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                               Smoking |
                              Diabetes | Exercise
                              | Food | High
                              blood pressure | Precautions  | 
                           
                          
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                              Tobacco
                              is a substance that seriously affects the heart.
                              The different forms in which tobacco is consumed
                              are cigarettes, bidis, cigars, pipe, through hukka,
                              pan, pan masala etc. The harmful effects differ
                              with different types of composition. 
                               
                              The main composition of cigarette is the tobacco
                              and paper. These on burning gives out carbon
                              particles, tar, carbon monoxide and
                              nicotine.  
                               
                              Harmful Effects 
                              
                                - 
                                  
Unburnt
                                  carbon , tar,  carbon monoxide --- leads
                                  to expanded chest (emphysema) and reduced
                                  blood oxygen thus causing congestive heart
                                  failure. 
                                 
                                - 
                                  
Tar
                                  and paper ----lung cancer 
                                 
                                - 
                                  
Nicotine---
                                  Ischaemic heart disease, high blood pressure,
                                  constriction of coronary arteries, thus
                                  precipitating and worsening angina. 
                                 
                                - 
                                  
Cigarette
                                  smoking -- lowers HDL cholesterol in blood
                                  thus susceptible to heart attacks. 
                                   
                                  Quit Smoking: 
                                  * liability to heart attack decreases
                                  if YOU quit smoking. 
                                  * chronic bronchitis is reduced if YOU quit
                                  smoking. 
                                  * higher blood pressure lowers to normal if
                                  YOU quit smoking.   
                                 
                               
                                
                               
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                               Diabetes
                              is a long term disease which has an adverse effect
                              on the heart and blood vessels. Insulin is the
                              enzyme secreted by the pancreas which metabolizes
                              the sugar present in the muscles and other
                              tissues. In case of diabetes mellitius , pancreas
                              is unable to create insulin thus the muscles and
                              other tissues are unable to metabolize the sugar. 
                               
                              Excess of sugar which is not metabolized increases
                              the blood cholesterol, thus depositing the fatty
                              acids in the arteries resulting in increase in the
                              infarction.
                              
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                               Lack of exercises and obesity leads to
                              unhealthy lifestyle that causes heart attack. 
                               
                              Advantages of Exercise 
                              * It reduces the obstruction in the coronary
                              arteries by opening up the collateral coronary. 
                              * Too strenuous or overexertion of exercises may
                              be dangerous or may even lead to death. 
                              * It should be known that what and how much of the
                              exercise is to be done. 
                               
                              It is very necessary to first accustom to the
                              exercises and also to its harmful effects. For the
                              elderly, the exercises should be avoided if they
                              are suffering from- 
                              * prolonged breathlessness 
                              * tiredness and 
                              * chest pain  
                               
                              Walking is the best
                              exercise for people of all ages. 
                              
                                
                                  
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                              A mixed diet containing a wide variety of
                              foodstuffs is recommended for heart patients. It
                              should mainly comprise the following: 
                              * Vegetarian food, generally, including
                              antioxidant containing items. 
                              * Animal food, occasionally, as a good source of
                              proteins. 
                              * Fish  
                              * Fair amount of milk and yogurt (curd), with most
                              of the fat skimmed off, as a source of protein for
                              the vegetarians. 
                              * Vegetable oil (soybean, corn, sunflower) as a
                              cooking medium, in limited quantity. 
                              * Sparse consumption of ghee and butter. 
                              * Eggs, should be avoided, but, if not possible,
                              not more than 5 per week, should be consumed. 
                              * Pulses in plenty, as a source of proteins. 
                              * Low salt, low spice and minimum chilies in the
                              food; sparse use of pickles and chutneys
                              (especially for hypersensitive people). 
                              * Plenty of fresh vegetables, fruits and salads. 
                               
                              Foods that can be taken in
                              plenty 
                               
                              Clear soups, thin butter, milk, salads like
                              cucumber, onion, tomatoes, lettuce, cabbage etc.,
                              leafy vegetables, other vegetables like gourd,
                              cauliflower, brinjal, etc., sour-lime, dal
                              (pulses)-water, thin curd curry. 
                               
                              Moderately Restricted food 
                               
                              Cereals, pulses and legumes, egg, (if obese and
                              having cardiac problems then avoid egg-yolk), lean
                              cuts of mutton, chicken without skin, roots and
                              tubers-potatoes, sweet potatoes, beet-root etc.,
                              fruits including citrus fruits (twice a day) like
                              orange, papaya, apple with its skin, guava etc.
                              
 Cooking
                              Oils 
                                
                              Vegetable oils, which are low in saturated fats
                              but high in mono or polyunsaturated fats should be
                              used. Apart from the vegetable oils, certain fish
                              oils are very useful in reducing blood
                              cholesterol, but they are not available for
                              general consumption in India. The vegetable oils
                              are not only low in cholesterol but they also tend
                              to reduce the cholesterol manufactured by the
                              body. 
                               
                              Restricted food 
                               
                              Refined cereals, sugar and sugar products, rich
                              cakes, pastries, ice-creams, milk shakes (of whole
                              milk), organ meats, egg yolk, nuts, oilseeds,
                              coconut (fresh and dry), soft-drinks, hard-drinks,
                              whole milk and its preparations.
                               High
                              consumption of salt also leads to high blood
                              pressure. Communities which consume a low salt
                              diet habitually show lesser incidence of
                              hypertension, which is an adverse factor for the
                              heart. 
                               
                              Vegetarian v/s
                              Non-Vegetarian 
                                
                              Now, it has been proven that vegetarian diet is
                              healthier as it provides most of the antioxidants
                              which are protective against free radicals. While
                              on the other hand non-vegetarians, in general,
                              have a lesser span of life  because of the
                              increased cases of heart attacks. 
                               
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                              Hypertension and diabetes are two common
                              conditions which accelerate the production of
                              ischaemic heart disease. The damage is compounded
                              if both the conditions coexist in the same
                              patient. 
                               
                              Normal range of blood
                              pressure 
                               
                              Generally, 140/90 is considered to be the upper
                              limit of normal blood pressure at the age of 40.
                              This figure is somewhat lower for younger and
                              higher for older people. 
                               
                              Effects of hypertension 
                               
                              The high pressure in the arteries causes their
                              degeneration. This high pressure forces the
                              cholesterol into the arterial wall in the form of
                              deposits. Thus atheroma (fatty deposit) formation
                              is facilitated by hypertension. These atheromas
                              cause obstruction to the flow of blood in the
                              arteries. Occurring in the coronary arteries, they
                              produce angina and heart attacks. In the arteries
                              of the brain, they produce stroke and paralysis.
                              Similarly, they can affect other organs, such as
                              the kidneys, eyes and legs. 
                               
                              There is also a direct, adverse, mechanical effect
                              on the heart and brain due to hypertension. The
                              left ventricle which is the principal pumping
                              chamber of the heart, has to work against high
                              pressure in the arteries. This puts an extra load
                              on the left ventricle, which in course of time
                              enlarges, its function suffers and it may
                              ultimately fail. Acute rise of blood pressure
                              above 200 mm can cause brain haemorrhage. 
                               
                              All hypersensitive people should, by habit, take a
                              low salt diet, say one-third of the
                              average consumption, unless they are being given
                              diuretic drugs. 
                              
                               
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                              The hypersensitive people should perform regular
                              moderate exercise keeping in mind their age and
                              capacity. Regular exercise is known to lower blood
                              pressure. The hypersensitive people should keep
                              themselves calm and composed, follow a regular
                              schedule of meals, work and sleep. 
                               
                              Drug treatment becomes necessary if the above
                              measures do not bring about a sufficient drop in
                              the blood pressure. Drug
                              treatment is lifelong. Regular
                              check-ups by your physician are essential for
                              proper adjustments of dose of anti-hypersensitive
                              drugs and to watch for any complications arising
                              from the disease or from the long-term use of
                              drugs.
                              
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