Predicting and preventing heart attacks & strokes

By Prof. Chamila Mettananda
According to the latest WHO data published in 2018, Coronary Heart Disease Deaths in Sri Lanka
amounted to a record high of 22.64% of total deaths within the nation. While until recently, fatal
heart attacks or strokes came with no prior warning, decades of global research in the field has
enabled healthcare specialists to identify and predict the risk of developing or dying from these
conditions, during the next ten years can now be assessed. This also helps arm patients against these
fatal medical conditions, helping most enjoy an optimum quality of life.

The Process of Prediction
Using charts put together for Sri Lanka by the World Health Organization, factors such as age, sex,
smoking status, blood pressure, evidence of diabetes mellitus, height, weight, and total cholesterol
value are taken into account to gauge a patient’s risk of developing a cardiovascular diseases (CVD).
In terms of accuracy, it has been shown that these predictions were accurate for 81 out of 100
people (81%) that were tested. Anyone, aged 40 years or above (with some exclusions), including
those with adult-onset diabetic patients (Type II) should consider getting this prediction done. The
prediction assessment is also recommended for patients that are aged 40 years or younger bearing
significant risk factors which include the presence of diabetes, a family history of high blood pressure,
kidney disease, high cholesterol levels, or a pattern of heart attacks or strokes in the family before
the age of 50. Depending on this prediction, patients are then equipped by their healthcare
specialists with precautionary measures to prevent succumbing to the fatal implications of these

What comes after a prediction?
Depending on a patient’s risk, they will be put on appropriate treatment plans. Low risk patients are
advised to make certain lifestyle modifications with their progress reassessed every 12 months.
Intermediate risk patients will again be advised to make lifestyle modifications as well as educated on
other measures to help control risk factors. A course of medications might also be considered, with
their progress being reassessed every three months. Patients that display the highest risk will be put
on a strict lifestyle modification plan and medication with frequent assessments.

The golden rules of preventing and treating cardiovascular conditions
The prevention of cardiovascular disease can be achieved by practising regular exercise, by keeping
to a balanced healthy diet, engaging in physical activity for a minimum of 150 minutes per week,
eliminating tobacco use and reducing the use of alcohol. In terms of medication, patients should be
put on a course that helps maintain blood pressure, sugar and cholesterol in a manner that takes
into account their 10-year risk predictions.

Leading private healthcare provider, Hemas Hospitals offers a comprehensive portfolio of diagnostic
and treatment solutions to help Sri Lankans combat non-communicable yet critical medical
conditions rising from cardiovascular diseases. Hemas Hospital’s Wellness Center is primarily
focused on preventive care and integrated management of diseases and medical conditions.
Employing a multi-disciplinary approach, well trained medical officers will lay out a treatment plan
and guide patients through the treatment process and ensure medical conditions are managed, in the
case of non-communicable diseases, through constant follow ups.

If prevention is simple and possible, why don’t people take better care?
Today, with a global environment that warrants extremely busy lifestyles to stay ahead, many people
do not focus on their healthcare at the preventative stage. Since not many cardiovascular disease
symptoms present before an actual attack, many tend to only concentrate on what hinders them
daily. But it is important to remember that once a person gets a heart attack or a stroke, it is mostly
irreversible and consequences will follow the rest of your life. However, if proper precautions are
taken and a healthier lifestyle is followed, life can be a beautiful and happy affair that isn’t plagued by
the physical, economical and social implications that come with disease. Remember, prevention is
always better than cure!

[The writer is Professor Chamila Mettananda (MBBS, MD, MRCP, PhD (Cardiovascular
epidemiology), FRCP, FRCPE, FACP, FCCP), Professor in Pharmacology & Specialist in
General Medicine, Faculty of Medicine, University of Kelaniya. She is also a consultant
at Hemas Hospitals, Wattala.]

Prof. Chamila Mettananda (MBBS, MD, MRCP, PhD (Cardiovascular epidemiology),
FRCP, FRCPE, FACP, FCCP), Professor in Pharmacology & Specialist in General Medicine, Faculty of
Medicine, University of Kelaniya, and Consultant at Hemas Hospitals, Wattala.

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