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Journalism of Courage
Thirty-year-old Sailesh Vishakarma has been planning to join the gym to lose some weight, his obesity being a result of long work hours, sedentary living, late-night eating, lack of sleep and exercise. At a time when young people are becoming increasingly susceptible to heart attacks, he has been concerned about why he heaves and pants while climbing up just two flights of stairs. So he decided to join a gym where the instructor suggested a treadmill test. All the diagnostic laboratories he called for a basic heart health checkup recommended a battery of tests, too. Snowed in with differing advisories, he was confused. But you do not need to find yourself in this condition as cardiologists tell you how monitoring blood pressure, cholesterol and fasting blood sugar levels are enough markers of your heart health. And the doctor is the best person to tell you what to do if your markers are deranged.
What are the tests you need to check the status of the heart?
Doctors recommend that every 30-year-old, especially men, undergo tests to check at least the three basic parameters — blood sugar, blood pressure and cholesterol levels as elevated levels of each increase the risk of heart attacks and strokes. The fasting glucose test, which measures your blood sugar levels after a night of fasting, can indicate prediabetes and diabetes, which increase the risk of heart disease. A fasting blood sugar level of 99 mg/dL or lower is normal, 100 to 125 mg/dL is considered prediabetes, and 126 mg/dL or higher indicates diabetes. The HbA1c test, on the other hand, indicates the average blood sugar levels over the last three months and should be less than four per cent.
Elevated blood pressure levels are a measure of the force that your heart uses to pump blood around your body. If left unregulated, this heightened pressure can have adverse effects on the functioning of your arteries and blood vessels, impeding the functioning of the heart. The blood pressure needs to be measured at least a couple of times on different days to ensure accurate readings. The normal blood pressure is around 120/80mmHg.
A cholesterol test, also called a lipid panel or lipid profile, measures fats in the blood. When we consume cholesterol beyond the body’s utilisation capacity, the surplus cholesterol has the potential to accumulate within the arterial walls, including those surrounding the heart. Watch out for levels of bad cholesterol or low-density lipoprotein (LDL) and triglycerides. Doctors may prescribe statins if the LDL levels are very high. A normal LDL level is considered to be below 100 mg/dL and a normal triglyceride level is below 150 mg/dL.
How do I know which test is right for me?
With young Indians becoming more vulnerable to diseases, do they require to subject themselves to a battery of tests? Dr Rakesh Yadav, professor of cardiology, AIIMS, Delhi disputes that young people in their 20s or 30s need to go through multi-pronged tests. “There is no scientific basis simply because the tests haven’t been shown to reduce mortality,” he says. With cases of young heart attacks on the rise — and many not knowing that they have diabetes or hypertension — Dr Yadav feels that the focus of preventive health checks should be on three parameters only. “We need to know the blood pressure, blood glucose and cholesterol levels of a person. That’s it. And, the three tests are only meant to make people aware of their status and start medication if needed. For all other parameters, whether they are high or low, the only intervention is lifestyle change, which we anyway suggest. If the genetic risk is high, the lifestyle risk needs to be reduced,” he says, adding there is no need for tests like ECG, echocardiogram or treadmill test. These tests should be done only for diagnosing certain conditions on advice of a clinician, he suggests.
Once the marker tests are done, the person need not undergo another preventive health check for five years. “After the age of 30, everyone should get the three parameters tested once in five years. After the age of 40 or 45, it should be once every two to three years. And, only after the age of 60 years should the tests be done annually,” says Dr Yadav. Should you develop complications in the intervening period, please consult a cardiologist or a medical practitioner.
How do these tests help in timely intervention?
Early diagnosis of the three conditions and keeping the parameters in check can bring down the risk of heart attacks, strokes and other complications. The three conditions, especially hypertension, do not usually manifest as perceptible symptoms, meaning that people may remain undiagnosed for years in the absence of the preventive tests. This gives the diseases time to wreak havoc on the other organ systems, including the heart. And even when diagnosed, it is not easy to control all three parameters. An ICMR-supported study published last year found that only 7.7 per cent of the people who had already been diagnosed with diabetes could get these three parameters under control.
The idea behind preventive health tests is not just to detect life-threatening conditions early but to inform a person about their general health and the precautions they might take to avoid lifestyle-related conditions like diabetes, hypertension and heart disease. And these three increase the disease burden of Indians. “A preventive health check can help in early detection of diseases and triggers, where perhaps a lifestyle intervention can change the course. We will know how to care for our bodies,” says Dr Suranjit Chatterjee, Senior Consultant, Internal Medicine, Indraprastha Apollo Hospital, New Delhi.
