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Coronary Heart Disease
by Ibrahim B. Syed,
Ph. D.
The Qur’an teaches Muslims to exercise self-restraint and lead moderate life styles. The Qur’an says:
Surely He does not love the extravagant.
…Qur’an 7: 31 And make not your own hands contribute to your destruction. Qur’an 2: 195
Nor kill or destroy yourselves: for verily Allah hath been to you most Merciful. Qur’an 4:29
“Nor be hurted or injure others.” — Hadith
Coronary Heart Disease (CHD) or heart attack in common language is the number one killer in the United States. Americans are becoming aware of this and attempting to live a healthier life and fighting CHD with diet, exercise, new drugs and expanded surgical options. It is the conclusion of major studies which state that what was doctor’s intuition all these years has become a scientific fact. The belief that CHD can be prevented by diet, smoking cessation and controlling blood pressure is now a scientific fact. A study of 12,000 men for a period of 10 years showed that men who stopped smoking, lost weight, lowered their blood pressure and ate a diet which lowered cholesterol had 24 percent fewer heart attacks than those who received only regular medical checkup. Another study involving 37,000 people located in different countries having high blood pressure, showed that if one reduced the blood pressure by 5 to 6 points then one’s risk of CHD reduced by 20 to 25 percent and one’s risk of stroke diminished by 30 to 40 percent. These findings are important for older people as CHD is mostly a disease of the older people because Dr. William Castellie, Director of the Framingham, Massachusetts Heart Study says “ A 70 year old man’s chances of having a heart attack within the next two years are twice that of a 50 year old man’s.” The experts say that by following the list of steps one can help prevent the heart disease.
HYPERTENSION Hypertension or high blood pressure is symptom less or it is often called the silent killer. It is the biggest risk factor of all. It affects 40 million Americans. The point at which blood pressure is too high is a matter of much debate. Hypertension is usually defined as a diastolic pressure (the lower of the two numbers, taken between contractions of the heart muscle) of more than 90 millimeters of mercury. Some authorities define 85-90 mm as a “high normal” range that warrants monitoring and possible treatment. The origin of hypertension is not clear. It is marked by a gradual narrowing and loss of flexibility in the arteries and arterioles-the hair-thin arteries that feed the tissues-causing the heart to work harder to deliver the same amount of blood. Hypertension is a major risk factor not only for CHD but also for stroke (reduced blood flow to the brain), blood vessel disorders, and other circulatory problems. If one need to get one’s blood pressure down, one should take the first line of defense and that is to achieve normal weight, cut back on salt and start exercising. If these methods don’t work, then there are many new drugs on the market that will lower the blood pressure with far fewer side effects than their predecessors. The only problem is they are expensive and patients may not take them as prescribed.
SMOKING It is generally accepted that cigarettes are the leading factor in lung diseases such as cancer and emphysema. But the habit is implicated in three times as many CHD deaths as lung cancer deaths, and thus ranks close to hypertension as the leading risk factor. Cigarette smoke consists of hundreds of chemical compounds, many of which directly affect the heart. By binding to the blood’s hemoglobin, for example, carbon monoxide in the smoke reduces the amount of oxygen that reaches the myocardium and other tissues. Sensitive lung tissues produce large amounts of chemicals (catecholamines) that increase the heart rate and vascular pressure. And although the exact reason is unknown, smokers generally have 15 % higher levels of blood cholesterol than nonsmokers- differences that cannot be explained by diet, exercise, or other variables. Cardiologists say that for those in the 55-65 age group, cessation of smoking is the number one step in preventing heart disease. The fact is that health benefits can be realized by stopping smoking at any age.
CHOLESTEROL There is a very strong link between dietary fats and heart disease. For example CHD incidence in rural Japan-an area with very low average blood cholesterol levels- is among the lowest in the world. In Japanese who migrate to Western countries and adopt Western diets, however, cholesterol levels gradually rise to match the country’s average; so do the number of heart attacks. Recent studies have shown powerful evidence linking cholesterol and heart attack. Almost everyone agrees that Americans’ cholesterol levels are far too high than the expected normal of about 200 milligrams per deciliter. In Japan the figure is approximately 160. 200 is the level now recommended by the American Heart Association. The National Cholesterol Education Project considers cholesterol below 200 milliliters per deciliter to be ideal, above 240 to be dangerous and between 200 and 240 to be border line high. Cholesterol level of 300 is probably not as worrisome for a 70 year old as it would be for a 50 year old.
EXERCISE Regular exercise makes one feel better by toning body muscles and expanding lung capacity. Several studies relate vigorous, regular exercise to high levels of high density lipoproteins (HDLs) in the blood (these are healthy ones), and low levels of low-density lipoproteins (LDLs-the bad ones). The HDLs seem to protect the arteries by transporting cholesterol to the liver for breakdown and disposal. About half an hour of brisk walking three or four times a week has been shown to reduce death rates by as much as 30 percent. If one performs about one hour of vigorous exercise four or five times a week then one can increase the body’s production of a natural “clot buster” chemically known as tPA (tissue plasminogen activator). This is an expensive drug which is administered to a patient who has suffered an heart attack or stroke by blood clot. One should be physically active-walking around at least an hour a day, climbing stairs, getting about, working in the garden, bicycling, swimming or working in the physical fitness rooms. Even aerobic dancing is considered a good physical exercise. The bottom line is to get one’s heart rate up and one has to sweat.
DIET One should eat a heart-smart diet which is low in fat particularly saturated animal fat. One should eat plenty of fresh fruits and vegetables, pastas, cereals, breads and low-fat dairy products (skim milk, yogurt, skim ricotta cheese and specially formulated processed cheese). Eating fatty, salty convenient foods will lead to artery-clogging. By eating low-fat diet one can lose weight. Overweight people suffer three times more CHD, heart attack or angina than ideal weight people. By reducing one’s weight one also reduces hypertension and high cholesterol. Obesity is clearly hazardous to the heart. Overweight subjects can develop nonfatal heart attack, angina (chest pain due to an insufficient blood supply to the heart), congestive heart failure, and stroke.
ASPIRIN The antiplatelet effects of ordinary aspirin are well known, and it is widely prescribed for postoperative heart patients. (Platelets are blood components that play an important part in blood clotting.) Many physicians routinely take at least one aspirin a day, reasoning that the dosage cannot hurt and could do some good. Now this is found to be true. There are some negative long term effects of aspirin which include gastritis (inflammation of the stomach tissues) and possible interference with natural prostaglandins-chemicals that help maintain blood vessel integrity.
STRESS Several years ago cardiology researchers identified two types of personalities: the hard-driving, CHD-prone “type A” and the more laid back “type B.” Researchers have since verified the popular theory connecting heart disease with the emotional and physical stress associated with type A behavior. In one study 70 per cent of hypertensive men fitted the type A definition. They were also found to have abnormally high levels of cholesterol and catecholamines. After treatment with a class of drugs called beta-blockers, many of the type A’s became more relaxed, with a corresponding blood pressure decline. While it is hard to draw a direct connection between stress and heart disease, the conventional wisdom of physicians is that people who are anxious, driven and aggressive are more likely than placid people to develop CHD. Those who slow down and have time to appreciate nature and family and friends will be helping themselves to live a longer and lovelier life. Dr. Dean Ornish of California’s Preventive Medicine Research Institute concluded that relaxation of one hour a day, along with regular physical exercise and diet free from animal fat actually helped reverse early signs of heart disease. Dr. Ornish says “ We feel life-style changes, like meditation and prayers, are as important as dietary one.” For Muslims Dhikr (Zikr), Salaat five times a day, recitation of the Noble Qur’an, fasting during Ramadan, Zakah and if possible Hajj performance plus ‘Aamilu Saalihaati (performing good deeds) should eliminate the stress.
GENETICS How important is heredity in heart disease? Most patients have a distinct family history of the disease. Just as often, persons with little or no such history seem to be virtually immune, despite the presence of one or more of the major risk factors. Dr. Stephen Scheidt, Professor of clinical medicine at the New York Hospital-Cornell Medical Center says “Certainly heredity is a powerful factor in heart disease. But people often says they ‘inherit’ heart disease, when in fact they inherit unhealthy eating habits or an early addiction to cigarettes. We cannot change our genes, but we can certainly change the way in which the genes affect our behavior and lifestyle.” |
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