Heart disease affecting a decade younger in Gulf

Eudore R. Chand

DUBAI 7 November 2020: The road to heart health starts with a focus on a well-balanced diet, physical activity and quality sleep from a young age, according to experts at Cleveland Clinic Abu Dhabi, part of Mubadala’s healthcare network.

Dr. Faisal Hasan, a Staff Physician in the Heart and Vascular Institute at Cleveland Clinic Abu Dhabi, says that advanced heart problems and heart attacks are becoming more common in younger people due to poor lifestyle habits.

“In this region, we see patients presenting with severe heart conditions almost a decade earlier than in the West. We see a significant number of patients in their 30s and 40s with cardiovascular problems and in some rare instances even earlier,” says Dr. Hasan.

Cardiovascular disease (CVD) is the leading cause of mortality worldwide and in the UAE. Many major risk factors, such as high blood pressure and cholesterol, smoking, diabetes, obesity and physical inactivity, can be controlled early in life and lower the risk of heart disease at a later stage. A 2019 survey of 1,000 residents in the UAE by Cleveland Clinic Abu Dhabi found that 71 per cent respondents have at least one major risk factor for heart disease.

“Caring for the heart and prevention of disease should start early. By the time people are in their 40s and 50s, it is sometimes too late to reverse a lot of the damage done. Habits of a healthy diet and adequate activity levels need to be instilled earlier,” says Dr. Hasan.

“There is also a very high prevalence of smoking among youngsters here. This is another major contributor for ischemic heart disease, a condition where plaque builds up inside the coronary arteries, obstructing blood flow to the heart muscle and ultimately causing a heart attack.”

Good quality sleep

He adds that another often overlooked risk factor for heart disease is good quality sleep: “Often times I see teenagers out late in the evening at the mall, which means that they are unable to get the right amount of sleep. Irregular and insufficient sleep increases the risk of cardiovascular disease because it disrupts biological processes like glucose metabolism and blood pressure.”

Heart health challenges have been exacerbated in 2020 due to movement restrictions and changes in routine necessitated in response to the global pandemic. Many people postponed check-ups and hospital appointments in the early part of the year, and the team at Cleveland Clinic Abu Dhabi are optimistic that the ‘What makes your heart beat?’ campaign will encourage people to come in and discuss any concerns.

Up to 80% of strokes could be prevented by changing lifestyle habits

Millions of strokes could be prevented worldwide by reducing lifestyle risk factors and knowing the warning signs of an acute stroke, says a leading expert.

Dr M. Shazam Hussain, Director of the Cerebrovascular Center at Cleveland Clinic, said: “Up to 80 percent of strokes can be prevented by controlling risk factors such as high blood pressure and high cholesterol. Risk factors can often be avoided or controlled with simple lifestyle changes such as exercising daily, having a healthy diet, and stopping smoking. Most people suffering from strokes do not get treated in time – they should be aware of the warning signs.”

BEFAST

He adds that the commonly used acronym, BEFAST, is an easy way to remember the warning signs: Balance (for example, losing balance, difficulty walking); Eyes (any trouble with vision); Face (droopiness on one side or the other), Arm (weakness or numbness, which could also apply to the leg); Speech (any difficulty speaking, slurring words or not understanding spoken words); and Time (calling emergency services immediately on spotting the warning signs).

“Time is vital as we lose somewhere in the order of about 2 million neurons a minute in the situation of acute stroke, so every second counts,” he says.

Strokes can be ischemic, when a blood clot cuts off the blood supply to the brain; hemorrhagic, when a blood vessel in the brain ruptures. Transient ischemic attacks, or “mini-strokes”, are short-lasting symptoms that can be a warning of a stroke to come. People with stroke symptoms, even temporary, should seek medical attention right away.

The World Stroke Organization estimates 14.5 million people will have a stroke in 2020, with 5.5 million dying from a stroke. Globally, 80 million people have survived a stroke.

For patients who have survived a stroke, they could still face significant recovery and rehabilitation to regain lost skills, relearn tasks, and work to be independent again. Research is promising that recovery can be aided with robotics and stem cell treatment in the future.

Look for stroke warning signals

Transient ischemic attacks (TIA), often referred to as ‘mini strokes’ or ‘warning strokes,’ mimic the symptoms of a full blown stroke. Caused by an in interruption in the blood flow to part of the brain, the symptoms which include weakness or numbness of the face, arm or leg on one side of the body, slurred speech and difficulty talking start suddenly. Other symptoms to be aware of include severe sudden headache, loss of vision out of one or both eyes and loss of balance. Unlike strokes, where these symptoms may be permanent, in the case of mini strokes, the symptoms go away completely after a short period with no lasting damage.

These warning strokes are frequently followed by a permanent stroke, with 15% of all stroke victims having experienced one before their stroke. If left untreated, the risk of stroke within the first month after a TIA is about 10% and the risk is highest in the first 2 days following an attack. As a result, people who experience one should visit an Emergency Department immediately, even if their symptoms resolve quickly.

“Since the symptoms go away completely – sometimes very quickly – it is often tempting to think that they are not serious. On the contrary, these are important warning signs and a mini stroke could be a strong indication that a more severe stroke is on the way. Immediate treatment may prevent a permanent stroke. It is therefore essential to grasp the opportunity a mini stroke provides to seek medical advice immediately,” says Dr. Victoria Mifsud, a neurologist and director of the Stroke Program at Cleveland Clinic Abu Dhabi.

Stroke is a leading cause of death and disability worldwide, despite the fact that up to 80% of strokes are preventable. One in four people experience a stroke during their lifetime. While the global average age of a stroke victim is over 65, the average age in the UAE is younger due to the high prevalence of risk factors such as obesity, high blood pressure and diabetes. Half of all stroke patients in the country are under the age of 45.

“Strokes may be preventable through lifestyle changes and proper management of chronic conditions. In a way, a mini stroke serves as a wake-up call that allows patients to work with their doctor to manage their risk factors and improve their overall health. Preventing stroke means patients can avoid the life altering complications it can cause,” continues Dr. Mifsud.

People at increased risk of stroke or who have experienced a transient ischemic attack require close management of their risk factors and any underlying conditions that contribute to them. In addition, they can make lifestyle changes to help reduce their risk of stroke including eating a balanced diet, getting regular exercise and quitting smoking.

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