World Heart Day: Combination of ‘Good Old Ways’ And Modern Clinical Approach Is Your Best Shot

Stress is emerging as one of the biggest causes of chronic disease among working professionals in demanding jobs, where the workload is high, deadlines tight and the margin for error is zero.

Decades of study across the world have proven that stress is not just a mental health concern, but a threat to physical health as well. Long-term activation of the stress response system, and overexposure to stress hormones, such as cortisol, adrenaline, and norepinephrine, can disrupt almost all processes in the body putting you at an increased risk for several diseases, including diabetes, hypertension, cardiovascular disease, heart attack, obesity, stroke, anxiety, depression, digestive issues, headaches, muscle tension and pain, sleep problems, and memory and concentration impairment.

Additionally, stress sends the brain into the “fix-it” mode. The brain wants to feel better instantly to get out of the stress state, making you crave sugary, greasy foods, tobacco, caffeine, excessive alcohol, and ignoring exercise – all of which are known lifestyle risk factors for metabolic conditions leading to cardiovascular diseases. Stress is also known to suppress the body's immune system, making it harder to recover from illnesses. It not only makes the body forget the basics of good health – sleeping enough, eating right, exercising – but actively hinders returning to them.

While giving a little extra attention to any one of these areas can improve the others, for high-performing professionals who are bound to face stress every day, doctors are increasingly suggesting the addition of a prevention-first, medicine-backed approach towards healthcare to fully draw the benefits from a lifestyle change to stave off diseases and resulting complications. This is particularly true for heart disease.

The World Health Organisation (WHO) underscores that one in three deaths globally is due to cardiovascular diseases (CVD), and India contributes to a significant part of this, more so among younger adults—about 40% of heart attack victims in India are under 55 years of age. About 25% of our population is either diabetic or in the pre-diabetic stage, with half of the pre-diabetics at risk of full-blown diabetes within five years.

Hypertension prevalence is alarmingly high at 35.5%. By the BMI measure, almost 29% of Indians are obese, and 39% have abdominal obesity–a known risk factor for diabetes and heart disease. Alarmingly, 24% also have hypercholesterolemia, a condition indicating elevated bad cholesterol levels, which is a known heart disease risk.

Being metabolic conditions and comorbidities, these diseases not only create a domino effect by following bad lifestyles and one another, but for Indians, their incidence is also increased by our genetic makeup.

Indians, and many other populations in the world, have what is called the ‘Thrifty Gene’. It is designed to store fat and evolved as a survival mechanism in response to famines. But, in today’s times of plenty and sedentary lifestyle, its presence predisposes us to disease in many ways, including by making the body store fat around the belly. “Central obesity” is a stronger disease risk factor than generalised obesity standardised as BMI>30. Indians and Asians with BMI>23 are considered medically obese.

We are also genetically predisposed to have higher LDL (bad cholesterol) and lower HDL (good cholesterol) further stacking the odds against our hearts, which are known to develop cardiovascular diseases at least a decade before their Western counterparts.

Stress not only potentiates these conditions, stress triggers early onset and complications. Add to it the fact that all these diseases progress silently in early stages—when they are reversible and most treatable—and what we have is a ticking health bomb that can only be deactivated with a considered and consistent promise to work with our body.

Some stress is good. In fact, some stress is important for your very survival. For example, it will be “stress” about your health that will push you to take corrective action and save yourself. It may sound funny and oxymoronic, but it’s true.

There are two kinds of stress—eustress and distress.

Eustress is the “butterflies” you feel before an important event, competition or even a date. In such situations, there is the release of stress hormones in the body, like adrenaline and cortisol, which makes your heart rate go up, and so does your breathing rate, you feel nervous but thrilled. This pushes you to perform well. As soon as the event is over the stress hormones reduce and there is a feeling of achievement and relaxation. This is good stress. It is what prepares your mind and body to be alert and respond well, including to “acute stress”. Even acute stress is not bad if we can help the body return to its natural state of relaxation.

Stress becomes bad when it is prolonged for long periods without periods of relaxation. The stress then becomes chronic, burn-out, constantly unpleasant or feels inescapable. Some of it can be changed, like finding ways to organise work and meet deadlines—an art you can perfect. But some distress still can’t be changed. What do we do? We learn to manage stress.

Learning to combat stress daily is as much a professional requirement as is continuous up-skilling. You need to stay fit to stay the course. This is also the stage where the bilateral nature of healthy eating, sleeping, exercise, and mental peace—all the things stress was hijacking—can be used to beat it.

1. Walk, if you can’t run. Try to complete your 10,000 steps every day, or meet the 150 minutes-a-week quota. Walk after dinner to lower the surge in blood sugar level and ward off diabetes for as long as you can.

2. Take mindfulness breaks. Get up from your chair once every hour to walk, share at the sky and break the cycle of stressful thoughts. Sitting is also the new smoking. If you must keep working, stand and do it.

3. If you smoke cigarettes, discuss gentle cessation techniques with your doctor. Avoid daily alcohol intake. If you must drink, limit it to 30ml for women and 60ml for men.

4.  Sleep at least six hours every day. If you must cut on sleep, ensure you restore balance within 72 hours, maximum. Amid the sleepless nights, find the little joys of life that will help you smile, breathe deeply, and meditate.

5. Eat meat in moderation, and choose a predominantly plant-based diet.

6. Do a digital detox every night. Switch off all gadgets for at least half a day once every week. Reduce loud noises in your environment. Choose soothing, calm music. Try the forced laughter technique; it works.

7. Use positive self-talk. Use sticky notes to remind yourself how amazing you are. Use sticky notes to tell your loved ones something similar.

8.  Reach out for help. Always talk to a friend, and count your doctor among them. In times of distress, stay regular with preventive health check-ups to catch the silently progressing problems. Work with your doctor to learn what your test report means.

9.  Be gentle with yourself. You may not be able to follow these tips all the time. When you can’t, forgive yourself and start afresh. Leave no space for guilt or self-deprecation.

These basics may not seem impressive, but the outcome of following them sure will be. Know that a combination of following these tips, and a holistic healthcare plan wherein a doctor empowers you with a 10-year heart disease prevention strategy, gives you the best chance to be the high-power professional you trained to become.

As hard-working Indians, who have won hearts globally, we owe it to ourselves and our families to invest in our health just as well as we invest in our financial portfolios. Know that bad health is not a fate we have to accept.