ABCDE Of Heart Attack Prevention — Dr Yap Jun Fai, Prof Dr Moy Foong Ming & Dr Lim Yin Cheng

About 90 per cent of first heart attacks may be attributed to nine modifiable lifestyle factors: smoking, alcohol intake, diet, exercise, obesity, stress, blood sugar, blood pressure, and cholesterol.

Heart disease is one of the leading causes of morbidity and mortality in Malaysia, with heart attack being the major manifestation. Approximately 90 per cent of first heart attacks may be attributed to the following nine modifiable lifestyle factors: smoking, excessive alcohol intake, poor diet, lack of exercise, obesity, stress, high blood sugar, high blood pressure, and high blood cholesterol.

We can take steps to reduce the risk of developing a heart attack. The first step is assessing cardiovascular risks.

In clinics and hospitals, doctors can estimate the 10-year risk of patients having a heart attack and stratify them into low, borderline, intermediate, or high-risk groups.

Treatment can then be tailored accordingly, whether it involves intensifying medications or continuing the current treatment plan.

High blood pressure is the persistent elevation of blood pressure, typically measured at least twice on two separate occasions, with readings above 140/ 90 mmHg.

The higher the blood pressure, the greater the chance of a heart attack. Therefore, it is crucial to monitor blood pressure regularly, as many patients with high blood pressure do not experience any symptoms. In fact, blood pressure should be measured at every chance encounter. 

Excessive bad cholesterol buildup in the main blood vessel walls can reduce the flow of oxygenated blood to the heart muscle. Therefore, it is advisable to screen blood cholesterol levels annually and discuss with medical practitioners for further cholesterol-lowering therapy if the levels are found to be abnormally high.

Various chemicals found in cigarette smoke can thicken the blood and promote the formation of plaque or clots inside blood vessels. Fortunately, smoking cessation can help reverse this process, although it may take many years for the blood vessels to fully recover.

For smokers who are willing to quit, a combination of behavioral interventions and nicotine replacement therapy maximizes the likelihood of cessation success.

Maintaining a healthy diet (with at least five servings of fruits and vegetables daily and appropriate calorie intake) is good for achieving an optimal body weight. For those who are overweight or obese, weight loss is strongly recommended and a healthy body mass index (BMI) between 18.5 and 24.9 kg/m2 should be aimed for.

Additionally, it is widely recognised that adhering to a diet rich in whole grains, seafood, beans, or nuts can offer cardioprotective benefits. For diabetic patients (especially those with uncontrolled blood sugar), it is important to monitor carbohydrate intake and avoid sugar-sweetened beverages.

Aerobic exercise helps build stronger heart muscles. The World Health Organization (WHO) has recommended engaging in weekly exercise of moderate intensity (such as brisk walking, vacuuming, or mopping) for at least 150 minutes, or vigorous intensity (such as hiking, jogging, or playing football) for at least 75 minutes per week.

Nevertheless, those who are not able to reach the recommended levels should be encouraged to attain some level of exercise, as any form of exercise is better than nothing. Furthermore, exercise stimulates the production of endorphins in the brain, which can be effective at reducing stress levels.

In line with Wellness Month (Bulan Malaysia Sihat Sejahtera), recently launched by the Ministry of Health and celebrated annually in September, we should always embrace healthy lifestyles by following the heart-protective ABCDE approach. 

  • A – Assessing risk.
  • B – Blood pressure management.
  • C – Cholesterol lowering/ Cigarette cessation.
  • D – Diet. 
  • E – Exercise.

The views expressed here are solely those of the writers, namely Dr Yap Jun Fai, Professor Dr Moy Foong Ming and Dr Lim Yin Cheng. They are affiliated with the Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya and the Department of Public Health, University Malaya Medical Centre. 

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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