December 2019 – Cardiac Wellness Institute

Everyone of us wants to lead a healthy and happy life. We like to be fit and active and avoid being sick or afflicted with disease. There is no doubt that any chronic health problem brings with it physical and mental strain due to the need for multiple drug therapy, surgical treatment and other invasive procedures. In fact, very often our fitness goals and competitive attitude take a back seat when diagnosed with cardiovascular or cardiometabolic diseases like heart attack, hypertension or diabetes.

Everyday, we at Cardiac Wellness Institute meet clients of different fitness levels with a recent cardiac diagnosis, angioplasty or bypass surgery. Some of them are depressed and disheartened that they will be unable to run the marathon they had signed up for or continue their passion for sports like swimming or cycling. It is during their personalised cardiac rehabilitation with our team that they begin to believe in themselves and that they can actually achieve their goals.

Let me share some real-life examples with you.

A 45-year old entrepreneur based in Delhi suffered a massive heart attack and immediately underwent an angioplasty where a stent was placed to restore blood supply to the heart. He was married and had a young child. He was worried and anxious about returning to work, leading a normal life and the impact this disease would have on his future wellbeing. He enrolled in our Home-based Cardiac Rehabilitation program right after his procedure and we initiated him on smoking cessation, dietary modification and graded exercise training. He was counselled about getting back to work gradually, about coping with the stress of a cardiac condition, about resuming normal sexual activities and about the actions and side effects of medications.

He had been a physically fit person aiming to participate in marathons when the heart attack had struck suddenly. After about 20 months of cardiac rehab, he is a very confident man who understands that his medical condition is not a barrier for his dream of participating in marathons. He trains regularly covering all aspects of fitness namely aerobic exercise, overall strength and core fitness. He eats a heart-healthy diet, manages his stress levels well and leads a normal work life and social life. His motto has been “try, try, try until you succeed”.

A 58-year old advocate, social activist, organic farmer and a badminton enthusiast suffered a heart attack for which he underwent bypass surgery. He had a poorly functioning heart as a result of the heart attack and that caused him great anxiety. His dream was very simple – to get back to his active life at the earliest. He enrolled in our Cardiac rehabilitation program after a month of bypass surgery and has been extremely consistent in following our exercise training, dietary advice, education sessions and psychological counselling. He was very glad that his physical stamina, exercise capacity, blood pressure control and cardiac function all showed improvement within 3 months.

After completing his intensive rehab program, he signed up for the monthly maintenance program with us and goes to a fitness centre near his residence regularly. He is back in action with more energy and confidence in his daily routine and says, “I believe in things that help me to do better. Regular exercise, appropriate diet and keeping the mind healthy are among them”.

It is clear from the above stories that cardiac rehabilitation can help individuals with heart problems achieve their fitness goals. Some things to be kept in mind are:

An expert rehab team has to assess your fitness level, medical history and presence of signs and symptoms prior to enrolling you in a rehab program and giving you an exercise prescription
You have to start with mild to moderate intensity exercise with adequate intervals between each exercise and then increase the intensity gradually
If you are passionate about running, cycling, swimming, hiking etc. guidance of a fitness instructor or physiotherapist with adequate knowledge about cardiovascular physiology will help
Taking care of your emotional wellbeing through psychosocial counselling is very important to help you overcome your fears and chase your dreams

In conclusion, performing exercises the right way, eating the right type of food, keeping your mindset positive and avoiding tobacco and alcohol are keys to overcoming your cardiac ailments and leading a healthy life. Dreams are meant to come true and goals are meant to be fulfilled irrespective of your health barriers; the right guidance is all you need.

As a Preventive Cardiologist, the question I get asked most often is this:

“I (or someone I know) have no bad habits and have not had any health problems in the past, but ended up with a heart attack. How come doctor?”

My immediate response is that there are 9 risk factors for serious heart and blood vessel disorders like heart attack and stroke. In fact, each of these 9 are independent risk factors which can cause disease by itself and when present in combination poses a very high risk of fatal heart disease.

The 9 cardiovascular risk factors: The Framingham (1) and the INTERHEART (2) studies are both landmark research works that have clearly identified the cardiovascular risk factors in all populations. The image below depicts the 9 risk factors that we should all be aware of and should watch out for.

A questionnaire-based survey was conducted this World Heart Day by Cardiac Wellness Institute to study the presence of behavioural risk factors for heart disease among college-going women in Chennai. Of the 554 students aged 15-30 years who responded to this survey, almost 40% reported to be chronically stressed. We have also noted a similar trend of staggeringly high rates of chronic mental stress among young corporate employees. Intensive lifestyle modification supervised by medical professionals has proven effective in changing dietary, exercise, sleep and stress-related risk factors in all age groups including young adults.

Hypertension, Diabetes and Dyslipidemia are the three silent killers which can only be identified by routine health check up. All 3 conditions often co-exist in the same individual but do not cause any symptoms leading to a very high risk of sudden death. Simple tests like blood pressure measurement and blood sugar and lipid level analysis will throw light on your risk profile. Mild variations from normal and early stage of disease can be managed with lifestyle changes alone but more severe abnormalities will require medications in addition to lifestyle changes.

Unhealthy diet, Inadequate exercise, Obesity, Mental stress along with tobacco use and alcohol abuse are the risk factors that are soaring high in our population. Spreading awareness about the ill-effects of these lifestyle choices is the first step in curbing them. The second and most crucial step is providing the right tools to help people modify their risky behaviour. Exercise training, meal planning guidelines, stress management techniques, goal-setting to become fit, and professional help to quit smoking and drinking are some ways we help individuals succeed in making these difficult but salient changes that impact their health in a very positive way.

If you have a family history of cardiovascular disease, that is your parents or siblings have had a heart attack, stroke or other cardiac problems, you need to be even more vigilant about the 9 risk factors and take all steps to lead a heart-healthy lifestyle.

Action Point 1 If you are over 40 years old and have not had a medical check yet, it is time you saw your doctor for a cardiovascular risk assessment. If you have had a doctor check up more than 2 years ago, you need to repeat one now.

Action Point 2 If you are over 20 years old and think you have 1 or more of the above risk factors, you should get a doctor’s opinion and blood examination every 5 years.

Action Point 3 If you have been taking medicines for any of the above risk factors, you need to revisit the problem along with your doctor to understand the response to medications and the need for lifestyle modification to reduce and eventually even stop medicines if all parameters are well controlled.