LETTERS: Heart disease is one of the leading causes of morbidity and mortality in Malaysia, with heart attack being the major manifestation.
About 90 per cent of first heart attacks are attributed to the nine modifiable lifestyle factors: smoking, excessive alcohol intake, poor diet, lack of exercise, obesity, stress, high blood sugar, high blood pressure and high blood cholesterol.
We can take steps to reduce the risk of developing a heart attack. The first step is assessing cardiovascular risks.
In clinics or hospitals, doctors can estimate the 10-year risk of patients having a heart attack and classify them into low, borderline, intermediate or high-risk groups.
Treatment can be tailored accordingly. The higher the blood pressure, the greater the chance of heart attack.
It is crucial to monitor blood pressure regularly, as many patients with high blood pressure do not experience symptoms. In fact, blood pressure should be measured at every chance encounter. Excessive bad cholesterol buildup in the main blood vessel walls reduces the flow of oxygenated blood to the heart muscle.
It is advisable to screen blood cholesterol levels annually and discuss cholesterol-lowering therapies with doctors. Chemicals in cigarette smoke can thicken the blood and promote the formation of plaque or clots in blood vessels.
Fortunately, smoking cessation can help reverse this although it may take many years for the blood vessels to recover.
For smokers who are willing to quit, a combination of behavioural interventions and nicotine replacement therapy maximises the likelihood of cessation success.
Maintaining a healthy diet, with at least five servings of fruits and vegetables daily and appropriate caloric intake, is good for achieving an optimal body weight.
For those who are overweight or obese, weight loss is recommended and a healthy body mass index of between 18.5 and 24.9 kg/m2 should be aimed for.
Additionally, adhering to a diet rich in whole grains, seafood, beans or nuts can offer cardioprotective benefits.
For diabetic patients, especially those with uncontrolled blood sugar, it is important to monitor carbohydrate intake and avoid sugar-sweetened beverages. Aerobic exercise helps build stronger heart muscles.
The World Health Organisation recommends engaging in weekly exercise of moderate intensity, such as brisk walking, vacuuming and mopping, for at least 150 minutes or vigorous intensity, such as hiking, jogging or playing football, for at least 75 minutes per week. Any exercise is better than nothing. Exercise stimulates the production of endorphins in the brain, which can reduce stress levels.
In line with the Wellness Month launched by the Health Ministry, which is celebrated annually in September, we should embrace healthy lifestyles by following the heart-protective ABCDE approach, referring to assessing risk, blood pressure management, cholesterol lowering/cigarette cessation, diet and exercise.
DR YAP JUN FAI, PROF DR MOY FOONG MING & DR LIM YIN CHENG
Department of Social and
Preventive Medicine,
Faculty of Medicine, Universiti Malaya, and
Department of Public Health, Universiti Malaya Medical Centre
The views expressed in this article are the author's own and do not necessarily reflect those of the New Straits Times