How Do I know My Heart Is OK?

Introduction

The recent death of 31 year old Music Mogul Jamal Edwards came as a shock to the entire nation. His sudden death by heart attack at such a young age has catalysed people’s concerns regarding their own heart health.

Cardiovascular disease is one of the major causes of mortality and morbidity, andaffects around 7.6 million people in the UK. 24% of all the deaths in the UK are attributed to a cardiovascular condition. 

It is important to track your heart´s health and begin early intervention in case of any abnormalities. There are many ways one can track their cardiac health and manage it accordingly.

Parameters like heart rate, blood pressure, cholesterol levels, C-reactive proteins and blood sugar levels provide a good insight into one's cardiac health. Other factors like amount of daily exercise, stress levels, breathlessness on exertion etc also signify important aspects of cardiac health. Some of these assessments can be done at home by yourself, while some require healthcare providers. Let’s dive deeper into each of these factors and understand how your heart calls out for help.

Check your heart rate

According to the British Heart Association, the heart rate refers to the number of times your heart beats per minute. It usually ranges between 60-100 beats per minute while resting, with the ideal rate being 72 beats per minute. A heart rate of less than 60 beats per minute is termed bradycardia, while a heart rate of more than 100 beats per minute is called tachycardia. 

Heart rates may fluctuate and are affected by factors like having a fever, exercise, stress, pregnancy, dehydration etc. However, if it causes dizziness, shortness of breath, blurred vision or confusion then you must contact your healthcare provider immediately. 

You can check your pulse by placing your index, middle and ring fingers on your wrist. Once you put your fingers on your wrist, you can feel the throbbing of the radial artery and count the number of beats per minute. Nowadays, digital devices like pulse oximeters and digital sphygmomanometers also show the heart rate.

Everytime the heart beats, it makes a lub-dub sound, and it can be heard using a stethoscope. Any changes in the sound signify some anomaly in the normal functioning of the heart.

Check your blood pressure

Blood pressure is the lateral pressure exerted on the arterial walls by blood. Blood pressure is classified into two- systolic and diastolic. Systolic represents the blood pressure during the contraction of heart muscles, and diastolic represents the pressure during the relaxation of heart muscles. The systolic BP ranges between 100-139 mm of Hg, while the diastolic ranges between 60-80 mm of Hg. A normal blood pressure is considered to be 120/80 mm of Hg, where 120 is the systolic and 80 is the diastolic BP. However, there is a lot of variation, based on age, sex, time etc.

A blood pressure of more than 140/90 mm of Hg is termed as hypertension, and a BP less than 90/60 mm of Hg is termed hypotension.

Hypertension is one of the leading causes of damage to the inner lining of the arterial walls leading to a stroke, haemorrhage, heart attack etc.

Previously blood pressure was monitored by a healthcare professional using a mercury sphygmomanometer and a stethoscope, but nowadays it has become easier to monitor using a digital BP apparatus. It has allowed for at home monitoring of BP, thereby improving intervention.

To check the BP accurately, the cuff of the BP apparatus must be tied around the middle of the arm, while the arm is kept in the resting position at the level of the heart. A stethoscope is then placed on the elbow pit, and then the cuff is inflated. This inflated cuff is then gradually released and korotkoff sounds are monitored. The point at which the sound starts is the systolic BP and the point at which it ends is the diastolic BP.

Check your cholesterol levels

Cholesterol is a naturally occurring substance in our body produced by the liver. Cholesterol may be good or may be bad, depending on its effects on the body. When low density lipoproteins (LDL) or triglycerides are in excess in our body it leads to the narrowing of the arterial walls. Clogging them can result in a stroke or heart attack. High density lipoprotein (HDL) is classified as good cholesterol. It protects the body from the detrimental effects of bad cholesterol by taking them back to the liver to be removed from the body. Hence, good cholesterol levels must be high and bad cholesterol levels must be low for the healthy functioning of the body. 

Cholesterol imbalance occurs due to intake of highly fatty food like fried food and red meat, processed sugars, smoking, an excess of alcohol and a sedentary lifestyle etc. Sometimes it is also genetic, and it occurs with other underlying conditions like hypertension and diabetes.

It is of utmost importance to maintain healthy levels of  cholesterol for a healthy heart. Cholesterol levels can be checked by a common blood test. According to the NHS, LDL must be 3 mmol/litre or below, HDL must be 1 mmol/litre or above and Triglyceride must be 2.3  mmol/litre or below.

Apart from taking a blood test, one should also monitor the visible signs of cholesterol imbalance like the deposition of cholesterol granules around the eyes also known as Xanthalesma. However this sign is more pronounced in Those assigned female at birth.

Check your glucose levels

Blood glucose level is the amount of sugar in your blood. An increased blood glucose level is termed as hyperglycemia and is a common sign of diabetes. In the UK, 4.9 million people have diabetes and 13.6 million people are at the risk of having diabetes. Studies have shown a close link between diabetes and heart diseases. It is thus also imperative to control and treat diabetes for better outcomes.

Common symptoms of high blood sugar are excessive thirst, excessive urination, excessive hunger, tiredness, blurred vision, unexplained weight loss and fruity breath. In case of any of these symptoms one must contact their healthcare provider immediately.

Blood sugar can be checked by  

• A capillary blood glucose or finger prick test, where a drop of blood is taken and tested on a glucometer. This is the most common method of at-home sugar monitoring and gives results within seconds
• A venous blood glucose test is done by collecting venous blood and sending it to a lab for more accurate results. It is usually done for diabetic patients.

Blood Glucose levels can be checked at various times. These include: 

• Fasting blood sugar levels 
• Post-meal sugar level
• Random blood sugar level

Glycated hemoglobin levels or HbA1c  levels are done by a healthcare provider and it gives the mean sugar levels for the last 2-4 months.

According to the NHS, “Normal fasting sugar must be in the range of 4-7mmol/l, while the post-meal sugar must be under 8.5mmol/litre. The HbA1c must be below 48mmol/litre.”

Check C-Reacting protein

 C- reactive protein (CRP) is an inflammatory marker and a plasma protein that is synthesised in the liver. The CRP levels increase in the blood in case of any infection, surgery or injury. CRP has long been associated as a risk factor with heart diseases like angina, stroke and heart attack.

In adults, normal CRP levels are below 0.3 mg/dL. High levels of CRP suggest acute inflammation and a level below 10 mg/dl suggest improvements and no longer indicate an ongoing inflammatory process. For heart diseases evaluation, CRP levels less than 1 mg/dL are considered  low risk while anything more than 3 mg/dL is considered high risk.

CRP level evaluation is done by healthcare practitioners when they suspect any chronic inflammatory disease. Sometimes it is also done for cardiac risk evaluations. 

How much physical activity do you do?

Physical activity  or exercise is always associated with better overall health including cardiac health. People with an active lifestyle are at lower risk of cardiovascular diseases, high blood pressure, type 2 diabetes and some types of cancer. Regular exercise reduces cardiovascular risk factors like lowering the blood pressure, blood sugar level, body weight, levels of LDL and increases the HDL cholesterol along with insulin sensitivity.

WHO recommends that healthy adults between the age of 18-64 years, 

• Must exercise moderately for at least 150 minutes per week or vigorously for 75 minutes per week. 
• Aerobic exercises must be done for the duration of 10 minutes each. 
• Muscle-strengthening activity must be done 2 or more days per week
• For better health outcomes, moderate exercise should be done 300 minutes per week or vigorous exercise must be done for 150 minutes per week

How are your stress levels?

A study by the Lancet has shown that stress is related to the development of cardiovascular diseases. Chronic stress causes pathological changes by stimulating various disease-causing responses of the body. Research has linked chronic stress at work and in private life to an increased risk of coronary heart disease by 40–50%. Interventions to reduce stress improve the quality of life for patients with advanced coronary heart disease, but there are conflicting results regarding their prognosis. Stress affects physical as well as mental health in the form of pains in various parts, anxiety, depression, infertility, palpitations, changes in dietary and sleeping habits etc. People start taking recreational drugs, tobacco or alcohol to deal with the stress which in turn causes more harm in the long run. It is important to measure and control stress levels for a healthy heart and life.

Is your breathing healthy?

The respiratory rate is the number of breaths per minute, it includes the process of inhalation and exhalation. It is usually expressed in breaths per minute, which is usually 12-20 per minute, but it can vary slightly. The most common breathing abnormality is dyspnea, which refers to shortness of breath and is a common symptom of heart attack, heart failure, arrhythmias etc. It is important that the respiratory rate is within the normal range with no abnormal sounds.

Signs of an Unhealthy Heart

• Pain in the chest, arms. Legs,jaws 
• Shortness of breath on exertion
• Abnormal heart rate
• Hypertension
• Discolouration of tips of fingers, and/or lips
• Abnormal heart sound, or breathing sounds
• Abnormal breathing patterns
• Anxiety, palpitation

Conclusion

To summerise, it is important to regularly check the health of your heart through monitoring herat rate, blood pressure, cholesterol, glucose and C-Reacting protein levels. Exercising regularly and regulating stress levels can also significantly improve heart health.