How to prevent Sudden Cardiac Death due to Heart Attack in South East Asians or Indians?

Do you know what causes sudden cardiac death?

This topic is dear to me.

I want to help as many people as possible by bringing awareness among Desis as heart disease is on the rise in young Indians. After a lot of research, I came up with the following information which is very useful for each one of us to prevent from dying early suddenly.

Recently, lot of GoFundMe campaigns are being shared in social media to gather funds to help those who died suddenly to help their families. It is even more sad to see if it happens in someone’s family that we know.

A sudden cardiac death is the result of multiple things. 

 

Let us first learn what are the Risk factors for Heart Disease. The following are some of them.

Diabetes mellitus, type 1 and 2

Hypertension [High BP] BP >140/90 and those who use blood pressure medication

High Cholesterol

High Homocysteine levels

Kidney disease

Cigarette smoking

Family history of coronary disease at a young age in parents or sibling less than 55 years for men and younger than 65 years for women

Gender: Men have a higher risk of cardiovascular disease than women at every age

Age: There is an increasing risk of cardiovascular disease with increasing age

Inflammation

Periodontal Health

Sleep apnea

Obesity: Asian Criteria for being obese is BMI [Body Mass Index] more than 25. For others, it is 30. So, we are supposed to be on thinner side than other individuals from a different culture. 

Indians have small arteries in the heart and so heart disease is more common as other risk factors listed above are on the rise. 

 

Check your Lipid Profile or Lipid Panel:

Lipids are found in your blood and are stored in tissues. They are important part of cells and they help keep your body working normally.

Lipids are one of the modifiable Risk Factors for reducing Heart Disease

Lipid Panel/Profile includes:

Total Cholesterol

High-Density Lipoprotein (HDL) –GOOD cholesterol

Low-Density Lipoprotein (LDL) –BAD cholesterol

Triglycerides [TG]

Lipoprotein a – These levels are not done routinely as part of lipid profile. It is Genetic. It is prone to oxidation resulting in atherosclerosis and also it increases clotting leading to heart attacks. It needs lifestyle modification as its levels do not change with medications.

 

Why do we check Lipid panel?

High cholesterol [=Hyperlipidemia or Dyslipidemia], may lead to life-threatening illnesses, such as coronary artery disease (CAD), heart attack, or stroke.

High Triglycerides can cause Pancreatitis.

 

When should you check Lipid Profile?

USPSTF recommends the following:

at age 35 in men without other risk factors for coronary artery disease and

at age 20 to 35 in men with risk factors.

at age 45 in women and perhaps at age 20 in women with risk factors for coronary disease.

 

Precautions to take just before the Lipid Profile Blood work to get accurate Lipid profile results:

Do not eat high-fat foods the night before the test.

Do not drink alcohol or exercise strenuously before the test.

Do not eat or drink anything except water for 9 to 12 hours before having your blood drawn.

Medicines can be taken with water

 

Lipid profile results and significance: 

Total Cholesterol

<200 mg/dL = normal

200 to 239 mg/dL = borderline high

>240 mg/dL = high

 

Triglycerides

Normal = less than 150 mg/dL

Borderline high = 150 to 199 mg/dL

High = 200 to 499 mg/dL

Very high – greater than 500 mg/Dl

 

HDL=GOOD cholesterol

> 60 mg/dL = excellent, protects heart

< 40 mg/dL = high heart disease risk


LDL=BAD cholesterol

<100 = Good

130-159 = Borderline

>160 = High

 

 

Typical South Asian Lipid Profile:

High TG

Low HDL

Lipoprotein a may be elevated-genetic risk factor for Premature vascular disease

LDL may be normal or elevated

Total cholesterol may be less than 200

 

 

Target levels of LDL for good heart health:

Without risk factors less than 130

With risk factors, DM less than 100

H/O stroke, heart attack or arterial disease less than 70

 

Target levels of HDL for good health:

Above 40 in male

Above 50 in females

Exercise and proper nutrition increase HDL levels

 

Why it is good to have High HDL, Low LDL and Low TG? 

A reduction in HDL by 5mg /dL, decreases Heart Attacks by 25 %.

Lipid-lowering therapy with statin medications decreases Relative cardiovascular risk by 20 to 30 % regardless of baseline LDL.

The ratio of Total Cholesterol / HDL should be less than 5 in men and less than 4 in women for good health.

If LDL > 190, Your Doctor will start Medication [Statins] even if no other risk factors.

 

        

How to calculate your 10-year risk of heart disease or stroke?

Go to www.cvriskcalculator.com, You will see a calculator like this. Put your numbers after you visit your family doctor to get vitals and blood work done.

how to prevent sudden cardiac death?

10-year risk of 7.5 or higher is bad.

This calculator will tell if you need to start taking
1. Aspirin
2. Statin or
3. Blood Pressure medication

 

Lipid lowering with diet or dietary supplements:

 

  1. Omega-3 fatty acids

Fatty fish, especially salmon

Plant sources such as flaxseed and flaxseed oil, canola oil, soybean oil, and nuts.

 

  1. Lifestyle modifications: What can you do now to improve your health?

Lose weight if you are overweight or obese. Moderation in diet and some exercise can help. 80% of weight gain is from food and only 20% is from not doing exercise. Eat less food. 10kg weight loss can cause 5-20mm Hg reduction in Systolic Blood pressure.

Aerobic exercise. Exercise daily for a few minutes even though it is 15-20minutes. 

Eating diets lower in saturated fats, Trans fats and Carbohydrates

Do not smoke or inhale second hand smoke. 

Do not drink excessive alcohol. 

We tend to accumulate fat in the belly which is dangerous. Do exercise, eat less and eat more leafy vegetables and try to reduce belly fat as soon as possible. 

 

The clinical benefits from LDL-C reduction from lifestyle modification may be evident within 6 to 12 months

how to prevent sudden cardiac death?

Remember this picture from ChooseMyPlate.gov when you go to buffet party in your friend’s house next time. Always fill your plate with fruits and vegetables in one half of your plate.

High salt content can increase blood pressure. Avoid high salt Indian food like pickles, papadums, chutneys, restaurant food, Indian snacks, canned/packaged/preserved food etc. Not all have high salt. Start reading labels and check salt content. 

Avoid white sugar as much as possible. Eating sugar causes , TG, LDL [=Bad], & blood sugar to go up and HDL [Good] to go down. Dr. Popkin from University of North carolina showed that link between heart disease and sugar is more than the link between heart disease and consumption of saturated fats.

Get dental check ups once or twice a year and floss daily as bad dental hygiene can cause heart diseases.  

It does not matter whether you have good or bad genes, whether you exercise or not. Diet is the Deciding factor.

Talk to your family doctor if  you want to start vigorous exercise program. It is not advised to start exercising vigorously suddenly. 

Choosing the right oil is important. Oils with Monounsaturated fats are healthy and those with Trans Fats are the worst. The oils should have high smoke points and slower oxidation to be healthy. Avocado oil has high smoke point and has monounsaturated fats. Ghee or Clarified butter has anti oxidant/anti viral and high smoke point. Canola oil has high Trans Fats/Poly unsaturated and should be avoided. 

Fish oil has numerous uses like reducing depression, High BP, Diabetes, obesity, Arthritis, Cancer, and Inflammation. It increases Heart Health, Kidney Health, Immunity, Fertility, Brain health and Maternity health and keeps you younger.

Reduce your stress. Do not try to do too many things. 

Get yearly check ups from family doctor even though you feel perfectly fine. Get routine blood work to make sure everything is OK. Do not neglect this. 

Keep yourself very relaxed mentally and physically. Don’t get worked up for simple things in life. Forgive others. Do not argue with spouse. This helps keep your body equilibrium and maintains good blood pressure and hormone levels. 

Do not neglect warning signs of a health problem like dizziness, chest pain, shortness of breath upon walking or going upstairs, palpitations, swelling in the ankles/legs, fainting etc. Seek medical attention when you experience any of these. 

When you check your blood pressure any time, do not get panic. Just relax and re check after a few minutes. It will go down. This tells how important it is to relax whenever you can. 

Eat bigger breakfast and light dinner. Give 13hrs gap between dinner and next day breakfast. This will help reduce insulin levels which prevents development of insulin resistance and there by preventing Diabetes. 

Drink one or two glasses of water before eating if you are obese and eating too much and can not lose weight. 

Take steps instead of elevator at work especially if your job requires you to sit all day long. 

Play well and Sleep well like a child. 

Be Healthy. Be Happy. 

Smile !!

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