Dr. Tamkeen at Medcare Hospital in Dubai talks about why cardiovascular disease in the UAE is on an all-time high.
24 December 2017| Last updated on 30 January 2018
A recent survey by the Emirates Cardiac Society of more than 4,000 people found that almost nine out of ten people in the UAE are at risk of cardiovascular disease and one out of three of them are unaware of the fact.
Cardiovascular disease (CVD) is now recognized as the leading cause of death and disability worldwide. The World Health Organization (WHO) estimated that in 2008, out of 17.3 million CVD deaths globally and the UAE is no exception, heart attacks (myocardial infarction) and strokes were responsible for 7.3 and 6.2 million deaths, respectively.
Hypertension, diabetes, dyslipidemia, obesity, smoking, physical inactivity, poor diet, and alcohol consumption are the most common risk factors for myocardial infarction (heart attack) and strokes worldwide.
The obesity rate in the UAE is about double the world average. More than 2.1 billion people — close to 30 per cent of the global population — are overweight or obese, the World Health Organization says.
The symptoms of obesity caused by poor diet and an inactive lifestyle are weight gain and a body mass index above 30. Without proper treatment, obesity can lead to serious complications including heart disease and stroke, high blood pressure, diabetes and cancer.
Recent figures from the International Diabetes Federation confirm 37 million diabetics in the Middle East and North Africa, including 803,900 in the UAE. It predicts the region’s figure will rise by more than 80 per cent to 68 million by 2035 unless action is taken. Type 2 diabetes often linked to factors such as obesity and a sedentary lifestyle accounts for about 90 percent of cases worldwide.
Left untreated, diabetes brings a heightened risk of blindness, kidney dysfunction, and more importantly cardiovascular disease — the highest cause of death among diabetic patients. Symptoms include excessive thirst, frequent urination, excessive hunger, blurry vision and sores or cuts that won’t heal.
The most important preventable cause of premature death. Cigarette smokers have a higher risk of developing several chronic disorders. These include fat buildups in arteries, several types of cancer and chronic obstructive pulmonary disease (lung problems).
Atherosclerosis (build up of fatty substances in the arteries) is a chief contributor to the high number of deaths from smoking. Many studies detail the evidence that cigarette smoking is a major cause of coronary heart disease, which leads to heart attack.
Lack of exercise
Studies by the World Health Organization (WHO) found that its Eastern Mediterranean Region, of which the UAE is part, was second only to the Americas in terms of low activity rates. Lack of exercise was the fourth leading risk factor for non-communicable diseases, ranking higher than obesity. Inadequate amounts of exercise were responsible for 27 per cent of diabetes, 30 per cent of heart disease and up to a quarter of breast and colon cancer cases.
Generally, experts recommend 30 minutes of exercise a day as the minimum required to stay healthy.
One out of every three adults in the UAE is suffering from hypertension, or high blood pressure, according to figures revealed by local health professionals. However, many of these cases go undetected as the symptoms are almost unnoticeable. With many health risks attached to the condition of high blood pressure, it is important to be aware of its presence. Normal blood pressure at rest is within the range of 100–140 mm Hg systolic (top reading) and 60–90 mm Hg diastolic (bottom reading).A reading of 120/75 mm Hg for example, would be an indicator of a normal blood pressure.
High blood pressure is said to be present if it is above 140/90 mm Hg.
The most common heart attack symptom in men and women is chest pain or discomfort. However, only half of women who have heart attacks have chest pain. Women are more likely than men to report back or neck pain, indigestion, heartburn, nausea (feeling sick to the stomach), vomiting, extreme fatigue (tiredness), or problems breathing. Heart attacks also can cause upper body discomfort in one or both arms, the back, neck, jaw, or upper part of the stomach. Other heart attack symptoms are light headedness and dizziness, which occur more often in women than men. Men are more likely than women to break out in a cold sweat and to report pain in the left arm during a heart attack.
Hypertension is the single biggest risk factor for stroke. It also plays a significant role in heart attacks. It can be prevented and successfully treated but only if you have it diagnosed and stick to your recommended management plan.
Abnormal blood lipid levels, that is high total cholesterol, high levels of triglycerides, high levels of low-density lipoprotein or low levels of high-density lipoprotein (HDL) cholesterol all increase the risk of heart disease and stroke. Changing to a healthy diet, exercise and medication can modify your blood lipid profile.
Tobacco use, whether it is smoking or chewing tobacco, increases risks of cardiovascular disease. The risk is especially high if you started smoking when young, smoke heavily or are a woman. Passive smoking is also a risk factor for cardiovascular disease. Stopping tobacco use can reduce your risk of cardiovascular disease significantly, no matter how long you have smoked.
Physical inactivity increases the risk of heart disease and stroke by 50%. Making physical activity a part of your life can benefit your health significantly and can reduce your risk of heart disease and stroke. Regular activity also helps prevent and control high blood pressure, high cholesterol, type 2 diabetes, osteoporosis, certain types of cancer and obesity. The Heart and Stroke Foundation recommends adults should accumulate at least 150 minutes of moderate- to vigorous-intensity aerobic physical activity per week
Type 2 diabetes a major risk factor for coronary heart disease and stroke. Having diabetes makes you twice as likely as someone who does not to develop cardiovascular disease. If you do not control diabetes then you are more likely to develop cardiovascular disease at an earlier age than other people and it will be more devastating. If you are a pre-menopausal woman, your diabetes cancels out the protective effect of estrogen and your risk of heart disease rises significantly. A diet high in saturated fat increases the risk of heart disease and stroke. It is estimated to cause about 31% of coronary heart disease and 11% of stroke worldwide.
Being poor, no matter where in the globe, increases your risk of heart disease and stroke. A chronically stressful life, social isolation, anxiety and depression increase the risk of heart disease and stroke.
In many individuals, the first symptom of coronary heart disease is heart attack or sudden death, with no preceding chest pain as a warning. For this reason, screening tests are performed to evaluate the cardiovascular risk and detect signs of coronary heart disease before serious medical events occur. Screening tests are of particular importance for people with risk factors for coronary heart disease. Some of the important screening tests are:
- Lipid profile
- Fasting blood sugar
- Thyroid functions
- Exercise stress test
Prevention is better than cure. So hold to it.
Dr. Tamkeen Athar Kinah
MD | PHD