Heart Attack and Stroke: What You Don’t Know May Kill You
Nearly two-thirds of people who have a heart attack die before they can reach medical care; and 60% of stroke patients die or become disabled. While it’s important to know the warning signs to act quickly, it is just as important to know the causes and risk factors to prevent a heart attack or stroke from ever happening. Prevention is always better than treatment, and most heart attacks and strokes can be prevented.What causes heart attacks and strokes?
Heart attacks and strokes are mainly caused by a blockage that prevents blood from flowing to the heart or the brain. The most common reason for this is a build-up of fatty deposits on the inner walls of the blood vessels that supply the heart or the brain. This makes the blood vessels narrower and less flexible. It is sometimes called hardening of the arteries or atherosclerosis. The blood vessels are then more likely to get blocked by blood clots. When that happens, the blood vessels cannot supply blood to the heart and brain, which become damaged.
Why does fat build up in blood vessels?
There are three main reasons for fatty build-up, and you can control them all:
1. smoking and other tobacco use;
2. unhealthy diet;
3. not staying active.
An early form of fatty deposits, known as “fatty streaks”, can even be found in some children younger than 10 years. These deposits get slowly worse as the person gets older.
Tobacco use
Tobacco smoke is full of substances that damage your lungs, blood vessels and heart. They take the place of the oxygen in the blood that your heart and brain need to work properly. Tobacco use greatly increases your chance of having a heart attack or stroke. Tobacco also causes cancer and lung disease, and harms babies during pregnancy. Inhaling the tobacco smoke of other smokers is as harmful as smoking yourself.
Unhealthy diet
An unhealthy diet is one with:
1. too much food (too many calories);
2. too much fat, sugar or salt;
3. not enough fruit and vegetables.
If you eat a lot of food and you are not active enough to burn it off, you will put on weight. You could slowly become overweight or even obese. Being overweight can lead to diabetes, high blood pressure, and high blood fat levels. All of these physical problems increase the risk of heart attacks and strokes. Obese people are at especially high risk if they have a lot of fat around the waist and stomach area. An unhealthy diet often contains too much “fast food”, which is high in fat and sugar, and sugar-loaded soft drinks. Fast food is also very high in salt, which increases blood pressure.
Lack of physical activity
When people do not stay active, heart attack and stroke risk increases greatly. Physical activity lowers your risk of heart attacks and strokes by:
1. helping your body burn sugars and fats and assisting in keeping a good weight;
2. lowering your blood pressure;
3. increasing oxygen levels in your body;
4. reducing stress;
5. strengthening your heart muscle and bones;
6. improving blood circulation and muscle tone.
Staying active also reduces the risk of other illnesses, such as cancer. Active people usually feel better and happier. They are likely to sleep better and to have more energy, self-confidence, and concentration. You do not have to be an athlete to get these benefits! Walking, gardening, or doing housework for at least 30 minutes on most days can help you prevent heart attacks and strokes.
Risk Factors
High blood pressure (hypertension)
Blood pressure is the force with which the blood pushes against the walls of arteries. If blood pressure is high, the heart is working harder than it should; over time, this will cause it to weaken. High blood pressure is one of the major risk factors for heart attacks. It is the biggest risk factor for strokes. To avoid high blood pressure, you need to stay active, maintain a healthy body weight, and eat a healthy diet. A healthy diet includes lots of fruits and vegetables. Limit the amount of salt in your diet, and do not drink too much alcohol. If you make all of these changes to your lifestyle, but you still cannot lower your blood pressure, there are medicines that can help.
High blood sugar (diabetes)
The body produces a hormone called insulin, which helps body cells to use sugar from the blood to produce energy. When the body does not produce enough insulin, or cannot use it properly, as in diabetes, sugar builds up in the blood. The high blood sugar levels speed up the development of atherosclerosis- the narrowing and hardening of the arteries. This greatly increases the risk of heart attacks and strokes. Treating diabetes involves changing your diet and lifestyle. Sometimes, medicines that lower blood sugar are needed.
High blood fats (hyperlipidemia)
Blood fats include substances such as cholesterol and triglycerides. When there are too many of these fats in the blood, they cause fatty deposits to build up in arteries leading to atherosclerosis (the narrowing and hardening of the arteries). This greatly increases the risk of heart attacks and strokes. If you have high cholesterol or triglyceride levels in your blood, you need to eat less fat, stay active, and control your body weight. If these measures are not enough, you may also need medicine to lower your blood fats.
Combined risk factors
If a person has two or more of the three risk factors - high blood pressure, high blood sugar, and high blood fats - the risk of heart attacks and strokes is greatly increased. The more risk factors you have, the higher your risk.
Other Important Risk Factors
Metabolic syndrome
When a person has central obesity (too much weight around the waist), abnormal blood fat levels (e.g. high triglyceride level or low HDL cholesterol); high blood pressure and high blood sugar at the same time, this is known as metabolic syndrome. People with metabolic syndrome are at high risk of developing diabetes or having a heart attack or stroke, and require careful medical attention.
Chronic stress
Feeling lonely, isolated, or anxious for a long time can combine with other risk factors to make a person more likely to have a heart attack or stroke.
Certain medicines
Some oral contraceptives and hormone treatments can increase the risk of heart attacks. Check with your doctor for details.
Irregular heartbeat (atrial fibrillation)
With irregular heartbeat, or atrial fibrillation, the heart does not contract as strongly as it should. This can cause blood to pool in the heart and form clots. When the blood clots dislodge, they may move to the brain, where they can become trapped in a narrow brain artery, blocking the blood flow and causing a stroke. Up to 20% of strokes may be caused by atrial fibrillation.
Many people are unaware that their heartbeat is irregular. If you are concerned about this, your doctor can easily check by listening to your heartbeat. If necessary your doctor may arrange for an electrocardiogram. If your heartbeat is irregular, medicines can significantly reduce the risk of strokes. Sometimes, an irregular heartbeat can be returned to normal with medicines or special medical procedures.
Reduce your risk
There is so much that you can do to reduce the risk of heart attack and stroke for you and your family. Start by making some healthy lifestyle choices:
1. If you smoke or use tobacco, quit. Avoid inhaling smoke from other people’s cigarettes.
2. Spend 30 minutes a day doing something active, like walking, gardening, or housework.
3. Eat 5 servings of fruit and vegetables each day.
4. Limit the salt, fat, and sugar in your diet.
5. Once a year, ask your doctor to check your weight, blood pressure, blood fats and blood sugar.
6. Encourage your family members and others to change their lifestyles.
