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Can Heart Attacks be Prevented?

Prot Habibuz Zaman
THERE fa a large body of accumulated evidence which Indicates that avoidance or cessation of the risk factors — tobacco smoking, high cholesterol levels In the blood, raised blood pressure, physical Inac ttvlty obesity and uncontrolled diabetes — can lead to the pre vention of coronary heart disease and heart attacks
Did any of your parents suffer a heart attack ?
Are you a male nearing 40. or a female over 50 ?
Do you smoke regularly 30 or more cigarettes a day ?
Arc you fond of rich food, full of saturated fats and cholesterol e.g. eggs, butter cream, full cream milk, beef mutton, brain or other organ meat viz hver. kidney, cooked with saturated fats like ghee or hydrogenated oils. (eg. daldaj pastry, cake, sweets prepared from milk, chocolates, or st mi iar products ?
Do you overeat — enjoying big meals to your heart's con -tent and also have helpings of snacks tn between ?
Does your occupation in voIve sedentary work for eight or more hours a day ?
Are you one of those, who do not care for a walk, or a game of badminton or any
other form of regular physical exercise ?
Do you spend all of your leisure time watching television or heading In bed ?
Are you obese and grossly overweight for your age and height (say over 154 lbs or 70 kg for an average Bangladeshi of medium build and 5 feet 4 Inches height)
Do you have a raised blood
pressure (over 150/90 mm Hg) which has remained un controlled over several years 7
Are you a known diabetic and have done nothing to control it ?
Are you a go getter, com petlttvr hostile. ever ambitious. driving yourself hard to achieve more and more ?
Are you argumentative and excitable, rather than calm and
composed ? do you have many sleepless nights ?
If your answers to most of the above questions are tn the affirmative. I am afraid you1 have several risk factors for developing coronary heart dis ease (CHD) You may be a good candidate for the development of atheromatious plaques in your coronary arteries These are channels, which carry blood to the heart muscle (myocardium) If these de posits of cholesterol keep on accumulating, your coronaries are pretty soon likely to get narrowed to point, when little or no blood and therefore oxy gen will reach the heart mus cle Ultimately the heart muscle cells in small and large numbers, are going to die At some point In time scarring Is going to occur inside one or more coronary artery thus fur ther narrowing the lumen Such a diseased state of the coronary artery predisposes to the formation of blood clots within the lumen of the artery (thrombus), thus completely shutting off the blood supply to a part of the heart. This leads lo the death of the affected heart muscle (acute myocardial Infarction) and the patient • suffers a heart attack.
Myocardial (M.l.) is an acute medical emergency and the patient faces serious conse
quences including imminent death In over 30 per cent of events of M.l. the patient may succumb to the very first attack With prompt medical attention and care, others may recover, but they carry the risk of a subsequent attack. Even with the finest medical ser vices as many as fifty per cent of cases of M l may have fatab ties within the first year
So you see the risks you are taking are real and serious
What can be done to prevent these risks ? Have any studies been carried out to prove Ilie point 7
Can the withdrawal or cessation of these risk factors prevent heart attack in an Individual or reduce the mortal Ity rate from CHD tn a com munity ?
In fact several well controlled studies In different countries have established the nature and relative importance of these several risk factors so that prevention of coronary heart disease Is a reality and a proven public health measure both at the individual and community levels.
Interventions to control these risks have been eminent su< cessful in a number of well known projects. Involving sizeable populations.