Predicting and Preventing Heart Attacks and Strokes

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By Prof. Chamila Mettananda

According to the latest WHO data published in 2018, Coronary Heart Disease Deaths in Sri Lanka amounted to a record high of 22.64% of total deaths in the country. While until recently, fatal heart attacks or strokes came with no prior warning, decades of global research in the field have enabled healthcare specialists to identify and predict the risk of developing or dying from these conditions, during the next ten years can now be assessed. This also helps arm patients against these fatal medical conditions, helping most to enjoy an optimum quality of life.

 The process of prediction

Using charts put together for Sri Lanka by the World Health Organization, factors such as age, sex, smoking status, blood pressure, evidence of diabetes mellitus, height, weight, and total cholesterol value are taken into account to gauge a patient’s risk of developing a Cardiovascular Disease (CVD). In terms of accuracy, it has been shown that these predictions were accurate for 81 out of 100 people (81%) that were tested. Anyone, aged 40 years or above (with some exclusions), including those with adult-onset diabetic patients (Type II), should consider getting this prediction done. The prediction assessment is also recommended for patients aged 40 years or younger bearing significant risk factors which include the presence of diabetes, a family history of high blood pressure, kidney disease, high cholesterol levels, or a pattern of heart attacks or strokes in the family before the age of 50. Depending on this prediction, patients are then equipped by their healthcare specialists with precautionary measures to prevent succumbing to the fatal implications of these CVDs.

 What comes after a prediction?

Depending on a patient’s risk, they will be put on appropriate treatment plans. Low-risk patients are advised to make certain lifestyle modifications with their progress reassessed every 12 months.  Intermediate risk patients will again be advised to make lifestyle modifications as well as educated on other measures to help control risk factors. A course of medications might also be considered, with their progress being reassessed every three months. Patients that display the highest risk will be put on a strict lifestyle modification plan and medication with frequent assessments.

The golden rules of preventing and treating cardiovascular conditions

The prevention of cardiovascular disease can be achieved by practising regular exercise, keeping to a balanced healthy diet, engaging in physical activity for a minimum of 150 minutes per week, eliminating tobacco use and reducing the use of alcohol. In terms of medication, patients should be put on a course that helps maintain blood pressure, sugar and cholesterol in a manner that takes into account their 10-year risk predictions.

 Hemas Hospitals offers a comprehensive portfolio of diagnostic and treatment solutions to help Sri Lankans combat non-communicable yet critical medical conditions rising from cardiovascular diseases. Hemas Hospital’s Wellness Centre is primarily focused on preventive care and integrated management of diseases and medical conditions. Employing a multi-disciplinary approach, well trained medical officers will lay out a treatment plan and guide patients through the treatment process and ensure medical conditions are managed, in the case of non-communicable diseases, through constant follow-ups.

If prevention is simple and possible, why don’t people take better care?

Today, with a global environment that warrants extremely busy lifestyles to stay ahead, many people do not focus on their healthcare at the preventative stage. Since, not many cardiovascular disease symptoms present before an actual attack, many tend to only concentrate on what hinders them daily. But, it is important to remember that once a person gets a heart attack or a stroke, it is mostly irreversible and consequences will follow the rest of your life. However, if proper precautions are taken and a healthier lifestyle is followed, life can be a beautiful and happy affair that isn’t plagued by the physical, economical and social implications that come with the disease. Remember, prevention is always better than cure!

 [Professor Chamila Mettananda (MBBS, MD, MRCP, PhD (Cardiovascular epidemiology), FRCP, FRCPE, FACP, FCCP), Professor in Pharmacology & Specialist in General Medicine, Faculty of Medicine, University of Kelaniya. She is also a consultant at the Hemas Hospitals, Wattala.]