Coronary diseases are Hypertension, Heart Failure. IHD, & Stroke, Genetic susceptibility and adverse environmental influences either alone or in combination plays a major role for clinical manifestation of any disease.
Cardiovascular diseases account for one-third of all deaths world wide, and two thirds of which occur in the developing countries.
Oxygen is important for a cell to survive. Lack of Oxygen results in cell death.
IHD means Ischaemic Heart Disease. Ischaemia is a condition where there is reduced Oxygen supply to cardiac musculature due to lack of good blood supply.
Hypertension results due to loss of blood vessel wall elasticity, thickening of vessel wall due to atherosclerosis and also due to other factors like familial and acquired conditions.
Heart failure is due to Cardiac enlargement as a result of hypertension.
Stroke or paralysis or weakness of limbs or facial muscles or speech difficulties are all due to ischaemia (lack of Oxygen) of Brain tissue, and short episodes of dizziness or weakness is known as Transient ischaemic attack.
Thickening of blood vessel is largely due to deposition of fat and calcium in the formation of atheroma which eventually results in atherosclerosis of vessel.
The main causes for all the above conditions are Dietary Habits & lack of exercise, which also contributes to Diabetes especially in the middle aged and elderly which is known as Type-2 Diabetes. Diabetes Mellitus is a major Risk factor followed by Hypertension which can cause Heart attacks..
Smoking narrows vessels and also contributes to increase the clotting mechanism. In addition Genetic predisposition also results in increased levels of Lipoprotein & Homocysteine. Folic acid and Vitamin B12 reduces levels of Homocysteine.
It is important to note that overcooking Vegetables which is common practise in Indian cooking methods destroys 90% of Folate available in green vegetables. Infection & Inflammation also plays a major role in CVD.
Due to lack of maternal nourishment during pregnancy, low Birth weight contributes in the subtle modification of genetic factors and intrauterine programming, which at later stages with combination of rich unhealthy diet results in Cardio vascular diseases.
Coronary artery disease and stroke is on increase in immigrant Asians.
On a broader view Life expectancy in India has increased compared to 1950s to over 60 years in late 1990s, but the number of CVD cases are also on the rise.
Asian Indians are ethnically more prone to CVD compared to native population.
Important Risk Factors are Obesity, Lack of Exercise, Diet rich in saturated fats, unhealthy lifestyle including Smoking, Alcohol.
Obesity, which leads to high blood pressure, diabetes, lipid abnormalities are better described as a 'predisposing risk factor'.
Diabetics patients show 4 times more risk of getting heart attack compared to Non-diabetic.
Obesity in Indians is of a peculiar type of obesity characterized by higher waist-hip ratios and higher body fat %, and that BMI measurements may not truly reflect obesity in Indians.
Indians also have been shown to have a distinctive lipid profile, characterized by low HDL cholesterol, hypertriglyceridemia, and high total cholesterol by HDL ratio, and high triglyceride by HDL ratio. Coronary Artery Disease in Indians is probably more HDL driven.
Smoking lowers HDL, raises fibrinogen, and causes platelet aggregation and coronary spasm.
- Alcohol, Smoking
– Turmeric, Cinnamon, Fenugreek, Ginger
– Red Grapes, Apple, Pineapple
- Cooking methods
– Blanch, Reduce Starch in Rice
- Carbs & Cals
– Beer can (12 oz) = 13 Gms = 150 cals
– Red Wine (5 oz) = 4.5 Gms= 116 cals
– Champagne (5 oz)= 4.5Gms [double in sweet]134cal
– Whisky= no carb = 73 cals in 30mL
Few examples of Calorific values:
- Jalebi - 150
- Laddu - 245
- Serving of Rice - 267 (cooked)
- Serving of Rice - 680 (Raw)
- Brown Basmati - 177
- Mango - 135
- Snickers - 273
- Crisps - 128
- Broccoli 4 oz - 30
- Potatoe 6 fried - 100
- Potatoe Chip 1 - 10
- Spinach 1 cup - 10
- Tomatoe 1 - 20
- Onion 4 oz - 40
- Sweet Potatoe 5 oz - 200
Few healthy facts:
- Brown Rice - Oil (low saturated), fibre, Mg, B
- Beans - reduces LDL, Fibre, Protein
- Garlic - Allicin, Reduces Cholesterol & Blood Clot
- Grapes & Blk Berries - Flavanoids (antioxidants) reduces Free Radicals (which increase LDL)
- Apple - Pectin Fibre lowers LDL
- Cinnamon - Lowers Cholesterol & Blood Sugar 1/2tsp
- Nuts - Almonds, Walnuts, Hazel & PeaNuts,Olives Reduce Cholesterol,Increaseselasticity of vessel wall--PUFA Reduces BP
- Soya - Fibre, PUFA
- Oil - Groundnut, Sesame, Rapeseed, Grapeseed, Coconut(Lauric Capric Caprilic)
- Ghee better than Butter
- Oats - beta Glucan stimulates Bile
- Fenugreek - minerals, protein, vitamins
- AntiOxidant Rich in certain
Prunes, Raisins, Blueberries, Blackberries, Strawberries, Raspberries, Plums, Oranges, Red grapes, Cherries
Spinach, Brussels sprouts, Alfalfa sprouts, Broccoli flowers, Beets, Red bell peppers, Onions, Corn, Brinjal
Average Requirement for an adult sedentary worker
- Calories are Important
- 1300 / day to live (minimum requirement)
– 55% from Carbs
– 29% from Fats
– 18% from Protein
High activity - 60 mins exercise / 3100
Medium activity 30 mins exercise / 2800
Free radicals causes Oxidative modification of Low Density Lipoproteins is an important step in atherosclerosis which can be rectified by use of antioxidants. The Antioxidant vitamins are Vitamin A, C & E, and is important to make sure of maintaining daily intake.
If someone becomes acutely unwell it is important to be able to suspect and recognize and to immediately seek Medical Advice
- Sudden Fainting
- Losing Consciousness
- Short of breath
- Lack of Oxygen
- Drop in Sugar
- Heart Conduction
- Drop in BP
In case of emergency especially if some one is having heart attack it is important to recognize the situation and take action to start external cardiac massage. The important features of heart attack are.,
- Severe central chest pain with sweating and collapse
Impending Heart attack can present as Angina
- Chest pain radiating to Left arm, towards neck and jaw
- Tired feeling and Short of breath with chest discomfort
- Occasionally Indigestion feeling
If a person collapses and becomes unconscious please do the following:
- Make sure you are SAFE to approach and touch the patient Wet Floors, Electric wire etc)
- Call for Help or ask someone to call for ambulance
- Try & wake up the person & see if he/she responds
- Feel the Pulse
- Bend over the person’s face and feel whether he or she is breathing
- If there is No Pulse is felt and No Breathing is felt START EXTERNAL CARDIAC MASSAGE.
- External Cardiac Massage.,
- Place both Hands one on top of the other with the fingers locked over the centre of chest (in line of the Nipples).
- Start Compressing the Chest with both Elbows kept straight to exert good force.
- The depth of compression should be between 1.5 to 2 inches
- The Rate of Compressions is around 120 per minute
- If you are getting tired hand over to another person to continue the Cardiac massage.
- Do not worry about breaking the Ribs, if you can bring back Life to the person you have done a great job and the Rib injuries will heal over period of few weeks.
External Cardiac Massage
CVD - Cardio Vascular Disease
HTN - Hypertension
DM - Diabetes
TIA - Tranasient Ischaemic Attack
AMI - Acute Myocardial Infarction
HDL - High Density Lipoprotein (Good)
LDL - Low Density Lipoprotein