Heart Health

Living Well in Myanmar

Look to lifestyle to protect your heart  

A discussion with your doctor about heart health will typically focus on medical issues such as high blood pressure and cholesterol. Patients and doctors often choose to start medications in order to reduce the risk of heart attack. But although pharmacological therapies are a well-established way to improve coronary health, they are not the best approach to protecting your heart. 

Repeated research studies have taught us that a healthy lifestyle is the optimal way to prevent a heart attack. Making good choices about the food you eat and how much you move your body can be literally lifesaving. Furthermore, using lifestyle as preventative therapy comes without negative side effects. Of course the same can’t be said for medications.

The five healthy behaviours that appear to matter most are:

1)   eating a diet rich in fruits, vegetables, beans, nuts, low-fat dairy and whole grains

2)   exercising multiple times per week

3)   maintaining a good weight and waist circumference

4)   not smoking

5)   drinking alcohol in moderation

A new study released last month in the Journal of the American College of Cardiology further boosts support for lifestyle interventions.The authors observed 20,000 Swedish men from 1997 to 2009, asked them questions about their lifestyle, and then noted how many heart attacks occurred. While only a small percentage of the study participants said they faithfully adhered to all five healthy behaviours, those who did were rewarded with 79 percent lower risk of having a heart attack. This result echoes previous studies with similar findings conducted in men and women in Asia and North America.

The public-health implications of the possibility of preventing the onset of heart attacks to this extent are massive. The challenge is translating what we know to be beneficial into practical interventions that result in individual behaviour change. Programs designed to increase the proportion of adults adhering to these risk-reduction behaviours would drastically reduce the global burden of heart disease.

From a statistical standpoint, a doctor can do a better job of helping patients by focusing on lifestyle rather than lab tests. However, making this shift in how people talk to their physicians is proving difficult. For example, it’s far easier to discuss lowering a specific blood pressure or cholesterol number than it is to quantify how well someone has eaten over the last month.

Going forward administrators and care providers need to creatively think about how to reorganise the health system such that it sets dietary, exercise, smoking and obesity targets that are consistently measured and pursued. Patients should walk into their doctor’s office and ask not only, “How is my blood pressure today?” but also, “How well am I meeting goals for food habits and activity level?”

gelsdorfMD@gmail.com  © Christoph Gelsdorf 2013