The bottom line is this: an appropriate mixed diet with a healthy balance of fruit and vegetables and a reduction in saturated fat, regular exercise, normalization of weight or at least some weight reduction in obese persons and avoidance of smoking will contribute 90% to the lowering of atherosclerotic risk. Additional measures can make a small contribution but some are actually harmful – especially if they divert attention from the known effective means of prevention. Most people will need the advice of a qualified dietician, a clear strategy and goals, regular monitoring and some form of support – until good practice becomes habitual. Many of the foods mentioned are also high in salt and most Westernised individuals eat salt far in excess of need, which may promote high blood pressure in susceptible people and have other adverse effects.
Exercise
The evidence is overwhelming that regular aerobic exercise at virtually any age reduces atherosclerosis and its complications. It has a variety of directly beneficial effects as well as being an important component of weight normalisation. The baseline should be set at five hours of aerobic activity dispersed throughout the week, such as walking, cycling, jogging, aerobics, rowing or swimming. This can be varied to prevent boredom and to maximise effect, and can be adjusted in intensity and duration according to the health status, age and objectives of the individual. The addition of mild to moderate resistance training can help strengthen muscles and bone and promote weight loss. Once again the advice of a professional ‘trainer’ is useful, especially in the early stages. The support of a family member, friend or group is very valuable. You should consult your doctor should you have any symptoms or concerns over your health status. It is vital to start slowly: in the long run it will do far more good than a crash start.Avoidance of harmful substances
First and foremost amongst these is cigarette smoking. Risk of coronary artery disease is at least doubled in most smokers and often more than that. It interacts with other risk factors elevating risk 10-fold or more. Besides heart disease, smoking promotes lung disorders such as emphysema and causes cancer. The good news is that the risk of vascular disease drops rapidly after stopping smoking, reaching baseline within two years. Professional help and support is again important, especially since stopping smoking promotes weight gain. Thus exercise and diet are part of the anti-smoking programme. Excessive alcohol consumption, eg. over 10 tots per week, can induce atherosclerosis and hypertension in susceptible individuals. Moderate alcohol consumption may be beneficial and wine, particularly red wine, reduces risk of atherosclerosis and cardiovascular disease. Binge drinking is definitely risky and should be strongly avoided.What is the outcome of atherosclerosis?
Because atherosclerosis usually progresses slowly over many years, it is commonly thought of as an affliction of the elderly. However, studies show that arterial deposits can begin in childhood, with significant plaque formation by the time a person is 30. In some people it progresses rapidly in their third decade; in others it doesn’t become threatening until they’re in their fifties or sixties. Women, in particular, are generally but not invariably protected before menopause. Atherosclerosis may never seriously affect the overall health of some people who have it. In many others, however, it is an important cause of illness and early death. In most cases, improvements in lifestyle can retard or even reverse the progress of the disease.When to call your doctor
The Clinical Guidelines recently published jointly by the South African Medical Association and the Lipid and Atherosclerosis Society of Southern Africa, recommends that all young adults be assessed at least once for the risk or presence of atherosclerotic vascular disease. This can be done as part of a normal medical visit. This provides you with the essential information (eg. blood pressure, total and HDL-cholesterol levels, triglyceride concentration, body weight and height, fasting glucose value) to modify your lifestyle so as to promote health and reduce risk. Occasionally the results may indicate the need for further investigation and more vigorous treatment, but generally a five year follow-up is recommended even for relatively low-risk individuals. In older people, above 60 years, more frequent examination is desirable. In addition to such baseline examination, you should consult your doctor under the following circumstances:- If you experience symptoms for the first time of a possible atherosclerosis-related medical condition. These include: chest pain, undue breathlessness, tingling or numbness in your arms, palpitations, visual, speech or coordination disturbances, any unexplained loss of consciousness or mental confusion, pain in your legs when walking which improves on rest, undue fatigue or excessive thirst, passing urine frequently.
- If you have an increase in any of the above symptoms.
- If you are at increased risk through family history, poor lifestyle habits, obesity or the presence of diabetes mellitus (or, more rarely, some other predisposing condition). If you develop discoloration or unusual skin sores in your legs or feet. This may indicate severe atherosclerosis and possibly a circulatory blockage that needs treatment to prevent gangrene.
It is possible to have atherosclerosis for many years without having symptoms and sometimes the clinical complications are worse than may be expected from the degree of atherosclerosis present. Despite these difficulties, a careful medical work-up provides the important information required for effective prevention and treatment.
(published with permission in writing from:http://www.health24.com/)
