CMAAO Coronavirus Facts and Myth Buster: COVID Preexisting Heart Disease

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1054: Meta-analysis evaluates impact of cardiovascular risk profile on COVID-19 outcome

Patients with COVID-19 with cardiovascular comorbidities or risk factors have higher odds of developing cardiovascular complications while hospitalized for COVID-19 and have a higher mortality risk, suggests a study published in PLOS One.
Investigators from Italy assessed data from 21 published observational studies on 77,317 patients hospitalized for COVID-19 in Asia, Europe, and the United States.
Mean age was 48.4±18.5 and 40.41% of the hospitalized patients were females.
About 12.89% had cardiovascular comorbidities, 36.08% had hypertension, and 19.45% had diabetes.
Nearly 10.74% of the patients were smokers, while 33.78% had obesity.
Coronary artery disease and heart failure were reported in 11.67% and 9.35% of patients, respectively, at presentation.
Around 5.30% had a history of chronic obstructive pulmonary disease.
Cardiovascular complications were noted during hospital stay among 14.09% of patients. The most common were arrhythmias (18.40%) and myocardial injury (10.34%).
Pre-existing cardiovascular comorbidities or risk factors significantly predicted cardiovascular complications (P = .019).
Age (P < .001), pre-existing cardiovascular comorbidities or risk factors (P < .001) and the development of cardiovascular complications during COVID-19 period (P = .038) were found to be the significant predictors of death. [PLOS One]
Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

Most diabetics unaware of their condition: HCFI

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People with risk factors such as a family history of diabetes must take precautions at an early age

New Delhi, 21st May 2019: A large-scale population-based study has found that only half the Indian adults in the most productive age group (15-49 years) are aware that they suffer from diabetes. Only one-fourth of those diagnosed and treated have their blood sugar under control. In light of the poor level of awareness, treatment and control, the need of the hour is to focus on primary prevention and screening efforts. This will help reduce the burden and impact of diabetes in India.

According to the WHO, there are about 62 million people living with diabetes in India, a number that is projected to increase to 70 million by 2025. The ‘lifestyle disease’ is a massive public health obstacle for the second most populated country in the world. Diabetes can increase the risk of life-threatening complications including kidney damage and heart disease.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “A high-calorie diet rich in processed and junk food, obesity, and inactivity are some of the reasons for the increased number of younger people with diabetes in the country. Not getting checked in a timely manner and not following the doctor’s protocol further complicates matters for them, putting them at a risk of acquiring comorbid conditions at a relatively younger age. There is also a belief that because young people with Type 2 diabetes do not need insulin, it is not as sinister as it seems. However, this is a false notion. This condition requires immediate treatment and management.”

The symptoms of Type 2 diabetes develop slowly, over time. Some of them include increased thirst and hunger, frequent urination, weight loss, fatigue, blurred vision, slow healing of infections and wounds, and skin darkening in certain areas.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “Small and gradual changes can be made in the family so that no one is left out. This will also be encouraging for youngsters with adults setting examples for a healthy lifestyle. Such changes can help a youngster lose weight (if that is the issue) or help them make better eating choices.”

Our ancient rituals and traditions have given us a way out of this conundrum. They advocate the principles of ‘variety’ and ‘moderation’, that is, ieat a variety of foods, and in moderation.

They recommend including all seven colors (red, orange, yellow, green, blue/purple, white) and six tastes (sweet, sour, salty, bitter, pungent, and astringent) for a balanced diet.

HCFI’s Formula of 80 to live up to the age of 80 without lifestyle disorders.

  • Keep lower BP, LDL ‘bad’ cholesterol levels, resting heart rate, fasting sugar and abdominal girth levels all less than 80.
  • Walk 80 minutes a day, brisk walk for 80 min a week with a speed of 80 steps (at least) per minute
  • Eat less and not more than 80 gm or ml of caloric food each meal.
  • Observe cereal fast 80 days in a year.
  • Do not smoke or be ready to shell out Rs. 80,000/- for treatment.
  • Do not drink alcohol; if you do, do not consume more than 80 ml per day for men (50% for women) or 80 grams per week. Ten grams of alcohol is present in 30 ml or 1 oz of 80 proof liquor.
  • If you are a heart patient, consider 80 mg aspirin and 80 mg atorvastatin a day.
  • Keep kidney and lung functions more than 80%.
  • Avoid exposure to PM 2.5 and PM 10 levels < 90 mcg/m3.
  • Avoid exposure to >80 dB of noise.
  • Take vitamin D through sunlight 80 days in a year.
  • Do 80 cycles of pranayama (parasympathetic breathing) in a day with a speed of 4 per minute.
  • Spend 80 minutes with yourself every day (relaxation, meditation, helping others etc.).

High cholesterol can be detrimental to the heart and lead to stroke over time

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People with a family history or heart disease must take precautions early

New Delhi, 25 April 2019: Researchers have unveiled how bad cholesterol enters the artery which leads to narrowing of the blood formation due to the formation of plaque. The narrow blood vessels cause heart attack and strokes, according to a study. In the early stages of atherosclerosis, LDL that has entered the artery wall attracts and is engulfed by important immune system cells called macrophages. LDL-laden macrophages become foam cells promoting inflammation and leading to formation of atherosclerotic plaques.

The plaques narrow the artery and can become unstable. Plaques that rupture can activate blood clotting and block blood flow to the brain or heart, resulting in a stroke or heart attack.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “After a certain point, to much cholesterol starts to build up in the arteries causing them to harden – a condition known as atherosclerosis. This is also the starting point for some heart and blood flow problems. Such a buildup can narrow the arteries and make it harder for blood to flow through them. Further, it can also lead to dangerous blood clots and inflammation causing heart attacks and strokes. Familial hypercholesterolemia (FH) is a genetic disorder, characterized by high cholesterol, specifically very high LDL ‘bad cholesterol’ levels, and premature heart disease. Patients may develop premature cardiovascular disease at the age of 30 to 40.”

Cholesterol levels in the body are be measured by blood testing. In addition to cholesterol and its different types, triglyceride levels can also be included in a lipid (fat) profile.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “The total cholesterol can vary by 4% to 11% within an individual due to multiple factors including stress, minor illness and posture. Values may also vary between different laboratories, with data suggesting that a single measurement of serum cholesterol can vary as much as 14 percent. Therefore, in an individual with “true” serum cholesterol concentration of 200 mg/dL the range of expected values is 172 to 228 mg/dL.”

Some tips from HCFI

  • It is important to eat a heart-healthy and cholesterol-lowering diet.
  • Exercising for about 30 minutes a day can raise HDL levels (the good cholesterol). Those with any other underlying medical conditions should check with their health-care providers about what kind of exercise they should undertake.
  • Aerobic exercise can help in improving insulin sensitivity, HDL, and triglyceride levels and may thus reduce the risk of heart disease.
  • Smoking increases HDL levels and therefore, you should quit immediately.
  • Losing even a little bit of weight can help in managing cholesterol levels.

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