Heart disease leading killer of Indonesians

By D. Amidi

JAKARTA (JP): Gone are the days when heart disease was a rare affliction in Indonesia and people generally succumbed to old age and its enfeebling shortcomings. In the 1950s, many people in Indonesia died quiet and natural deaths. But it was a lot more peaceful in the capital back then; no frustration from traffic problems like nowadays, for instance.

Frustration is one of the sources of stress which, in most cases, is harmful to man's most vital organ, the heart.

On the other hand, it would be impossible to lead a completely stressless life. Stress, in the good sense of the word, is necessary to fulfill one's ambitions. However, that is another story.

Rapid advances in the economy and business over the last two decades have, in general, not fostered a healthy lifestyle. Executives, young and old alike, are leading increasingly more sedentary lives, in which natural actions such as walking and running have become almost uncommon.

Most people are familiar with the businessman who takes a few steps to his car in the morning and, upon arrival at his office building, walks a few steps to enter the elevator, gets out on floor "x" and heads for his office a few meters away. In his office overlooking the busy Jl. Sudirman, the business executive settles down for the better part of the day in his comfortable chair.

Stress, lack of movement and a faulty diet are major factors found among an increasing number of people affected by coronary heart disease in the country. So much so, a household survey held a few years ago in Jakarta strongly indicated the disease's rise into first place over other killer maladies in Indonesia.

Although age does play an important factor in contracting the affliction, it is no longer unusual to find young people who have become vulnerable to heart attacks because of a much more breathtaking lifestyle than their older contemporaries had led.

With the country's economic advancement, today's executives are putting in more work hours and have less rest and recreation time than businessmen in the 1950s, for instance.

The disease often strikes men aged 30 years and up. It rarely affects people under 30 years.

Hypertension (high blood pressure) could also eventually lead to heart disease. People with blood pressure readings ranging between 150/100 or 150/95 are likely candidates for a coronary heart attack. People with higher blood pressure readings than those just mentioned usually suffer a stroke instead of a heart attack.

Hypertension patients should watch their weight. They should avoid doing exhausting work which will put a strain on their heart. This especially will be the case if one is overweight.

Smoking also accelerates plaque formation, which is caused by carbon monoxide and dioxide gasses and the nicotine of cigarettes.

Diabetes Mellitus patients suffering from unmanageable blood sugar levels, even with oral medication or insulin treatment, are in all likeliness vulnerable to an imbalance of carbohydrate metabolism, which in turn raises triglyceride counts. This condition is a potential danger to the heart of a diabetic patient.

Genetics

Aside from the aforementioned factors, genetics, the hereditary factor, also comes into play as one of the causes of heart disease. Research in Europe has strongly suggested that heart disease in many cases was traceable to a long-running family condition. There is also what is known as the X-factor, indicating that a high iron content in the body could lead to coronary heart disease, according to a Norwegian research study.

Heart attacks are mainly of the angina pectoris or myocard infarct type. The first affliction is caused by the narrowing of one or more branches of the coronary blood vessels, and is accompanied by pains in the chest.

Myocard infarct is a severely painful attack, lasting more than 20 minutes. It is accompanied by shortness of breath and cold sweat. In such a condition, the narrowed blood vessel has been totally obstructed, preventing blood from reaching the heart tissues.

Prevention

Are there preventive measures to keep heart disease away? Physical exercise goes a long way in the prevention of cardiac diseases. However, people aged 35 years and older are better off exercising in the evening instead of in the morning. This is because most heart attacks have occurred in the early morning hours. Research has disclosed that blood tends to clot easier in the morning hours, approximately between 4 a.m. and 9 a.m., which is caused by low fibrinolitic action.

Before taking up exercising, it is recommended to take a treadmill test first at a cardiac unit.

A healthy diet of reduced fatty foods could decrease people's chances of ending up with clogged arteries. Limit intake of carbohydrates like rice, bread and noodles. Eat more high fiber foods like cereals and seaweed.

For those who already suffer from heart disease, heavy exercise would not be commendable. Regular medication under the supervision of an expert is recommended.

Hypertension patients should not exercise before their blood pressure is under control.

Diabetics with blood sugar readings in excess of 140 mg after a two-hourly meal should regularly monitor their blood sugar levels.

Blood cholesterol and triglyceride levels should be regularly monitored in a heart disease prevention plan, except for those who are aged 70 or over.

Smokers should check this habit right away.

Last but not least, pray to lessen stress. You would be surprised to find what praying can do to calm down a stressful mind. Be grateful for the daily enjoyments God is bestowing upon you.

What to do in case of a heart attack? In case of an acute myocardial infarct, the patient should be kept very still. Movements would only widen the extent of the infarct, which could lead in turn to heart failure and cardiac arrest.

In case of a heart attack, the patient should be taken to a hospital and enter the Intensive Care Unit (ICU).

Myocard infarct patients who are not immediately treated in an intensive care unit would have their life expectancy reduced by as much as 85 percent. The mortality rate decreases to 42 percent when such a patient is entered into an ICU.

The writer is a cardiologist attached to several major hospitals and a modern health clinic in the heart of Jakarta.