Healthy Habits for a Happy Heart: Preventing Cardiovascular Disease

Namaste and good afternoon. Greetings from all of us at Apollo Hospitals. Welcome to our corporate health series. This is Dr. Sreenidhi Chidambaram here and I hope you're all staying safe and keeping great health. As you know we have been presenting a lot of these sessions on key topics related to your health because we believe that knowledge is key to early recognition of diseases and you know that early diagnosis leads to early treatment and better chances of complete recovery and when the information comes from top experts in various medical specialty details in this era of social media myths and misinformation. Our habits and lifestyle make us what we are. While a lifetime of healthy habits like a balanced diet, exercise and good sleep will enhance your health, the reverse is also true. If you abuse your body then you pay the price at the end. Many lifestyle factors can contribute to the development of heart conditions especially coronary artery disease which is plaque buildup in the arteries, stroke, heart attack and they could be anything. It could be obesity, smoking, physical inactivity, a bad diet, lack of sleep, substance abuse. So living a healthy lifestyle includes addressing lifestyle issues, mental health issues, stress management and it also involves understanding your risk factors, your genetics, making healthy choices always to enlighten us on how to keep your heart healthy and happy and how to follow the most healthy lifestyle for a healthy heart. To enlighten us on the most healthy habits for a happy heart, I'm delighted to welcome Dr. A. Srinivas Kumar, Distinguished Cardiologist at Apollo Hospitals, Jubilee Dents, Hyderabad. With over 25 years of experience in cardiology, his academic ground includes MBBS, MD, DM and FACC, underlining his extensive expertise in cardiology. As CEO and Founder Director of FACTS, Fraternity of Advanced Cardiovascular Techniques and Solutions, Dr. Kumar demonstrates leadership in advancing cardiac care. He also chairs FACTS professional services and is the founding course director of Advanced Cardiovascular Solutions, India, ACVS, TCT, India. Dr. Kumar specializes in TAVI TAVR, complex coronary interventions and his clinical experience is extensive, having performed over 15,000 angioplasties and more than 100 TAVI TAVRs. A member of the Indian Medical Association, Dr. Kumar has also served as Chairman of the Cardiology Society of India and today we are delighted to welcome him and we look forward to his valuable insights on healthy habits for a happy heart, focusing on preventing cardiovascular disease in high pressure environments. I'm sure his unique perspective, combining years of clinical experience make him the ideal guide for you, for your journey towards better heart health. Thank you so much Dr. Kumar for joining us today and we will begin by asking your valuable opinion about what are the heart diseases that can be precipitated by specifically poor lifestyle choices. Well, good afternoon everybody. Thank you Dr. Srinidhi Madam for the kind words of introduction and I'm happy to be part of this webinar to enlighten our corporate clients. Basically, a non-communicable disease is what we call, like previously India was known for infectious diseases but as we have grown and India has become no more, it started developing country, it's developed country, our disease patterns also simulate what is there in West more now. So, what we commonly see is no more infections but what we see more commonly is heart attacks, strokes, paralysis, which are actually called as non-communicable diseases. That means they don't come with infection spreading from one person to other. They basically come from the risk factors which we'll discuss further from inbuilt problems in the person and that keeps on increasing with age. So, these non-communicable diseases which are actually like heart disease, we call it as coronary heart disease and the brain, we call it as stroke or cardiovascular accidents and for kidney, we call it as chronic kidney disease and for the limbs, we call it as peripheral arterial disease and then probably if you have extend further, the cancer type of problems would also be coming as a non-communicable. All these non-communicable diseases at once, which increased by not taking care of your lifestyle, by spoiling your health, by not becoming, not being careful about the water, the healthy lifestyles, which we'll discuss further. So, it is not the infections but these diseases which increase by bad healthy habits. So, be it be heart attack, be it be paralysis, be it be heart failure, be it be kidney failure, be it be limb weakness and sometimes going to the amputation of limbs and all that, these all happens because of this bad lifestyle. So, now if you have to see what is bad lifestyle, what is good lifestyle, I think we'll discuss further but these are bad things which people have to know. India, the NCCDs are the commonest cause of death. It is no more the infections, no more the traffic accidents. It is actually heart diseases and strokes are the leading cause of death in our country already and about one-third population, if you analyze the mortality patterns, one-third of them die because of these diseases and the second thing what is common causes are not even near to it actually, it is about 10% plus that happens with road traffic accidents and then poisoning, snake bites, things like that. The third one is what is the probably with the infections like the respiratory tract infection and other things which was very common before. So, India has already grown out of the infectious diseases. I am happy to say that but at the same time, we are facing this challenge of non-covenant vertices. So, as you said lifestyle holds the key to many of these conditions. So, let's begin by talking about what a healthy lifestyle is. I think we will first ask you about one of the key components of lifestyle management which is what we eat. So, what role does food play in particularly heart health? So, actually any person, the good habits are starting with the like probably when you get up from what you sleep and what activities you do that is sort of exercise, then what we eat later, then how happy you are or how stressful you are and then probably then if at all unfortunately, if you have what is developing called risk factors, how careful are about controlling the risk factors. That is what is the general everything which comes under the risk factor categories. So, if you have to see the sleep is the one which is actually very important and also if you are careless about sleep, don't sleep properly, if you have very late night sleep habits and don't sleep, the entire body gets into trouble. As you understand that during the sleep, the entire cells of the body gets good reparative process and lot of wear and tear trauma which happens in day to day gets healed. So, appropriate sleep at least for five hours in a day, five hours per day, maybe in the night time and then maximum up to seven to eight hours depending upon the age of the person is important because if you don't, all of you must have experienced lack of sleep. You feel very often, you feel giddy, you don't feel well at all. So, it is very important to have appropriate sleep but unfortunately, many people due to stress can't sleep properly or even if they are sleeping, their sleep gets disturbed because of snoring and obstructive sleep apnea, obesity and other things like that which is not effectively relieving the stress in a person. So, proper sleep is important. Number two, as Madam said, once you get up, what is the activity you are doing? Well, do exercise, good habits and all that also play important role. So, life is equal to motion, exercise and how much activity a person does keeps you fit. Actually, all the parts of the body need to be kept in some sort of activity. If as you understand, any machinery or any engine, if it is not put into use, it will get jammed and get spoilt. Similarly, the human body, though God has created it with a lot of specificities and it's very difficult to produce a similar machine like a robot, but still it needs to be taken care of. So, if you have to say what is the most important, easiest thing is probably walking. Probably many of us can do it easily and if you can mark up, do a brisk walking for 30 minutes or more per day, five days in a week at least, that is usually a good habit and good exercise. If you want to jog, you can jog. If you want to swim, you can swim. If you want to do cycling, it's fine. But generally, the weightlifting which is very popular is not advisable for prevention because the body tells you, you can't again do weightlifting and try to become overnight Luthic Roshan, things like that. But you have to be monitoring your body. Body tells you how much stress and activity you can do it. According to it, you do it. But by and large, as a broad rule, 30 minutes of exercise per day, five days in a week at least. People do it for one or two days and expect the benefit, it doesn't happen. But again, the exercise needs to be having warm up and then gradually calm down again. But in the fast lifestyle, you won't actually want to finish off fast and then go, then that leads to trouble sometimes. So, the second important aspect is what is that exercise. Actually, what I mentioned, things you can follow. The third as Madam was highlighting, the most important again, which is causative for so many problems is what you eat, the dietary habits. So, whatever I say that you don't eat that, this, that, too much restrictions, I don't want to have it for all the audience. But anything you do it, you do it in moderation. There is a Sanskrit saying that, anything you eat in again, tons and tons of olive oil, the people say it is good, but you put tons and tons of it, it becomes bad. Sugars are bad, sweets are bad. Then probably anything in little moderation is fine. But generally, vegetarian diet is preferred. Have plenty of vegetables, salads and eat them, that's okay. But again, fruits and chocolates probably, these are okay health wise, but you have to take care of the calorie intake, which you are doing. Apart from it, the other high sugar sweets and then probably high saturated fats, these are not good. And the people ask about non-vegetarians, fish is probably okay. But if you try to avoid taking mutton, red meat especially, and chicken, somebody wants to eat, maybe fat can be removed, I take it in moderation. So this is something about diet. But in general, vegetarianism has become popular. And again, keep a note of your calories and don't eat just before you sleep, give some gap, and then probably that will help you not to make your body into more of excess fats and sweets. After the food intake, then the other important thing is, how comfortable are you with life? How happy are you with your life? I don't say don't become stressed up, that's a negative connotation, but being happy is important. If you're happy, then probably your heart will be healthy and you'll be happy. But happiness should not be by indulging in wrong habits like alcohol and smoking, but by helping others and being happy, it goes a long way. Yoga, meditation also helps you to keep yourself calm and happy. So this is another very important aspect, especially young people who get into trouble, the stress of smoking, all that is leading to trouble. And lastly, the fifth factor I would say is, generally, if you unfortunately develop risk factors like diabetes, blood pressure, high cholesterol, then probably go to a doctor and take immediate treatment. These five habits, what important things, what I mentioned is proper sleep, appropriate exercise, then probably good dietary habits, being stress-free and being happy, and then lastly, taking care of risk factors. This is called Panchasutra for prevention of cardiovascular disease. And if somebody is able to do all this, then you can decrease the risk of getting into trouble by not 1-2%, but studies have shown their prevention capacity is up to 81%. This is actually studied scientifically and proven. But many people, unfortunately, how many of the population is following that, all these five, only 1-2% follow this. It's unfortunate. That's why this sort of program will help you to educate more, and probably more of you can practice this and stay yourself healthy and happy, and avoid the development of this epidemic of cardiovascular disease, which is happening in our country, what we also call as NCCDs. So these are the message, opening statements I would like to give, and follow these and be healthy. Thank you, doctor. So I think the strongest message here is that consistency, and you have to keep doing this day in and day out. So now we come to some specific corporate or workforce-related issues that they may have in following these things consistently. So the first thing is given people's long hours and sedentary nature of many of our corporate jobs. So we said about physical activity, but most of the time, as you yourself said, that people don't, they usually say that they are too busy, or they have to leave early, or come home late. So what practical tips would you give to them to make sure that they're moving enough? Actually, it's very important for all of us to take some time out for us ourselves to be healthy. And you say you're busy, but busy by doing what? If your health gets spoiled, then you know the importance of it. So all of you should take some time out, at least 30 minutes a day, I said. And God is kind enough for you to take two days holidays too. But still, if you work the other way, it doesn't work. So at least 30 minutes of activity. Then people who have the habit of long sitting desk jobs. Actually, Apollo also did this Apollo life score calculations. We all had only Framingham score, but Apollo, through the help of Microsoft, others calculated the data from all the healthy volunteers, which come along with the pro health concept, which Apollo strongly follows, and analyze the data with lots of people. What came out is another important risk factor is a prolonged sitting, inactivity, sedentary lifestyle, is bound to be another very important useful factor in development of disease. So for all those professionals, doctors too, who continuously sit and practice, or software professionals who continuously sit, my advice is at least, you should keep walking in between, at least once in two hours, take a break, and then walk for 10-15 minutes. But as in interventional cardiology, we are fortunate to go to cath lab, do procedures, then we can come back and see patients. But some doctors who continuously sit and do only desk works, so probably they should take some time out after every two hours to keep yourself fit and active, and move your all parts and do a walking in between. And don't again, continuously stress yourself without any proper intake or proper lack of sleep, that will again create trouble. And probably, I was told that Google and other companies mix these healthy activities along with the professional work, that's very important. If you analyze, all of us have spent more time in our office work than at home. So maintaining healthy lifestyles, good habits is important. That's how this concept of how to be healthy in your work environment has come, and most of the offices now create some spaces for you to do some activity, if you can do some treadmill exercise and all that, along with maintaining some healthy food and work spaces. So what I would like to say is, don't pile up your work, don't stress yourself too much. And regarding the physical activity, try to be active and have some motion to each part of the joint. And then probably after two hours, definitely get up and walk for some time in between. If somebody is not able, also will help you partly to stay healthy and happy. So some sort of activity, if the walking space is not there, then probably moving, sitting, any sort of activity which is convenient to you, you can do it. But in some spaces where cycling, gyming, or some sort of swimming is possible, you can actually take up any of the activity, but try to follow some patterns of exercise. Don't suddenly exercise and suddenly relax, follow like warming up and then gradually cooling down, if you're doing heavy exercises. Otherwise in office space, at least be comfortable, don't stress up, then don't get indulged in smoking, all the bad habits. And for every two hours of continuous eating, you should take some break and walk. These are some of the broad tips which I could give at the workspace. And then probably heavy binge eating during work and canteens is also not good. So you have to eat moderately. Actually, even if you eat one good meal a day with some light and spread out, means breakfast is also okay. But we generally indulge in overeating, which is not very good. And that's how it becomes obese. Once you become overweight, then you can't do activities much. That's also important to maintain activity, good health, good health, and probably control your weight also. What about other, like people often turn to a lot of stimulants in order to work better. So it might be not only just smoking, but then constantly having caffeine, coffee, tea, and also like maybe some people even have these energy drinks. So what is the impact of all these things on the heart? Actually, anything in moderation, I said is okay. But the same thing, if it's done too much, becomes bad. Same thing with the coffee, tea, caffeine, and tea, basically one or two cups a day is fine. In fact, the tea, which is supposed to be having some antioxidants, and sometimes coffee is also okay. The same thing is done 10 times, 20 times a day, then it becomes like toxic, where it becomes not only calorie point of view, but you start getting irritations, you start getting GI, side effects, and things like that. So one or two cups of coffee or tea is okay. And then regarding the energy drinks again, you want to do something which is very fast, and you want to do something where you don't want to work too much to get its benefit. That never happens in life, actually. So that sort of energy drinks, which suddenly give you energy, could be stimulants, but then continuously taking things natural means, if you want to take milk, remove that fat and take it. And if you want to take some fruit juices, again, keep a consciousness of your calories, because again, if you drink tons and tons of fruit juices, it's bad. Probably you can take some direct fruits with fibers that are good. And then regarding the intake of some, some people have peculiar habits of taking some peculiar pills, which are supposed to be good and healthy, that again, are not happy to be encouraged. And anything which is closer to nature is always welcome, but anything going away from nature, it doesn't give you good results. In fact, it could be leading to trouble. Some sort of these pills which people take are found to be also having damage effect on kidneys and also decrease your blood counts and lead to various bone marrow problems and other things. So keep a watch on what you're taking and appropriately, what broad advice is, be closer to nature in what you're taking. So that will help you to remain We know that when it comes to heart health, early detection is very important, knowing your risk factors is important. So what advice would you like to give our audience regarding screening themselves for not only their heart health, but their overall health status? Actually, it's very important. Many of the people think that once you go for screening, there's suddenly something new comes up and then you become deceased. That's not true. The latest concept is don't come to hospitals like Apollo only when you become sick. You have to maintain your health. Hospitals are your friends. Doctors are friends to advise you to remain healthy and also guide you to how to remain healthy. These Apollo hospitals, Chairman Pratap Dindigar and others have started with this passion, the bro health concept. The idea is to keep you fit and healthy. So this is very important to undergo appropriate checks if you already have any disease. If you ask me what is the broader age at which we can start this, it's basically if you have a family history of heart disease, the earlier you do, the better it is. And probably at 30 years of age, it will be fine. But if you don't have it, then probably the disease frequency increases much more from 40 years of age. So anybody who is that age should get checked out once at least. And once you have done a heart health check or a general overall body check, the other important beauty in the bro health concept of Apollo is it is not yet over. The appropriate counsellors actually keep a watch on you and probably contact you every year. That works for about three years. Once you follow those for three years, the idea is then probably you will continue to do it. If all the tests come normal, then probably once in three years or so you can go. But if any of the factors come abnormal, then depending upon what abnormality the person has, how much it has already produced a problem in the body, then you have to take expert consent advice and then follow it accordingly. By and large, then it is always good to undergo some sort of health checks, be it the sugar check, be it the cholesterol check, not public, not to get confused. And then Apollo made it all together as for the bro health concept and what is all required both in men and women, though slightly different, everything is checked in this concept. So if you are looking more towards the elderly population or more towards the women, there are specific packages, health checks designed. But one thing people generally everything gets criticized. Now people say that hospitals will make money by these health checks and all is useless. I would like to mention to all the listeners, it is not so. The regular tests, which cost about 10,000 plus are all burdened into 3,000, 4,000 rupees in these health checks and done at a much, much subsidized price with the idea of preventing the disease and not making you succumb to disease already. So if you detect it early before it strikes, there's nothing like it. If suppose somebody suffers heart attack, then heart gets damaged is a problem. The idea of these packages is to detect the blast early and probably when you find it, you should start taking preventive treatment so that you will not go into over Finally, let me ask you in the workplace, what should people be aware of? What do you think are the red flags? What would signal an immediate medical consultation or going to the emergency? In other words, to say what are the early signs or warning signals of heart disease, that's what I think Menem is trying to ask. What I would like to mention is when you were resting, if you understand this concept, you'll already know about this. Whenever you're sitting and resting, heart beats at about 72 per minute. That's what people know. But anywhere in between 60 to 75 already is okay. But when the heart beats faster, then the heart needs more oxygen, more blood. In people who do not have blocks, the blood supply increases. When the heart contracts more, the blood supply increases. But in people who develop disease, whenever the heart contracts more, then the blood supply will not increase because of the development of blocks. That's how they get into discomfort. Just discomfort is called angina. And when they take rest again, it decreases. So any complaint which happens at exertion, when you're climbing up, walking briskly in the office and things like that, you should be more careful to rule out any associated heart disease. Sometimes it may not be just pain. It could be like only blood pressure, especially in females. It comes as an angina equivalent, what we call it. That could be important. So any exertional breathlessness or exertional chest pain happening becomes very important to rule out heart disease or cardiac disease. But sometimes people complain, especially young females, of localized pricking pain. One particular point, not engaging with exertion, continuously staying, all that is unlikely to be cardiac. But any pain, any discomfort, whether breathlessness, chest pain, happening in exertion, especially when you're climbing upstairs, going, running, your posture is happening, you have to make sure that you're free from disease. Then we also ask you this, for people who already have heart disease and who are working, what would your advice be to them? Would it be something that's going to impact their career? What should they do? Should they take any extra effort? No, one more good thing is, though disease is becoming more common, but what I'd like to reassure everybody is, even if you have disease, you can still lead a normal life, provided you come on time to take treatment. If you suffer heart attack and then come, then heart pumping gets affected. That's where you land in trouble. But if you have taken treatment and your heart pumping is normal, and you come to a hospital like Apollo where angioplasty is done on time, heart is not damaged, then all activities which you were doing before, you can continue to do it. That's the beauty of taking treatment on time. That's why we always highlight this aspect, despite the following prevention, if you get chest discomfort, please go on to reach hospital, nearest hospital in time. The first one hour is called golden hour, because if you go there, treatment is given, heart is normal, and you can lead a normal life like before. Of course, following the preventive measures and taking some minimal dietary precautions and tablets, which doctor advises. In other words to say, if your pumping is normal, then you can do all the activities like yoga, meditation, walking, cycling, whatever I told. Whatever a person of your age can do, you can still be able to do it. But the problem comes when you don't go to hospital on time. When your heart suffers a heart attack and your pumping becomes less, that's where the trouble is. The cardiac rehabilitation programs, which Apollo has and other things are helpful in analyzing and identifying each person, how much activity he can do. Depending upon the pumping function of the heart, we counsel the patients, and initially we'll help them in increasing their exercise capacities. We call it a cardiac rehabilitation program post-MI, and then according to it, we can guide. But one thing I can assure you is, gradually following all these exercises, measures, you would actually try to get these people as close to the lifespan as possible. So there's nothing to worry. At the same time, it has to be practiced and followed. If you do it on one day, again, it's not sufficient. You have to do it at least five days in a week. If God has given you two days holidays, in the nature of God, be happy about it. But if you work for two days, one or two days, the benefits won't come. So take this and that. Another important feature which somebody should be having, avoiding getting into stress due to lack of sleep and probably doing wrong things in life, all these negative things should be avoided. And if you're happy and follow these dietary precautions, being exercised and take those minimal tablets, that probably will be made better. But on the other hand, if the heart pumping is less, then you do undue exertion, you become worthless. So that has to be individualized, and the counseling needs to be taken as per somebody's disease, which they have. But if it is not done on time, still all the things which we mentioned can go forward, even in chronic. Thank you so much Dr. Srinivas Kumar for this wonderful discussion and I hope our dear viewers have been motivated to maintain their heart health. The message is simple. Eat healthy, get active, keep moving, stay at a healthy weight, quit smoking, keep everything in moderation, manage stress, get a good sleep and get screened regularly. This will surely keep your heart happy forever. Till we meet again, stay safe, stay healthy. Thank you and God Bless.