On World Heart Day, cardiac surgeon Dr Naresh Trehan, chairman & MD of Medanta, tells Anuja Jaiswal how heart health is less about extreme diets or punishing workouts, and more about knowing risks, staying active, keeping healthy weight and cutting stressThere’s more awareness about heart health today. People are going to gyms, exercising, eating healthy. Yet, heart attacks remain a major cause of death in India. Why?Only a small percentage of people belonging to a certain social circle go to the gym and eat healthy. Even with a healthy lifestyle, a small risk remains owing to genetics. If it runs in your family, you are already at a higher risk. Diabetes, abnormal lipids, environmental factors, diet, pollution and stress add to the risk. High blood pressure, diabetes and lipid levels can be managed. It’s important to know your risks, get checked and make the necessary changes rather than waiting until something goes wrong.Does knowing you are genetically predisposed mean you should live in fear?No. The purpose is exactly the opposite. Today, genome sequencing can identify genes associated with heart disease, and we are moving towards personalised or precision medicine where we look at genome, lifestyle, environment, and biological markers. Together, these can give you a “health horoscope” to help identify risks early. Knowing you’re at high risk will help you take appropriate measures. It is not about making people anxious. Excessive worry and stress are themselves not good for health.Does healthy living mean giving up on all that we enjoy eating?No. Deprivation is not a healthy diet. If you want to eat a pakora or samosa occasionally, you can. The important word is moderation. You don’t have to eat the whole plate; adjust your diet according to your body. If you are overweight, have high blood sugar or cholesterol, you need to be more careful. If your health parameters are good and you exercise regularly, you have more flexibility. You don’t have to deprive yourself, but you don’t have to live in the fast lane either. The middle path is the safest. Use your wisdom to decide what your body needs.What are the basic things people overlook when it comes to protecting heart health?First, exercise. The simplest form is a brisk walk for about 40 minutes, five times a week. Second, keep weight within a healthy range. Third, de-stress every 24 hours. It can be yoga, music or anything else that refreshes your mind. Piled up stress can adversely affect health. And periodically check your BP, blood sugar and lipid levels.
You don’t have to deprive yourself, but don’t have to live in the fast lane either. The middle path is safest. Use your wisdom to decide what your body needs
Dr Naresh Trehan
At what age should people start getting their heart checked?Get a full screening before 25 if you have a strong family history of heart disease, diabetes or a genetic disorder. Otherwise, get it done before 30. If there’s no family history or abnormality in BP or blood sugar, a check-up every couple of years may be sufficient until 40, after which an annual check-up may be appropriate.We hear about young people collapsing suddenly. Is it always owing to blocked arteries?No. Sudden death can also occur because of irregular heartbeats, abnormal heart muscle conditions such as hypertrophic obstructive cardiomyopathy, or valvular disease. Some of these conditions may be present without the person knowing about them. That is why a check-up can be crucial, particularly when there are warning signs or a family history.Why are Indians particularly vulnerable to heart disease?Indians are more prone to heart disease than Western populations and genetics may have an important role to play. Studies among Indian communities in the US and UK have also shown a higher incidence, suggesting the same. If you know you are genetically predisposed, take simple measures: avoid tobacco, eat appropriately, maintain weight, and exercise.What are the warning signs people in their 30s, 40s and 50s should not ignore?In younger people with congenital or structural abnormalities, warning signs can include breathlessness, early exhaustion or exercise tolerance not appropriate for their age. With blocked arteries, a classic symptom is pain or discomfort during physical activity that improves after stopping. One may notice they could earlier walk a kilometre but now have discomfort after 500 metres. Pain is not always in the chest but can present as jaw or back pain. Repeated symptoms with activity should not be ignored.Many dismiss chest discomfort as acidity. Is that dangerous?Yes. Some mistake heart-related symptoms for acidity and go to sleep instead of seeking help. If you have repeated symptoms, it’s better to get checked. A quick ECG and blood test can help assess if there is heart damage. Don’t conceal symptoms from your family, and don’t delay medical attention.What about sitting at a desk or on the phone for eight to 10 hours, but exercising for an hour? Is that enough?You should not sit continuously. Prolonged sitting can make lower body circulation sluggish. Take short breaks. Even a three-minute walk every hour or a five-minute break every 2-3 hours can help counter the effects of prolonged sitting.How does heart health change as we age?Before 30, the body is quite resilient, except in people with diabetes, heart disease in the family, or genetic disorders. Between 30 and 40, metabolic rate starts declining, so you need to match your activity with calorie intake. After 50, hormonal changes become more important. After 60, maintaining muscle mass gets critical. Muscle loss can affect immunity, so adequate protein and exercise become very important. Maintaining brain activity is also crucial as we age.GLP-1 drugs are now being discussed for their potential heart-health benefits. Do you see these medicines benefiting people with heart disease?Theoretically, yes. If you can reduce weight and adipose tissue in the body, it can also help reduce risk factors such as abnormal lipid levels, and potentially protect the heart. But this is a relatively recent development, and when I say theoretically, I mean long-term studies and evidence are still needed to establish what is beneficial or harmful for the heart.Click here to listen to the podcast
