Young, slim, but still at risk

Studies show that people below the age of 40 are also at risk for heart disease.

A recent study from the Canada-based Heart and Stroke Foundation last year found that even young, slim people aged between 18 and 35 years old are still prone to heart disease, as reported by sciencedaily.com.

The build-up of fat in the walls of arteries, or atherosclerosis, was also found among the younger age groups in the study. Atherosclerosis can eventually lead to serious problems including heart disease, stroke or even death.

Beyond simple weight and body mass index (BMI) measurements, the researchers suggest that people of all ages follow all the guidelines of healthy lifestyle - a healthy diet, physical activity, knowing and controlling blood pressure and cholesterol levels as well as remaining tobacco-free and limiting alcohol consumption.

Another study from Northwestern University's Feinberg School of Medicine found that maintaining a healthy lifestyle from a patient's early 20s would lower the risk of heart disease.

"Cardiovascular diseases are still the number one killer in the world. We also see the same trend in Indonesia," Dewi Andang Joesoef, chairwoman of Indonesian Heart Foundation, told The Jakarta Post at her office in Jakarta recently.

A 2007 health study conducted by Health Ministry revealed that heart disease was in the top-three most widespread non-communicable disease nationwide, affecting 7.2 per cent of the population.

In first place was joint disease at 30.3 per cent, followed by hypertension at 29.8 per cent.

Cardiologist Indriwanto S Atmosudigdo of the Harapan Kita National Cardiovascular Center said that better awareness among people under 40 might explain the high numbers, though not necessarily because the condition was more widespread.

"We haven't got the specific statistics on that, but in general, those who came here with possible symptoms of cardiovascular disease are young. Maybe because they have better knowledge and awareness," Indriwanto, who is also chairman of the Indonesian Cardiologist Association's Jakarta branch, told the Post.

In the past, heart disease was thought to be closely related to old age.

The most common predisposing factor for cardiovascular disease is high cholesterol (hypercholesterolemia), he said.

"Diabetes mellitus and hypertension are among the enabling factors that can be influenced by unhealthy lifestyles such as smoking; eating a poor diet low on less fruits and vegetables and heavy on fast food; and a lack of exercise and physical activity, such as always traveling using air-conditioned cars and choosing the elevator instead of the stairs.

"Cardiovascular disease aims at all kinds of people, regardless age. The most common factor among my patients is their smoking habit."

Indriwanto said young people tended to take up smoking very easily. Access to cigarettes was indeed quite easy and cheap here, as compared to developed countries.

"One cigarette contains more than 4,000 substances that can cause illnesses, including cardiovascular disease," he said.

Cardiologist BRM Ario Soeryo Kuncoro, also from Harapan Kita, said that unhealthy lifestyles had played a major role in cardiovascular cases in big cities.

"The thing that can commonly be seen in young executives in big cities is that they are accustomed to a sedentary lifestyle - a lifestyle with no or irregular physical activity," said Ario, referring to the lifestyle colloquially known as a "couch potato".

"Another factor is related to food consumption. The main risk of consuming fast food is high blood cholesterol levels. It's because high levels of sodium may cause problems related to the constriction of blood vessels. In the long term, it can cause coronary disorders," he explained.

Despite the risks for middle-class people, cardiovascular disease may also affect the lower income brackets too.

"Lower-class people may also consume unhealthy food, such as fried foods from vendors on the sidewalk that are usually cooked with re-used cooking oil or the instant noodles that contain preservatives and high levels of sodium.

"All of those foods increase the risks of developing hypertension, which can lead to the constriction of blood vessels and coronary problems," said Ario.

Facts:

• Low- and middle-income countries are disproportionally affected: Over 80 per cent of cardiovascular disease deaths take place in low- and middle-income countries and occur almost equally in men and women.

• By 2030, almost 23.6 million people will die from cardiovascular diseases, mainly from heart disease and stroke. These are projected to remain the single leading causes of death.

• Heart disease kills more than 7 million people each year and strokes kill nearly 6 million. Most of these deaths are in developing countries.

Risk factors for cardiovascular diseases:

• The most important behavioural risk factors of heart disease and stroke are: unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol.

• Behavioral risk factors are responsible for about 80 per cent of heart disease and cerebrovascular disease.

• The effects of an unhealthy diet and physical inactivity may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids and obesity. These are called "intermediate risk factors" or metabolic risk factors.

Common symptoms of cardiovascular diseases:

• Symptoms of a heart attack include: pain or discomfort in the centre of the chest; pain or discomfort in the arms, the left shoulder, elbows, jaw or back.

• In addition, a person may experience difficulty in breathing or shortness of breath; feeling sick or vomiting; feeling light-headed or faint; breaking into a cold sweat; and becoming pale. Women are more likely to have shortness of breath, nausea, vomiting and back or jaw pain.

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