CARDIOVASCULAR health is frequently being referred to as heart health but it also encompasses the health of blood vessels that supply all other organs. The build-up of plaques within the arteries mainly due to high cholesterol and other substances, narrows the passage for blood flow resulting in a condition called atherosclerosis.

Cardiovascular events which include heart failure, heart attack and stroke are preventable and manageable. Some of the causative factors are uncontrollable high blood pressure, hypercholesterolemia and diabetes along with poor diet, exercise and stress management, which are preventative most of the times.

Cardiovascular disease is more prevalent in men than women and is the major cause of reducing life expectancy to below 70 years. If the patient survives a cardiovascular event, it can impact on their social and economic well-being since they are no longer able to be as productive prior to the disease.

According to a 2022 publication of FIP (International Pharmaceutical Federation), cardiovascular deaths account for 32 percent of the current global deaths. It is projected to increase to 32.3 million by 2030, a steady incline from 18.9 million in 2020 and 12.1 million, three decades earlier in 1990.

Globalization and urbanization across all levels of global economies have created major changes in diets and lifestyle where the highest incidences of cardiovascular events occur in the poorest countries.

However, modifications can be made in all of the following categories of persons who are at risk for cardiovascular diseases:
• Overweight or obese persons – BMI calculation verifies your category
• Physically inactive persons
• Consumers of unhealthy diet
• Smokers
• Excessive alcoholic consumers
• Those persons affected by chronic stress and psychosocial factors
• Those persons affected by sleep disorders
• Hypertensive patients
• Dyslipidemia patients – elevation of low density lipids, total cholesterol and serum triglycerides
• Diabetic mellitus patients – elevations of blood sugar levels due to poor dietary, behavioral and lifestyle choices

So, persons are encouraged to seek guidance on disease prevention and on their progress of monitoring blood pressure, blood sugar and cholesterol levels; also medication adherence, and lifestyle modifications by managing diet, exercise, alcohol consumption, smoking cessation and de-stressing, are to be addressed.

A DASH (Dietary Approaches to Stop Hypertension) diet is the heart healthy one recommended, comprising of vegetables, fruits, nuts and seeds, less than one teaspoon of salt per day, less than 5 to 10 percent of daily intake from simple sugars and lean proteins such as legumes (beans, peas, and lentils).

Currently, there is a trend noted with kids where there is a reduced consumption of vegetables and fruits.

Saturated and trans fats, salt and sugar and low fiber intake are the culprits in a healthy diet. Meal planning and preparation and reading food labels are the way to mindful eating. Indulgence in foods at social gatherings and cultural celebrations can be silent killers.

So, restrict your taste buds for treats such as fast foods (French fries, fried chicken, fried rice, hot dogs); snacks made with lard such as pastries, bread, pizza, and most desserts like cakes, cookies, ice cream, chocolates, sodas or frizzy drinks, puddings and pies. Some cultural sweet meats are also loaded with sugars and fats such as parsad, sirnie, halwa, vermicelli, mithai, kheer, goja, gulab jamun and peera.

It is believed that 80 percent of cases such as heart failure, heart attack and stroke do not have to be experienced if patients were to take their medications, cease smoking, follow a heart friendly diet and do a minimum of 75 minutes of vigorous physical activity or 150 minutes of moderate activity per week.

Sleep deprivation due to insufficient sleep and a late onset sleep from 11pm may induce high levels of stress hormones causing a 25 percent increase in heart events as compared to those who sleep at 10:59 pm or experience good sleep hygiene. Those include a quiet, clean and cool bedroom; reducing blue light levels from gadgets, limiting stimulants such as coffee, nicotine and alcohol just before bedtime; eating at least four hours before bedtime and getting enough exercise, but not close to bedtime.

Stress reduction and psychological therapy is recommended by referral to a specialist only if the first steps to exercise, mediate and enhance sleep quality have failed to address the stressors.
Cost, access and quality of care were the areas of concern for practitioners and researchers when they designed a more comprehensive model of care to address the scale of the escalating global epidemic of this non-communicable chronic illness.

The goals of addressing cardiovascular health are:
• Prevention
• Screening
• Clinical management by physician
• Therapeutic optimization by a team of physician, pharmacist and nurse

So, in more developed countries there is training in prevention by reducing risk factors, screening of high risk persons and medication management, which encompasses a review for medication compliance, identify medicine related incidents, flag for dosage adjustments and provide long term solutions by addressing weight and behavioral habits of smoking, binging of alcohol and stress relieve.

Pharmacists can spot drug-induced hypertension and can quickly suggest corrective actions either by limiting usage or avoiding altogether the following list: caffeine, alcohol, cocaine, decongestants, non-steroidal anti-inflammatory, systemic corticosteroids, herbal supplements, amphetamines, antidepressants and oral contraceptives.

In more developed countries the Kozma’s ECHO (Economic, Clinical and Humanistic Outcomes) model is the metrics used to measure the progress of the pharmacy and other services offered to patients.

For further discussion, contact the pharmacist of Medicine Express Pharmacy at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic, kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg. Tel: 225-5142.