Are you a cardiac patient who experiences exercise-induced chest pain? You may not need a stent implant

Stents have been the saviour for many cardiac patients experiencing chest pain. But a landmark study presented at the American Heart Association’s annual meeting in Philadelphia, suggests that inserting stents might be unnecessary in some of these cases. It points out that medication along with lifestyle changes may be enough for managing exercise-induced chest pain patients suffering from heart diseases.

What is exercise-induced chest pain?

Exercise increases our body’s oxygen requirement. Meeting this requirement during a workout session gets hard for heart patients at times, which causes chest pain. There are different types of heart diseases. Focus group of this study included patients with ischemic heart disease. In this condition the patients have plaque buildup in their coronary arteries which transport blood to the heart. Accumulation of plaque narrows the arteries down making it difficult for the arteries to pump blood, especially during an exercise. This causes chest pain and the condition is called angina. However, it subsides when the patients rest. In the medical fraternity, this is known as stable angina. Though this condition isn’t considered as a medical emergency, it requires a cardiologist’s attention for sure.

What does the new research say?

So far, doctors have been recommending stent procedure in case of exercise-induced chest pain caused by shortage of blood supply to the heart. This is because lack of blood supply to the cardiac muscles may lead to death. However, findings of the new study suggest that doctors need to rethink their approach as medications such as aspirin and drugs can treat these exercise-induced chest pains simply by managing high cholesterol levels. Cholesterol is a fat-like substance that promotes plaque build-up. The study looked at 5,179 patients in 37 countries. The results showed that blood pressure drugs such as ACE inhibitors and beta blockers taken for high cholesterol can work just as effectively. For this condition, the study also recommended lifestyle modifications like weight loss initiatives, cutting down saturated fat and quitting smoking.

Stent procedure and its complications

Inserting stent in the heart arteries or any other part of the body is a surgical procedure. It comes with all the complications of any surgical intervention. A slight slack or mistake by the doctor can prove to be dangerous. Moreover, the stent metal can also lead to an allergic reaction. Other complications associated with inserting a stent are internal bleeding, infection, breathing problems due to anesthesia, blood clots and re-narrowing of the artery.

Lifestyle modifications for exercise-induced chest pain

The cornerstone of managing exercise-induced chest pain is medication. However, as the new research already mentioned, lifestyle modification is also important in handling the condition. If you are a smoker, it is essential to join a smoking cessation programme as the link between this habit and coronary artery issues is well-established. Your body weight can be a significant contributing factor behind angina. Consult a nutritionist for proper dietary guidelines. She may advise reducing overall fat intake, and including a lot of fruits and vegetables in your meals among others.

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Heart patients may benefit more from exercise than healthy people

Exercise can do more to lower the risk of premature death for patients with cardiovascular disease than for healthy people, a new study suggests.

Healthy people did have a lower chance of dying during the study when they were more physically active. But the beneficial effect of exercise was more pronounced for people with heart problems, researchers reported recently.

The study team scored participants' exercise levels and intensity based on a measure known as metabolic equivalent of task (MET) minutes per week. For optimal health, adults should get at least 500 MET minutes per week. (Because MET minutes can be difficult to calculate, an easier recommendation to follow is to get at least 150 minutes a week of moderate to vigorous exercise.)

When people had heart disease, every additional 500 MET minutes per week of exercise was associated with a 14 per cent lower risk of dying from all causes during the study. For healthy people, the same increase in activity was tied to only a 7 per cent lower mortality risk.

Altogether, researchers followed 131,558 patients with cardiovascular disease and 310,240 healthy people starting when they were around 60 years old. By the time half of the people had been in the study for at least seven years, those with cardiovascular disease were more than twice as likely to die during the study from all causes than individuals without this condition.

"Physical inactivity causes various non-communicable diseases such as coronary heart disease, diabetes, and breast and colon cancers, which ultimately lead to premature mortality," said  a co-author of the study.

"Physical activity fosters normal growth and metabolism," he said. "In addition, physical activity can make people feel better, sleep better, and perform daily tasks more easily."

While the physiologic benefits of exercise may be similar for people with and without heart disease, it's possible that heart disease patients benefit more from exercise because they have so many more risk factors for a premature death that might be addressed by getting more activity, he said.

"Physical activity has shown to lower blood pressure and blood (sugar), and (cholesterol)," he added.

Among people with cardiovascular disease, most had ischemic heart disease, also called coronary heart disease, in which the arteries supplying the heart become narrowed. People with heart disease tended to be older and they were also more likely to have other health issues like diabetes, high blood pressure and elevated cholesterol.

The study wasn't a controlled experiment designed to prove whether or how exercise might directly impact the risk of premature death. Researchers relied on questionnaires to assess exercise, which isn't always reliable, and didn't examine activity levels at work or other non-leisure pursuits.
Even so, the results underscore the importance of getting moving after a heart attack, said an expert.

"Everybody knows that increasing one's amount of exercise or general physical activity is quite a challenge, but I would say that for individuals who have survived a heart attack or similar event, it is indeed important to really try,"said another  who wasn't involved in the study. "It will not happen overnight, over a few weeks or even months, but little by little, one travels far."

And if heart patients go the extra mile and get more than the minimum recommended amount of exercise, they will see more benefits, said the  Dr.

"The plateau in the relation between physical activity level versus reduction in the risk of death is reached at a higher level of activity than in adults without cardiovascular disease," said another who wasn't involved in the study.

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Include almonds in your diet to be healthy

Most of us know that almonds are good for memory. But a new study review shows that it is also good for your heart health, especially for Indians, who are more prone to heart disorders than their European counterparts. 

The review of over 1,500 studies published , suggests that daily inclusion of almonds as part of a healthy diet can reduce dyslipidemia, one of the most important risk factors for cardiovascular disease among Indians.

Dyslipidemia is a condition marked by high LDL-cholesterol and triglyceride levels and low HDL cholesterol levels. “Daily consumption of 45 grammes of almonds in any form (crushed, wholesome, or in snacks) can help reduce dyslipidemia,” said  the lead author of the study. 

“Typically, dietary strategies to reduce harmful LDL-cholesterol, such as decreasing saturated fat, also reduce beneficial HDL cholesterol, but that is not the case with almonds,” said the author.

The review also included a study conducted in India that showed the inclusion of almonds in daily diets contributed towards reduced abdominal fat which is known to be a major factor in metabolic syndrome and ischemic heart disease (IHD).

Cardiovascular diseases account for 28% of all deaths in India, more than any other cause. Due to their genetic make-up, Southeast Asians (especially Indians) have a higher risk of cardiovascular disease, characterised by elevated levels of harmful LDL cholesterol and triglycerides and lower levels of beneficial HDL cholesterol.

What causes heart disease
Lack of physical activity, poor dietary habits such as diets rich in sugar, salt and saturated fats are responsible for several conditions such as abdominal obesity and insulin resistance which are now more common among Indians. Coupled with these lifestyle factors and conditions, genetic propensity makes Indians much more prone to heart disease than their Caucasian counterparts, according to the review by researchers.

Numerous studies worldwide have shown that almonds have the potential to help improve blood cholesterol levels. The health benefits of almonds are thought to be due to their fat profile (predominantly mono- and poly-unsaturated fats i.e. good fats), antioxidant vitamin E, dietary fibre, and other important nutrients.

Other nuts to include in your diet
Here are 5 other nuts that you must include in your diet:
Cashew
Cashews are a rich source of Vitamins B6 and E. They can also be used to bring a rich texture and flavour to various dishes. Studies have also shown that people who regularly snack on them may face a lower risk of heart disease than people who don’t.

Walnuts
Eating walnuts along with other nuts like hazelnuts and almonds can help you reduce weight.  Walnuts are also loaded with vital Omega-3 fatty acids, dietary fibres, proteins, antioxidants, vitamins and minerals. This superfood also activates an area in your brain which decreases hunger. A study shows that half a cup of walnuts may help protect your digestive system by increasing the aount of probiotic bacteria in the gut and ward off risks of heart and brain disease as well as cancer. 

Pistachios
Research found that eating a handful of pistachios could cut the risk of coronary heart disease by nearly 30 % while also reducing the risk of cancer by 15 %. Another study found that pistachios could help fight colon cancer by detoxifying the body against cancer-causing elements. And if you sugar levels are high, eating pistachios could reduce vascular response to stress in type 2 diabetes as well.

Peanuts
Along with pistachios, peanuts can strengthen brainwave frequencies associated with cognition, healing, learning, memory and other key brain functions. A 2017 study showed that eating about three ounces of peanuts with a high-fat meal is good for your heart. And another study showed that eating peanuts while breastfeeding may protect newborns from developing allergies later in life.


Macadamia
These nuts should be part of a well-balanced diet. It is rich in selenium and zinc and boosts hair growth and reduces dandruff. It can also destroy fungus from the scalp.

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Higher risk of heart attack for certain blood groups

People in certain blood groups have a higher risk of heart attack and stroke, according to new research presented on Sunday at the European Society of Cardiology Congress. 

 

The study was a meta-analysis that combined a vast amount of data from multiple studies into both O and non-O blood groups in order to reach a more definitive and conclusive answer than one standalone study ever could.

“It has been suggested that people with non-O blood groups (A, B, AB) are at higher risk for heart attacks and overall cardiovascular mortality… If this was confirmed, it could have important implications for personalised medicine,” the lead author of the study, Tessa Kole, said in a press release.

The research, which involved a total sample size in over 1.3 million participants, focused on instances of heart attacks, heart failure, and coronary artery and ischemic heart disease, as well as various other “cardiovascular events,” which damage the muscle tissue in the heart.

Within the overall test group, 23,154 “cardiovascular events” were recorded. The researchers then analyzed the correlation between such events and the blood type of the person.

The analysis of all the data sets showed that non-O blood groups were at higher risk of experiencing a cardiovascular event but, surprisingly, it did not yield any significant difference in fatal coronary events between O and non-O blood groups.

“We demonstrate that having a non-O blood group is associated with a 9 percent increased risk of coronary events and a 9 percent increased risk of cardiovascular events, especially myocardial infarction,” Kole said.

The cause behind the increased risk has yet to be fully determined, though researchers believe it is connected with higher concentrations of a clotting agent known as the von Willebrand factor in non-O blood groups.

However, certain blood groups (A) do have a natural proclivity towards higher cholesterol, which makes identifying one overarching cause across the non-O blood groups difficult to pin down.

“More research is needed to identify the cause of the apparent increased cardiovascular risk in people with a non-O blood group. Obtaining more information about risk in each non-O blood group (A, B, and AB) might provide further explanations of the causes,” Kole added.

Greater insight into the specific risks faced by individual blood groups will greatly improve the preventative healthcare doctors can provide, while affording policymakers the ability to more accurately assign funding as and where it is needed.

“In future, blood group should be considered in risk assessment for cardiovascular prevention, together with cholesterol, age, sex and systolic blood pressure,” said Kole.

“It could be that people with an A blood group should have a lower treatment threshold for... hypertension, for example. We need further studies to validate if the excess cardiovascular risk in non-O blood group carriers may be amenable to treatment,” she added.

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High bp can reduce heart elasticity

The 120/80 is the standard measurement for Blood pressure in an adult. The above serves as a dynamic number that keeps on fluctuating during the day. However, if your Blood pressure remains higher north of this consistently, you might be suffering from High blood pressure. High blood pressure (HBP) can lead to a lot of heart conditions referred as Hypertensive heart disease.

Heart failure, coronary artery disease, thickening of the heart muscle can be attributed to Hypertensive heart disease.

Types of Heart disease
The major types of heart diseases are caused due to narrowing of the arteries or thickening and enlargement of the heart. High blood pressure can cause the blood vessels to become narrow, which can slow or stop the blood to reach the heart. This condition is medically known as coronary heart disease (CHD), also called coronary artery disease.

CHD puts the individual at an increased risk of heart attack from a blood clot that gets stuck in one of the narrowed arteries which cuts off blood flow to the heart.

The heart has to work harder to pump blood because of HBP. The consistent extra work makes the heart muscles thick. Such a change is generally observed in the main pumping chamber of the heart, the left ventricle, which is known as left ventricular hypertrophy (LVH) can put pressure on the coronary arteries leading again to CHD.
When the heart has to work hard to compensate for weakening muscle for reduced pumping power, the heart’s chambers stretch to hold more blood. Over the time, this reduces the elasticity of the heart muscles. This keeps the blood flowing but reduces the pumping power of the heart furthermore. As a result, the kidney makes the body to retain fluid (water) and sodium. Thus resulting in fluid buildup in the arms, legs, feet, lungs or other organs, and leads to congestive heart failure.

Complications that can arise
Both CHD and LVH can lead to various complications such as a Heart failure (inability of heart to pump enough blood to the body), arrhythmia (abnormal beating of heart), heart attack,( blood flow is interrupted to the heart) sudden cardiac arrest (heart stops working suddenly, no breathing and loss of consciousness), ischemic heart disease (heart doesn’t get enough oxygen), stroke and sudden death.

Who all are at risk?
Heart diseases are the leading cause of death in India accounting for nearly 26% of all deaths reported. Any individual with a high blood pressure is at a risk of hypertensive heart disease.
Regular physical check ups can indicate if one suffers from high blood pressure. One should take extra care to look out for symptoms of heart disease.

People, who are overweight, eat high fat and high cholesterol foods are exposed to the risk of high BP. This risk is aggravated when people smoke and don’t exercise regularly. Heart diseases can also be genetic. Statistics show that men are more prone to get heart disease than women who haven’t gone through menopause. This risk is same for women post menopause. This risk increases with age, regardless of the gender.

Symptoms of Hypertensive Heart Disease to be looked for:
Symptoms vary depending on the severity of the condition. One may experience no symptoms at all, as in silent heart attacks, experience 

symptoms that may include:
Chest pain (angina), tightness or pressure in the chest, shortness of breath, pain in the neck, back, arms, or shoulders, persistent cough, loss of appetite, foot or ankle swelling and persistence fatigue.

Prevention of Hypertensive Heart disease
Periodical monitoring and taking corrective steps to prevent the blood pressure from getting too high are one of the most important ways of prevention.

Maintaining a healthy weight and keeping the cholesterol levels in check by eating a healthy diet and monitoring stress levels are possibly the best ways to prevent heart problems. Sleep adequately, exercise regularly and keep a healthy lifestyle are recommended. Visit your physician every 3-6 months for check ups.

Treatments
Depending on the condition, doctors recommend various treatments. In case the heart rate or rhythm is not regular, doctors surgically implant a device called pacemaker that produces electrical simulations similar to normal working heart. 

In case of blocked coronary arteries, a coronary artery bypass graft surgery is done. This is done in serious life threatening conditions. Final resolve if the condition is especially severe is a heart transplant.

by- Dr Keshava R, Consultant Interventional Cardiologist Fortis Hospital

 this is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.

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30 Minutes Can Make All the Difference

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Screening family history helps prevent diseases

Screening family history could lead to preventive treatment of multiple cancers, heart disease and diabetes - altering the destiny of many of these diseases that pass on from generation to generation, a study has indicated.

Researchers have identified a set of questions that can be used to identify people who may be at increased risk of various diseases because of their family history of these conditions.

The family history screening questionnaire can be used to provide insight into people's susceptibility to breast, ovarian, bowel and prostate cancer, melanoma, ischemic heart disease and type 2 diabetes, researchers claimed.

"This finding could be used as a screening tool in general practice to identify people who need a more detailed discussion about their family history of cancer, diabetes or heart disease," said Jon Emery, a professor of primary care cancer research at University of Melbourne in Australia.

"Some people may require referral to a genetics clinic to discuss genetic testing, many more may require earlier cancer screening and lifestyle management," he added.

Family medical history remains the most relevant genetic risk tool in use in clinical practice.

Evidence suggests that having knowledge of a family history of a specific condition is associated with improved uptake of a range of disease-preventative activities, such as cancer screening and reduced sun exposure.

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