Michael Abrahams | Heart attacks: deadly but avoidable

Over seven million people die from heart attacks annually. Fortunately, most (80 to 90 per cent) heart attacks are considered avoidable, especially through lifestyle modifications.

For example, smoking is one of the top risk factors for heart disease. However, quitting significantly decreases the pre-existing risk, with risks for cardiovascular disease (CVD) becoming similar to those of people who have never smoked after quitting for about 10 to 15 years.

Our diets have a great impact on the health of our hearts. Apart from watching portion sizes and not eating too much, we must also be conscious of the constituents of our diets.

For instance, salt intake negatively affects cardiovascular health. Within 30 minutes of consuming excess salt, your blood vessels’ ability to dilate is impaired, and studies have shown that for every 1,000 mg increase in sodium per day, there may be an up to 18 per cent increased risk of CVD. We should also watch our fat intake, especially of saturated fats, as they raise low-density lipoprotein (LDL) cholesterol, or “bad” cholesterol. Consumption of red meat should be limited in favour of more plant-based diets, as red meat contains high levels of saturated fat, cholesterol, and trimethylamine-N-oxide (TMAO), which is produced by gut bacteria during digestion and increases inflammation, facilitating plaque formation in arteries.

On the other hand, we should incorporate adequate soluble fibre into our diets, as this can help lower LDL. A diet rich in omega-3 fatty acids is also good for the cardiovascular system, as these substances lower triglycerides, decrease blood pressure, and reduce inflammation, blood clotting and plaque buildup in our arteries. Almonds, walnuts, pecans, and other tree nuts contain heart-healthy fats, protein, and fibre and should also be included in our diets.

Tea, both black and green, is also heart-healthy. A meta-analysis of 22 studies found that increasing tea intake by three cups daily reduced the risk of coronary heart disease by an average of 27 per cent. And dark chocolate is also beneficial to our hearts as it contains flavonoids, compounds that help reduce inflammation.

Move your body throughout the day. Being sedentary for over 10 to 15 hours a day significantly increases CVD risk, with studies showing a 40 to 60 per cent higher risk of heart failure and cardiovascular death, and up to 2.5 times higher likelihood of recurring cardiac events. Research has found that an inactive lifestyle causes nearly twice as many deaths as obesity.

If you use a desk at work, try using a standing desk if possible. Incorporate walking into your schedule. Try to include regular exercise in your lifestyle. Aim for 30 minutes of moderate-intensity physical activity, five days a week, to improve and maintain your health. Ideally, this should include both aerobic and strength training sessions.

Being overweight or obese increases your risk of CVD, so try to be at a healthy weight. Body Mass Index (BMI) is a screening tool that estimates body fat by dividing weight (kg) by the square of height in metres (m²). It is used to categorise adults as underweight, healthy weight, overweight, or obese. Although it may not be accurate in all cases, a higher BMI is associated with an increased risk of heart attacks and CVD. Waist-to-hip ratio (WHR) is another important measurement. A healthy WHR for women is 0.85 and 0.90 for men. A high WHR indicates increased visceral fat, which is linked to inflammation, high blood pressure, and diabetes, and predicts a higher heart attack risk, often more accurately than BMI.

Get enough sleep. Sleeping less than five to six hours per night significantly increases the risk of heart attack, with some studies showing a 20 to 200 per cent higher risk compared to sleeping seven to eight hours. Chronic sleep deprivation raises blood pressure, increases inflammation, and spikes cortisol, which promotes plaque buildup and increases cardiovascular stress.

Regular check-ups are important because they can detect issues that require attention. If you have chronic non-communicable diseases such as, but not limited to, heart disease, hypertension, diabetes and hypercholesterolaemia, it is important for these to be controlled. Know your numbers, such as blood pressure, cholesterol, blood glucose levels and BMI. A coronary artery calcium (CAC) scan may also be useful for assessing cardiovascular risk and determining whether intervention is required.

When gums are inflamed (periodontitis), oral bacteria enter the bloodstream, triggering systemic inflammation and damage to blood vessels, which contribute to arterial plaque and raise the risk of heart disease by up to 20 per cent. So check-ups should also include dental examinations.

Managing your mental health is very important. Our moods, attitudes and mental states do influence cardiac function. For instance, research has found that an intense, acute episode of anger or a heated argument can increase the risk of a heart attack by approximately 8.5 to 9.5 times within the subsequent two hours. Studies also indicate that high levels of pessimism can more than double the risk of developing or dying from heart disease compared with low pessimism levels. Also, depression significantly increases heart attack risk, with studies showing that persons afflicted with the disorder have up to a 66 per cent higher risk of developing coronary artery disease.

We must identify our stressors and take steps to manage them. Laughter, listening to music, engaging in hobbies, keeping a gratitude journal, practising mindfulness, meditation, and yoga are all useful in decreasing stress and improving our mental well-being. Research has found that owning pets, especially dogs, improves heart health by increasing physical activity, lowering blood pressure, reducing stress, and boosting emotional well-being. Limit your social media exposure, too. Excessive social media scrolling and prolonged screen time increase heart attack and CVD risk by promoting a sedentary lifestyle, causing chronic stress, and disrupting sleep.

There are so many things we can do to lower our risk of having a heart attack. How many are you willing to try?

Michael Abrahams is an obstetrician and gynaecologist, social commentator, and human-rights advocate. Send feedback to columns@gleanerjm.com and michabe_1999@hotmail.com, or follow him on X , formerly Twitter, @mikeyabrahams