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Dr K K Aggarwal

Results of the longest, 10–year, major study on stress in women, presented at the American Heart Association conference on Nov. 14 has shown that women with demanding jobs are 40% more likely to have a heart attack or stroke than women with less stressful jobs. There were 17,415 participants in the Women’s Health Study.

Stressful positions were defined as those with demanding tasks and little authority or creativity. Women with demanding jobs and little control over how to do them were nearly twice as likely to have suffered a heart attack as women with less demanding jobs and more control. Also women with high–stress jobs face about 88 percent more risk of a heart attack than if they had low workplace strain.

Worrying about losing one’s job also raised the odds of having cardiovascular disease risk factors, such as high blood pressure and higher cholesterol levels –– but not actual heart attacks, stroke or death.

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Men and women have about the same adjusted in-hospital death rate for heart attack — but women are more likely to die if hospitalized for a more severe type of heart attack.

According to a report in Circulation: Journal of the American Heart Association:

  1. Women are twice as likely as men to die if hospitalized for a type of heart attack known as Read more
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To live above the age of 80 without a heart attack, one need to have ideal health parameters and life style and both can be remembered with the formula of eighty.

Health Parameters: In order to achieve this, it is advisable to maintain fasting blood sugar (FBS) (mg%), fasting low-density lipoprotein (LDL) bad cholesterol (mg/dL), diastolic lower blood pressure (mm Hg), resting heart rate, and abdominal girth (cm) all below 80.  Apart one should also keep the kidney and ling functions above 80.

1. Abdominal (Waist) Circumference: Increase in abdominal obesity (also called central adiposity or visceral, android, or male-type obesity) is associated with an increased risk of morbidity and mortality. Patients with abdominal obesity are more likely to develop heart disease, diabetes, hypertension, and dyslipidemia.

2. Abdominal obesity is assessed by measuring body mass index (BMI) and waist circumference. The waist circumference is measured with a flexible tape placed on a horizontal plane at the level of the iliac crest as seen from the anterior view. In adults with a BMI above 23 kg/m2, waist circumference >80 cm is associated with a greater risk of hypertension, type 2 diabetes, dyslipidemia (abnormal cholesterol levels), and heart disease.

3.  Blood Pressure: Diastolic lower blood pressure should be kept below 80 mm Hg. If it is between 80 and 90 mm Hg, it is called pre hypertension and if it is above 90 mm Hg, it is called hypertension. A person with pre hypertension is three times more likely to develop heart attack and 1.7 times more likely to develop heart disease than a person whose diastolic lower blood pressure is <80 mm Hg. If pre hypertension is aggressively treated, 45% of all heart attacks can be prevented.

4.  According to the guidelines of The 2007 United States Preventive Services Task Force (USPSTF), individuals with diastolic lower blood pressure <80 mm Hg are recommended for screening every 2 years, whereas individuals with diastolic lower blood pressure between 80 and 89 mm Hg are recommended for yearly screening. Patients with pre hypertension have a greater prevalence of cardiovascular risk factors than those with normal blood pressures. Presence of at least one adverse risk factor (high cholesterol levels, overweight/obesity, and diabetes mellitus) is significantly more likely among pre hypertensive patients than normotensive individuals. There is an association between pre hypertension and microalbuminuria (presence of albumin in urine in micro amounts), which is a risk factor for cardiovascular disease and early cardiovascular mortality.

5. Blood Sugar: Fasting blood sugar above 80 mg% increases the risk of macrovascular diseases (heart attack, paralysis, and peripheral vascular disease), but not microvascular diseases (retinopathy, neuropathy, and nephropathy- eye, nerve and kidney involvement). However, Fasting blood sugar above 126 mg% increases the risk for both macrovascular and microvascular diseases. For optimum cardiovascular protection, the blood sugar should be below 80 mg%.

6.  Cholesterol: The optimal value for LDL bad cholesterol is < 80 mg% for Indian population,  A one standard deviation (38.5 mg/dL) LDL increase is associated with an age-adjusted relative risk for heart disease of 1.42 for men and 1.37 for women.  Patients at high risk of developing heart disease might also be expected to benefit from more intensive lipid-lowering therapy. Such patients should be treated with the lowest dose of a statin that reduces their LDL-C below 80

7. Resting heart rate: Higher the resting heart rate more the chances of sudden death. Ideal rate is to keep it lower than 80 per minute.

8.  Kidney functions: If the kidney functions are below 80% the person is at risk for heart blockages.

9.  Lung functions: One should keep the lung capacity above 80% to get the maximum benefit of Pranayama.

Healthy life style: Again whatever you do follow the principle of 80.

1. Diet: Eating fewer calories has been shown to reduce the chances of developing heart attack. One gram of food contains six calories on an average ( 9 grams in fat, 4 each in carbohydrates and proteins). One should not eat more than 80 g or 80 ml of caloric food in any meal. The less you eat the more you olive is a Vedic saying.

Also it’s a Vedic saying that one should not eat cereals ( wheat, rice) for up to 80 days in a year and was the basis for Vedic spiritual fasts. Eating cereals every day especially the refined carbohydrates ( white sugar white maida and white rice) is responsible for high insulin levels  with insulin resistance.

2. Exercise: Adequate walking cum exercise duration per day is 80 minutes. Cardiovascular training exercise involves walking 80 steps a minute for 80 minutes a week.  Cardiovascular exercise involves attaining 80% of target heart rate (220- age is 100% target heart rate).

3. Time to yourself: One should give atleast 80 minutes of time to oneself in a day

(includes time for meditation,  getting absorbed in the present work, relaxing, fulfilling your hobby etc). This can also be done  smiling and laughing when ever an opportunity arises to 80 times a day.

4. Pranayama: One should do 80 alternate nostril pranayama a day. Or one should do 80 UMMMMM chanting a day.

5. Alcohol: For those who consume social drinks (with no contraindications) the dose is less than 80 g in 1 week (10 g is 30 mL 80 proof whisky). In women, it is 80 g in 2 weeks. Also one should not take more than 80 mL of whisky in 1 day (males). For females it is half of that of males.

6. Clapping: those who believe that clapping is good for the health should do 80 clapping a day.

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There is a seasonal pattern of deaths from heart attacks with more fatal events (20 to 30 percent variation) occurring in the winter than the summer. But this seasonal pattern is absent in diabetics or those taking beta blockers or aspirin.

The heart attack trends are independent of gender, geographic location, age, and the type of heart attack (ST elevation or non-ST elevation). In-hospital mortality fatality rates for heart attack also follow a seasonal pattern, with a peak of 9 percent in winter and 8.4% in the summer.

Deaths from heart attack are highest in January and lowest in September, with a relative risk difference of 18.6 percent.

About the author: Dr K K Aggarwal is Padmashri and Dr B C Roy National Awardee, President Heart Care Foundation of India, Dean Board of Medical Education Moolchand Medcity, Sr. Physician & Cardiologist, Chairman Ethics Committee Delhi Medical Council, Visiting professor Clinical Research DIPSAR, Past President Delhi Medical Association and Past Academic and Research Wing Heads IMA.

 

 

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