The illusion of “I am fine” create dangerous complacency after individuals undergo health checks which inform them that their overall health parameters are normal. However, muscle loss due to sedentary lifestyle, insulin resistance, and pathological visceral fat can accumulate for years before any standard medical test or blood marker turns abnormal.
A bloop pressure (BP) reading in a doctor’s office may be normal, but absence of nocturnal BP dip or early morning BP surge, psychosocial stress-induced BP rise or BP elevation during periods of obstructive sleep apnoea (masked hypertension) are the first indicators of hypertension-induced complications.
A normal resting electrocardiogram (ECG) may hide underlying significant coronary artery disease in 30% of cases, especially if associated with metabolic syndrome (abdominal obesity, pre-diabetic status, borderline hypertension or mildly abnormal lipids). Abdominal obesity is a ticking bomb which drives inflammation and can be fertile soil for development of diabetes, hypertension, vascular disease, dyslipidaemia, cancer and degenerative cerebral disease.
A normal treadmill stress test only tells you that exercise you have undertaken at that juncture, did not produce ECG changes. As moderate degree of coronary obstruction will not give ECG changes on exercise. The heart can look and feel fine until the extra demand of heavy lifting or extreme exercise increases adrenergic overdrive and causes turbulence, increased shear stress in a partially blocked artery, or irritates an electrical focus in the heart – then it fibrillates and stops pumping. Minor coronary plaques can turn dangerous, rupture and cause life threatening heart attacks if the individual is exposed to active or passive tobacco smoke, substance abuse (specially cocaine), violent emotional outbursts, extreme exercise (youngsters collapsing in gyms or running marathons), uncontrolled metabolic parameters, especially blood sugars.
One should make sure to not neglect atypical symptoms like unexplained fatigue, breathlessness on daily activities or bending, jaw pains or pains in upper abdomen. As a heart attack does not occur without a reason; it may result from a combination of genetic, epigenetic, and environmental influences, along with concomitant risk factors such as hypertension, diabetes, obesity, tobacco or substance abuse, sleep deprivation, abnormal cholesterol metabolism, and a sedentary lifestyle.
{{/usCountry}}One should make sure to not neglect atypical symptoms like unexplained fatigue, breathlessness on daily activities or bending, jaw pains or pains in upper abdomen. As a heart attack does not occur without a reason; it may result from a combination of genetic, epigenetic, and environmental influences, along with concomitant risk factors such as hypertension, diabetes, obesity, tobacco or substance abuse, sleep deprivation, abnormal cholesterol metabolism, and a sedentary lifestyle.
{{/usCountry}}A normal health check is not to be considered a passport to healthy next decade of life. Healthy plant-based diet which enables healthy gut microbiota, 30 minutes exercise (aerobic and resistance training) for five days a week, seven hours of uninterrupted sleep and avoiding mental turmoil is the mantra to good cardiovascular health.
(The views expressed are personal)
This article is authored by Dr Prakash Sazangiri, consultant cardiologist, Lilavati Hospital And Research Centre, Mumbai.