Cardiovascular diseases: Types, risk factors and prevention

Dear Doc,

Cardiovascular is a disease of the heart or blood vessels. Could you shed light on this?

Alnashir

Dear Alnashir,

Cardiovascular refers to heart and blood vessels. The cardiovascular system supplies blood throughout the body and is made up of the heart, arteries, veins and capillaries. Cardiovascular disease refers to a disease of the heart or the blood vessels. Patients will have reduced blood supply to a particular region of the body either due to the presence of a blood clot or due to atherosclerosis. Atherosclerosis refers to the build-up of fatty deposits on the walls of the arteries, leading to the narrowing and hardening of the blood vessels.

There are four main cardiovascular diseases:

 Stroke – damage or death of brain tissue due to reduced or lack of blood supply to an area of the brain. This may either be due to a blockage of blood flow or due to a ruptured blood vessel.

Coronary heart disease– damage or death of heart muscle due to interrupted or blocked blood supply to the heart muscles. If the blood vessel is completely blocked, then a myocardial infarction (heart attack) can occur.

Peripheral artery disease – blockage of a blood supply to a limb, usually the lower limb(s).

Aortic disease – blockage of blood flow through the aorta, which is the largest blood vessel in the body. The wall of the aorta may be damaged and weakened, and bulges, creating an aortic aneurysm.

Cardiovascular diseases are the leading cause of death globally. The biggest contributors to cardiovascular disease include hypertension, diabetes, smoking, poor diet, lack of exercise, excessive alcohol consumption, obesity, stress and family history.

To prevent, delay and/or manage cardiovascular diseases, the first step is lifestyle change. This includes taking high-fibre diet rich in fruits, whole grains and vegetables; limiting salt intake; exercise; weight management and adequate treatment of underlying diseases.

Dear doctor,

I have problems falling asleep at night. Could it be because I have short trips abroad from time to time? This happens even when I am home.

Dear reader,

The body has an internal clock, the pineal gland, which keeps time for us so that even if you had slept through the day, the body still recognises that when it is night, then you should be asleep. This is what gets “confused” when you cross time zones, leading to jet lag. To reduce jet lag, when you are travelling to a time zone with a difference of one or two hours from your home, you can maintain your schedule like you would back home. For three or more hours’ time difference, you can begin to change your routine for a few days before traveling to making it closer to what you will experience when you travel and once you arrive, change your sleeping time to the new hours as soon as possible and get out into the sun when it’s time to wake up.

There are medications that can be given by prescription to help you fall asleep, like melatonin. Medication is only advisable as a short-term solution.

For the time you are in the new place or when you are at home, it is best to have good sleep hygiene and therefore develop good sleep habits.

Sleep hygiene refers to those practices that improve quality of night time sleep and contribute to alertness during the day. These include:

a) Make your bedroom a relaxing place with a good bed and find a way to block out noise and light such as using heavy curtains.

b) Sleep at the same time and wake up at the same time every day, whether it is a work day, weekend, leave day or holiday

c) Try to sleep when you are tired or sleepy to avoid spending too much time awake looking for sleep

d) If you are unable to fall asleep after 20 or more minutes, wake up and do something boring or calming, with the lights dimmed, until you feel sleepy again. Avoid bright light and gadgets (like TV, computer, phone) or anything very interesting.

e) A well timed bath (one to two hours before bedtime) may help you sleep better.

f) Develop and follow a sleep time ritual. For instance, every day I shower at 9pm then read a book for 30 minutes then pray for 10 minutes in the dark in my bedroom before I enter bed.

g) Keep your day time routine the same, whether you had enough sleep or not. Hopefully, by evening, you will be tired enough to have a good night’s sleep. Avoiding your day time activities or sleeping during the day may worsen the insomnia.

h) Expose yourself to natural light during the day and keep the bedroom dark at night. The light and darkness will help your internal clock with the sleep-awake cycle.

i) Avoid using the bed or bedroom for work or watching TV, using the laptop or the phone.

j) Avoid caffeine or tea before sleep as they can be stimulating. Do not take a heavy meal just before bed time. Milk has tryptophan, which is a natural sleep inducer, so taking a cup of milk may be helpful. Also avoid alcohol about four-six hours before sleep as it interferes with the quality of sleep.

k) Avoid sleeping during the day. If you have to, take one 20 to 30 minutes day time nap before 3pm.

l) Do not watch the clock when you are unable to sleep. It adds to your stress and makes it more difficult to sleep. If this is a problem for you, hide the clock.

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