in check.

It is a common belief that dietary regulations and a strict check on body weight need only be observed after the age of 40. Until then caution can be thrown to the wind and dietary excesses can be indulged in without any care. Is this justified? Top

No, this a myth. Atherosclerotic fatty plaques have been detected in the coronary arteries of males as early as in their second decade in autopsies of Korean and Vietnam war victims. This clearly implies that primary prevention of atherosclerosis must begin early in life and diet must be taken care of right from childhood.

In fact, it is the considered opinion of many physicians today that good health maintenance practice should include a test for detection of hyperlipidaemia in all persons between 20 and 30 years of age and dietary restrictions advocated, if necessary at that age itself. This is of especial relevance in all young persons who have a family history of premature CAD.

What are the guidelines for an ideal diet? Top

A diet with a caloric intake adjusted to achieve und maintain ideal body weight, a reduction in total fat calories to about 30% of total calories (with saturated fats not exceeding one third or 10% of these calories), and a reduction in cholesterol intake to less than 300 mg per day-are the basic essentials of a prudent diet. Although a causal relationship between sodium intake and high blood pressure has not been firmly established,
.it is recommended that excessive dietary salt should be avoided too, if a person has high blood pressure.

What does all this mean? Top

Frankly, that you go and see a nutritionist, or a dietitician who would make a diet chart for you, after taking into consideration your body weight and daily caloric requirements. Some idea can be had from diet charts, provided as an appendix to the text.

What are the general recommendations and rules to a rosy heart? Top

The best way is to identify one's risk factors and apply brakes on them-avoid them, correct them, without letting them win over your resolve. Even at the cost of repetition, it is worthwhile to consider the precautions you are expected to observe:

Keep a watch on your diet, and not just when you enter your 40s. It should be right from your school days.
Maintain your ideal body weight. Do not allow bulges to appear in the middle.
NO, smoking, please. If you are a smoker, kick the habit today.
Cut down on alcoholic beverages. Alcohol can cause rise in triglycerides.
Keep a check on your blood pressure. If you are hypertensive, take regular medication and observe all necessary precautions to keep your blood pressure under control.
Do regular physical exercise. Even if you have CAD, a guarded exercise programme under watchful supervision of a physician can do you a world of good.
Do not allow emotional stress and anxiety to queer your pitch. Be a karamyogi. Learn to relax. Meditation may be useful. Find time with your family. Go on outings with them, or do things which please you and allow you to get rid of negative feelings bottled up inside.
All right, you can't help being a part of a high-risk family. But surely, this should set you on your guard as regards other potentially reversible risk factors. Keep them down, and keep them out. Now sit down and go over these points again, one by one. Apply them to yourself, or members of your family. Have a good family discussion, and decide what changes you intend to make.

Do this today, and as from this very minute!
Remember, it may add five, ten, or fifteen extra years of happy healthy living to your life

Herbal Cure for Heart - Complete Pack
Total Heart Support	Arjuna	Arjun Tea	Arjun Saar	Kumari Saar	Total Price
					Free Shipping and Handling Worldwide! No Side Effects!
2 Bottles	1 Bottle	1 Pack	4 Bottles	4 Bottles	Free Shipping and Handling Worldwide! No Side Effects!
$47.90	$ 31.00	$ 14.95	$ 75.80	$ 75.80	~~$ 274.55~~
Price after Discount 20%					$ 220.00
Buy This Pack for Just $ 220.00
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