Heart attacks or myocardial infarctions used to occur almost exclusively in older people, but, as you rightfully noted, we are now witnessing an increase inits occurrence among young people.In fact, in industrial countries, possibly as many as 10% of all heart attacks occur in people, mostly men, who are below 45 years of age, and some of the victims are only in their 20s.
A heart attack occurs when a blood vessel (coronary artery) that supplies the heart gets completely clogged leading to the death of the heart tissues that it supplies. In more than 80 percent of cases, a heart attack is simply the end result of coronary artery disease (CAD), a condition in which the coronary arteries get narrowed because of deposition of cholesterol and other fatty materials in their walls. In CAD, the narrowing of the arteries is a gradual process that starts in childhood, but manifest only during adulthood. It takes many years before the cholesterol plaque has built up enough to trigger a heart attack.
Except for advancing age, the risk factors for coronary artery disease are the same for the old and the young: family history of coronary heart disease, smoking, hypertension, dyslipidemia (i.e., persistently high blood levels of cholesterol), obesity, chronic diseases like diabetes mellitus, sedentary lifestyle and chronic psychological stress.
So, why are a growing number of young people experiencing heart attacks? Evidently, it is because many of the risk factors for CAD, notably smoking, obesity, dyslipidemia, sedentary lifestyle and stress, are increasingly becoming more common among the young. Childhood obesity for one has already become a worldwide epidemic, while the prevalence of smoking among the youth continues to increase.
Coronary artery disease is largely preventable. But the preventive measures should be instituted early—as early as childhood, ideally—for maximum lifetime benefit.
Hence, everyone, especially young people, will be well advised if they adopt the lifestyle practices that have been proven to prevent CAD, which include:
1. None smoking.
2. Sticking to a low-salt, low fat diet that contains a variety of foods from all the food categories, with emphasis on fruits and vegetables. In practical terms, this means: Eating lean meat only by trimming the fat from meat, discarding the skin and fat from chicken and other fowls, and avoiding processed meat and innards (tripe, liver, kidneys, etc.); eating a lot of fish, but passing up on shellfish (lobster, shrimp, crabs, etc.) and canned fish; eating a lot of leafy vegetables, cereal and grain products, legumes, nuts and fruits; limiting salt intake by cooking food only to taste and not using “sawsawan”; cooking with a minimum of cooking oil, which should be vegetable oil; taking skimmed instead of whole milk; avoiding butter, saturated fats, lard, gravies, bacon drippings and cream sauces; and refraining from foods that contain or were prepared using trans fat such as margarine and many snack or “junk foods.”
3. Moderating alcohol intake: Two drinks per day for men and one drink per day for women.
4. Attaining and maintaining an appropriate body weight.
5. Exercising regularly: A minimum of 30 to 60 minutes moderately vigorous exercise such as brisk walking at least five times a week, supplemented by extra activity such as gardening and housework.
6. Avoiding and managing stress. Indulging in sports and listening to music are ways of handling stress.
7. Undergoing annual regular check-up with a physician to ensure early intervention in case a risk factor for CAD occurs.
By EDUARDO GONZALES, MD