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Dr K K Aggarwal

Smoking makes you 5 years older

By Dr K K Aggarwal
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  • Men have a greater chance of dying than women, and smoking increases any adult’s risk of death just as if five years were suddenly added to their age.
  • For men who have never smoked, heart disease presents their greatest risk for death at any age, exceeding the odds of dying from lung, colon and prostate cancer combined.
  • Male smokers face a lung cancer risk that is greater than the odds of heart disease taking their lives after age 60, and is tenfold higher than the chance of dying from prostate and colon cancer combined.
  • The chances of dying from heart disease and breast cancer are similar for nonsmoking women until age 60, when heart disease becomes a greater risk.
  • For female smokers, dying from lung cancer or heart disease is more likely than dying from breast cancer after age 40.

Nine modifiable risk factors for heart attack

By Dr K K Aggarwal
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The majority of known risk factors for heart attack are modifiable by specific preventive measures.

The nine potentially modifiable factors include smoking, dyslipidemia, hypertension, diabetes, abdominal obesity, psychosocial factors, regular alcohol consumption, daily consumption of fruits and vegetables and regular physical activity. These account for over 90 percent of the population attributable risk of a first heart attack.

In addition, aspirin is recommended for primary prevention of heart disease for men and women whose 10-year risk of a first heart attack event is 6 percent or greater.

Smoking cessation reduces the risk of both heart attack and stroke. One year after quitting, the risk of heart attack and death from heart disease is reduced by one-half, and after several years begins to approach that of nonsmokers.

A number of observational studies have shown a strong inverse relationship between leisure time activity and decreased risks of CVD. Walking 80 minutes in a day and whenever possible with a speed of 80 steps per minute are the current recommendations.

Women Beware of Heart Disease

By Dr K K Aggarwal
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Cardiovascular disease is very common in women. The warning signals of heart attack include:

  • Uncomfortable pressure, squeezing, fullness or pain in the center of the chest. It lasts more than a few minutes, or goes away and comes back.
  • Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  • Shortness of breath with or without chest discomfort.
  • Breaking out in a cold sweat, nausea or lightheadedness.

However, women are more likely than men to have heart attack symptoms unrelated to chest pain, such as:

  • Neck, jaw, shoulder, upper back or abdominal discomfort.
  • Shortness of breath.
  • Pain in one or both arms.
  • Nausea or vomiting.
  • Sweating.
  • Lightheadedness or dizziness.
  • Unusual fatigue.

In the presence of any of the above, one should not wait for more than five minutes and get to a hospital right away.

More than 80% of cardiac events in women can be prevented by modifying diet, exercise and abstinence from smoking.

A mix of exercise protocol is better

By Dr K K Aggarwal
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A combination of weight training and aerobic exercise is the best prescription for overweight patients at risk for diabetes and heart disease.

Only aerobic exercise is also good as it reduces weight and inches off the waistlines. Just weight lifting alone has very little benefit.

According to a study published in the American Journal of Cardiology, people in the weight-training group gained about 1.5 pounds and those in the aerobic group lost an average of 3 pounds and half an inch from their waists.

Those who did both weight and aerobic training dropped about 4 pounds and 1 waistline inch. This group also saw a decrease in diastolic blood pressure and in metabolic syndrome score.

Both the aerobic-only group and the combined-exercise group also lowered their levels of triglycerides.

Tips to prevent future heart disease in women

By Dr K K Aggarwal
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  • Do moderate intensity physical activity for at least 30 min and for 60 to 90 min for weight management on most days of the week.
  • Avoid and stop cigarette smoking and passive smoking.
  • Keep waist circumference less than 35 inches.
  • Consume a heart-friendly diet.
  • Control cholesterol level, high blood pressure and diabetes.
  • Women who smoke should avoid oral contraceptive pills.
  • Aspirin 80 mg should be added for women older than 65 years of age.
  • Treat underlying depression.

Smoking makes you 5 years older

By Dr K K Aggarwal
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  • Men have a greater chance of dying than women, and smoking increases any adults risk of death just as if five years were suddenly added to their age.
  • For men who have never smoked, heart disease presents their greatest risk for death at any age, exceeding the odds of dying from lung, colon and prostate cancer combined.
  • Male smokers face a lung cancer risk that is greater than the odds of heart disease taking their lives after age 60, and is 10-fold higher than the chance of dying from prostate and colon cancer combined.
  • The chances of dying from heart disease and breast cancer are similar for nonsmoking women until age 60, when heart disease becomes a greater risk.
  • For female smokers, dying from lung cancer or heart disease is more likely than dying from breast cancer after age 40.

All about Diabetes

By Dr K K Aggarwal
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  • India is the diabetes capital of the world.
  • People with diabetes are nearly two times more likely than people without diabetes to die from heart disease, and are also at greater risk for kidney, eye and nerve diseases, among other painful and costly complications.
  • Type 2 diabetes can be delayed or prevented, and both types 1 and 2 diabetes can be managed to prevent complications.
  • In type 1 diabetes, the body does not make insulin. In type 2 diabetes, the body makes insufficient insulin or does not use insulin well.
  • Gestational diabetes occurs in some women during pregnancy. Though it usually goes away after the birth, these women and their children have a greater chance of getting type 2 diabetes later in life.
  • Type 2 diabetes has begun to affect young people.
  • Losing a modest amount of weight — about 15 pounds — through diet and exercise can actually reduce your risk of getting type 2 diabetes by as much as 58 percent in people at high risk.
  • In type 1 diabetes, tight control of blood sugar can prevent diabetes complications.
  • Choose healthy foods.
  • Take a brisk walk every day.
  • Talk with your family about your health and your family’s risk of diabetes and heart disease.
  • If you smoke, seek help to quit.
  • Make changes to reduce your risk for diabetes and its complications — for yourself, your families and for future generations.

What type of a vegetarian are you?

By Dr K K Aggarwal
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There are 4 main types of vegetarian diets:

  • Lacto–ovo–vegetarian consumes dairy products and eggs but no meat, poultry, or seafood
  • Lacto–vegetarian eats dairy products but not eggs, meat, poultry, or seafood
  • Ovo–vegetarian eats eggs but no dairy products, meat, poultry, or seafood
  • Vegan does not eat any animal products, including meat, fish, poultry, eggs, and dairy products; many vegans will also avoid honey.

Vegetarian and plant–based diets are associated with a reduced risk of obesity, diabetes, heart disease, and some types of cancer as well as increased longevity. Vegetarian diets are typically lower in fat, particularly saturated fat, and higher in dietary fiber. They are also likely to include more whole grains, legumes, nuts, and soy protein, and together with the absence of red meat, this type of eating plan may provide many benefits for the prevention and treatment of obesity and chronic health problems, including diabetes and cardiovascular disease.

Man Vachan Kaya

By Dr K K Aggarwal
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Man, Vachan, Kaya are the three fundamental principles used to define non-violence (ahimsa) and truthfulness (satya).

Being truthful means what you think, speak and do, are the same. You should be one in whatever you think, do or speak.

Ahimsa is the fundamental principle of Jainism, which means that you should be non-violent not only in your actions but also in your speech and thoughts. Being truthful makes you Satyugi. Only in certain circumstances, you may differ in your thinking, speech and actions. For example, you cannot tell a patient he is going to die in the next week. Here, your mind may be saying something, your speech and actions will be something else.

Any discordance in Man, Vachan and Kaya ends up with guilt and suppressed emotions, which later on can cause blood pressure, diabetes and heart disease.

(Disclaimer: The views expressed in this write up are my own).

Heart risks detected by age 7 in overweight kids

By Dr K K Aggarwal
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Children at risk of future obesity should be examined for body mass index (BMI) rebound.

BMI rebound is the age at which BMI reaches its lowest point before increasing through later childhood, adolescence and adulthood.

An earlier BMI rebound age is associated with adverse risk factors for heart disease as measured at age 7: higher BMI, higher systolic and diastolic blood pressures, higher serum insulin and leptin levels, higher left ventricular mass and left atrial size.

Early BMI rebound age for children is lower than 4.4 years for boys and 4.2 years for girls. Normal values are 4.4 to 6.6 years for boys and 4.2 to 5.7 years for girls.

All children who start gaining weight between 3-4 years should be classified as a high risk for future diabetes and heart disease.

Kidney patients more at risk for future heart attacks

By Dr K K Aggarwal
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Chronic kidney disease patients with kidney function less than 60% are included in the list of criteria for defining people at highest risk for future heart attacks.

In a large cohort Canadian study published in The Lancet led by Dr Marcello Tonelli at University of Alberta, patients with only chronic kidney disease had a significantly higher rate of heart attacks than those who only had diabetes. Those who had already had a heart attack had the highest overall rate of heart attacks.

Chronic kidney disease should be regarded as a coronary heart disease risk equivalent, similar to diabetes, as patients with the condition have high rates of cardiovascular events, particularly when they also have proteinuria. When chronic kidney disease was defined more stringently with kidney function less than 45% and increased proteinuria, the rate of first heart attack was higher in those with both chronic kidney disease and diabetes than in those with either disorder alone.

Women beware of heart disease

By Dr K K Aggarwal
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More women die of cardiovascular disease than from the next four causes of death combined, including all forms of cancer. Over 80 percent of cardiac events in women can be prevented by modifying diet, exercise and abstinence from smoking. The following may be the warning signals of heart attack:

  • Uncomfortable pressure, squeezing, fullness or pain in the center of the chest. It lasts more than a few minutes, or goes away and comes back.
  • Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  • Shortness of breath with or without chest discomfort.
  • Breaking out in a cold sweat, nausea or lightheadedness.
  • Chest pain or discomfort is a presenting symptom in women, but they are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

In presence of any of the above one should not wait for more than five minutes and get to a hospital right away.

Prefer Meditation and Not Medication

By Dr K K Aggarwal
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Meditation and not medication should be the first line of treatment for most lifestyle disorders. The very fact that our body has a receptor for each and every drug means it has the capacity to produce that drug. God never made these receptors for pharmacological agents or drugs. The key lies in achieving the undisturbed state of consciousness, which can be obtained by either controlling the disturbed state of mind or bypassing it by using the mantra. The subject of spiritual medicine should be included in schools, colleges and medical sciences.Confession and communication are two easy modes to control a disturbed state of mind. As darkness is absence of light, negative thoughts are absence of positive thoughts. To reduce negative thoughts, one should inculcate positive thoughts, actions and behaviors. One cannot hate a stranger. One can only hate a person whom he or she has loved. Hatred is therefore withdrawal of love, and it can only be removed by bringing the love back. By the process of meditation, it has been shown that diseases like diabetes, high blood pressure, heart disease, paralysis, asthma and acid-peptic disease can be kept under control without or with minimal medicines.

Walk 2000 extra steps to lower your risk of heart disease

By Dr K K Aggarwal
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Walking 20 minutes at a moderate pace each day is associated with improved cardiovascular outcomes in patients with impaired glucose tolerance, according to a study published in The Lancet.

People who walked 2,000 steps more per day at baseline had a 10% lower risk of cardiovascular death, paralysis or heart attack during an average follow–up of 6 years, according to Thomas Yates, PhD, of the University of Leicester in England, and colleagues. And those who increased the amount they walked by 2,000 steps per day from baseline to 1 year had a similar reduction in risk of cardiovascular events.

The findings from NAVIGATOR trial support both the promotion of increased ambulatory activity, and the avoidance of decreased ambulatory activity irrespective of the starting level, as important targets in the prevention of chronic disease.

Heart disease starts in youth

By Dr K K Aggarwal
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Autopsy studies of young people who died in accidents have shown that by the late teens, the heart blockages, the kind of lesions that cause heart attacks and strokes are in the process of developing. The best opportunity to prevent heart disease is to look at children and adolescents and start the preventive process early. More than a third of children and adolescents are overweight or obese.

The first signs that men are at higher risk of heart disease than women appear during the adolescent years despite the fact that boys lose fat and gain muscle in adolescence, while girls add body fat.

Between the ages of 11 and 19, levels of triglycerides, a type of blood fat associated with cardiovascular disease, increases in the boys and drops in the girls. Levels of HDL cholesterol, the “good” kind that helps keep arteries clear, go down in boys but rise in girls.

Blood pressure increases in both, but significantly more in boys. Insulin resistance, a marker of cardiovascular risk, which is lower in boys at age 11, rises until the age of 19 years.

Any protection that the young women have for cardiovascular protection can be wiped out by obesity and hence obesity in girls at any cost should be handled on priority.