World Heart Day: How to check the heart health

Heart disease is a major concern for many, and even those leading healthy lives often wonder if they are truly safe from a heart attack. A friend recently asked me what early signs of heart disease he should look out for, despite living a seemingly healthy lifestyle. This question is common and important, but do we have a reliable answer?
Common early warning signs of heart problems include chest pain, which can feel like tightness, squeezing, or aching, often spreading to the neck, arms, stomach, or upper back.Shortness of breath is another major symptom, as is swelling in the legs or ankles, which may indicate heart failure. Fatigue, dizziness, and fainting are also signs of potential heart issues, and a loss of appetite or nausea can occur when the heart isn’t pumping blood effectively to the digestive system.
Unfortunately, many people ignore these signs, mistaking them for minor issues such as aging or indigestion. Basic tests like ECGs, echocardiograms, stress tests, and blood work can be ordered by your primary doctor and could save your life. However, early warning signs are not always reliable, with only about one-third of people experiencing symptoms before a heart attack. In many cases, chest pain might be caused by something unrelated, like muscle strain.
So, can we truly predict our heart disease risk, and more importantly, reduce it? Medical research has identified several risk factors that increase the likelihood of heart disease. The good news is that many of these are reversible. According to the World Health Organization, a healthy lifestyle can prevent 80% of heart attacks. The American Heart Association highlights eight essential factors for heart health, including four key behaviors—eating a healthy diet, avoiding smoking, exercising regularly, and getting good sleep. Additionally, four important health measurements to track are blood pressure, blood sugar, cholesterol, and body weight.
Using online tools like the Qrisk3.org calculator, you can predict your 10-year or 30-year heart attack risk by entering data such as age, family history, diabetes status, smoking habits, and blood pressure. Although these calculators can’t predict your exact fate, they can provide a general idea of your risk and offer insight into how to lower it. While these tools are developed in Western countries, they have proven useful for Indians, especially with adjustments for South Asian ancestry.
Regular health check-ups, particularly after age 40, are vital for assessing heart disease risk early. By catching problems before they become symptomatic, your doctor can recommend lifestyle changes, medications, or even further tests like a heart CT scan or blood work for inflammatory markers like hsCRP.
In conclusion, the best approach is two-fold: monitor and correct any risk factors you can control, and remain vigilant for early warning signs. Heart disease is common, but it doesn’t have to be inevitable. Taking proactive steps can significantly improve your odds of living a longer, healthier life.
(Author: Dr Rajiv Agarwal, Principal Director, Cardiology, Max Smart Superspeciality Hospital, Saket, New Delhi)