Heart Health

Not only does the 1 September herald the beginning of Spring in the Southern Hemisphere, but it also announces the start of World Heart Awareness month. As we notice the first blossoms and the returning swallows, we focus on heart health and the challenges we face to increase awareness regarding healthy lifestyles.

During his Budget Speech presented to Parliament in May 2011, Dr Aaron Motsoaledi, our esteemed Minister of Health explained the quadruple burden of disease that we South Africans have to contend with and said the following about the threat of NCDs ( non-communicable diseases:  high blood pressure and other cardio-vascular diseases; Diabetes Mellitus; chronic respiratory disease; the various cancers and mental health (sic)

‘I am saying so, because NCDs are not only biomedical, but are largely diseases of lifestyle. They are divided roughly into four categories namely:

• High blood pressure and other diseases of the heart and blood vessels
• Diabetes mellitus and a few other metabolic disorders
• Chronic respiratory diseases and asthma
• The cancers

These diseases are driven mainly by four identifiable risk factors viz:

• Smoking
• Harmful use of alcohol
• Unhealthy eating behaviours (diet)
• Lack of physical exercise’

These NCDs are seen as a great threat to  health and health expenditure globally and is becoming more devastating in Sub-Saharan Africa as it is adding on problems of communicable diseases or infectious diseases that have been plaguing   Africa for centuries. At a global high-level health summit in Moscow, consensus was reached that the prevention and control of NCDs requires leadership at all levels to create the necessary circumstances to practice healthy lifestyles. It was stated that cost- effective interventions to reduce the risk of NCDs were affordable in low-income countries and could prevent millions of premature deaths every year. These measures include tobacco control, reduce salt intake and reduce the harmful use of alcohol. Attention must be paid to promote healthy diets i.e. low content of saturated fats and trans-fats, salt and sugar and high concentrations of fruits and vegetables and physical activity in all aspects of daily living.

In conclusion the Minister stated that the effective NCD prevention and control require the active and informed participation and leadership of individuals, families and communities, civil society organization, private sector where appropriate, employers, healthcare providers and the international community.

With this in mind, one can appreciate that the pharmacy personnel are well positioned to drive heart health awareness in September (and always)  Since the heart (and the vasculature) are the starting point for the well-being of all  organs and systems of the human body to function optimally, by taking care of this vital organ the rest of the body will be in a better state.  The cardio-vascular system is a closed system with the heart as the powerhouse that pumps oxygenated blood via arteries to all the organs and returns de-oxygenated blood (via the veins) to the right side of the heart to transport it via the pulmonary artery to the lungs to be re-oxygenated. This oxygen rich blood is then pumped by the muscular left ventricle (a heart chamber) to the required areas. The heart functions continuously at a set rhythm with alternating periods of contraction (systole) and relaxation (diastole). The pressure within the veins and arteries differ during these two periods but should remain at more or less 120/80 mmHg.

Any factors that affect any of these aspects of the cardio-vascular system, can have deleterious effects on the well-being of a person as seen below:

As a pharmacist assistant you are in a privileged position as you have a trusting relationship with your regular clients. This relationship can be developed even more by you providing top-class healthy heart advice. There is so much one can address but for the purposes of this September edition, let’s focus on five medication free strategies to prevent heart disease and have a healthy heart .

Quit smoking or using tobacco

When it comes to heart disease prevention, no amount of smoking is safe, please stress when speaking to your clients that secondhand smoke is also very dangerous. Chemicals in smoke damage one’s heart and cause atherosclerosis (narrowing of the arteries) thereby forcing the heart to work harder. Carbon monoxide in cigarette smoke replaces some of the oxygen in your blood.

Advise your client that there are specialized programmes to assist him/her to quit. Smoke Enders, Alan Carr, the Men’s Clinic all see good results. Nicotine replacement pills, chewing gum, patches and sprays are available OTC. For those who have relapsed more than once, a specifically developed product like varenicline could be prescribed by a medical practitioner. Bupropion has also been available for a while. When discussing this issue with your client, the improved success rates of following a behavior modification programme must be stressed.

(please refer to previous Front Shop editions for additional advice such as supplementation during the quitting phase)

Exercise for 30 minutes at least 3 times per week

Getting some regular exercise can reduce the risk of fatal heart attacks. This physical activity helps a person control their body weight and may reduce the possibility of developing other stressful conditions e.g. high blood pressure. Remind your clients that activities like gardening, housekeeping, taking the stairs and walking the dog all count towards total exercise and have an added benefit of enjoying our lovely fresh air and the beauty of our country whilst out walking.

  Eat a heart-healthy diet

Eating a special diet called the Dietary Approach to Stop Hypertension (DASH) can help protect one’s heart. One would consume the following: foods that are low in cholesterol and salt. The diet is rich in fruits, vegetables, whole grains and low-fat dairy products, which can help protect the heart. Beans, other low-fat sources of protein and certain types of fish also reduce the risk of heart disease.

Of the fats consumed, one should avoid saturated (red meat) and trans –fats (deep fried fast food, bakery products, margarine, potato crisps) as these increase the risk of coronary artery disease by raising blood cholesterol levels. (please see previous FrontShop for an extensive article on cholesterol)

Add fruits and vegetables to the diet to have a healthy heart and also prevent cancer.

Omega 3 fatty acids, a type of polyunsaturated fat may decrease the risk of a heart attack, protect against irregular heartbeats and lower the blood pressure. Good sources of Omega-3 are salmon and mackerel and to a lesser extent, flaxseed oil, walnut oil, soybean oil and canola oil. There are many presentations of Omega 3 fatty acids on the market today to make supplementation extremely easy such as Re-vite Omega 3.

At a moderate level, alcohol may have a protective effect on the heart. Much has recently been written about resveratrol, a polyphenol found in red wines. Resveratrol is a powerful anti-oxidant thereby playing a role in increasing the HDL or ‘good’ cholesterol. It also prevents s damage to the lining of the blood vessels. HeartBeat Tablets contain 400mg CardioAid™ active plant sterols as well as the same amount of resveratrol that is contained in 34 glasses of red wine. HeartBeat tabs also contain heart-supporting amino acids, B-complex vitamins, Coenzyme Q10 and essential minerals.

Solgar Resveratrol is also available as a supplement to augment one’s intake of resveratol should you opt for a more driving friendly option.

The epidemic of obesity in our country needs to be addressed as a matter of urgency. The Heart and Stroke Foundation of SA recently published the following stats that 59% of women and 29% of men were obese. In certain subsets of the population the figure went up to 70%.  We know that carrying extra body mass leads to metabolic diseases and many cardiovascular disorders. It is quite disconcerting as many children are also overweight at an early stage.

Sweet placement in your pharmacy could assist moms with children not to purchase sugar laden chocolates at the till (rather display nuts, bran bars or better yet fruit, carrot sticks at the pay points)

Please refer to the previous articles in Front Shop to be of assistance to your clients by providing them with healthy eating plans.

Fortunately there are many cardio-protective products available at pharmacies today. The following will be valuable to a client who has taken the decision to follow a heart healthy lifestyle:

HEARTBEAT™ CHOLESTEROL SUPPORT DRINK MIX- a palatable drink that will help to lower cholesterol while providing essential nutrtionals.

HYPERTROL® RX-BLOOD PRESSURE® TABLETS – nutritionally supports healthy blood pressure of normo-tensive clients.

TOCOTRIENOL RX-CHOLESTEROL® SOFTGELS – this fruit-based tocopherol will support vascular efficiency

In conclusion, for excellent healthy heart advice,  please visit the Heart and Stroke Foundation of South Africa on www.heartfoundation.co.za