Heart
Heart Attack
‼️Wake up India: Epigamia co-founder Rohan Mirchandani, 42, died from a sudden cardiac arrest.
1 in 4 reading this in India will die of a disease of the heart (Atherosclerosis). 33% of these will experience their first cardiac event as ‘sudden death’ like Rohan Mirchandani or Ambareesh Murthy of Pepper Fry
Is Atherosclerosis really sudden? I lost my father (at 37) & my brother (35) to heart disease (not an attack). I am at high risk of the same. Thus, I have read a lot on heart attack + stroke. Here are some things every Indian must know:
- It is the no.1 killer in India & the world
- Atherosclerosis is ubiquitous & inevitable. You either die from or with it
- It starts in your teens (7% deaths) but takes decades to manifest
- Women are 10x more at risk to die from Atherosclerosis than breast cancer
- The medical world knows a lot about Atherosclerosis. We can delay it
- Your biggest risk = AGE
- We blame cholesterol but there is no such thing as good or bad cholesterol. No cholesterol = No life. Not more than 10% of dietary cholesterol makes its way into circulation
Then what causes it?🤨
Body makes its own cholesterol, some cells more & some less. Hence needs transportation to the ones that make less. It is the transportation of cholesterol and triglyceride inside a lipoprotein (both being hydrophobic) that starts the process of Atherosclerosis.
Every Lipoprotein vehicle that transports is wrapped with apoB. The number of vehicles = Lipoprotein/apoB is a predictor of risk. Sadly we measure weight as a risk. Wrong. The NMR technology that can detect apoB particles or LDL particles that predict the risk decades early is not available in India.
While travelling inside the blood vessel, apoB particles get stuck in the single layer endothelial and release oxidative stress. Body sends soldiers to fight➕repair the damage. The more damage (smoking/blood pressure/carbs/sugars etc) the more repair is needed. As the damage continues the repair process accelerates breaks open, and enters the blood vessel and body sends bigger tanks and aircraft to combat resulting in plaque, narrowing the blood vessel and restricts the flow of oxygen leading to heart attack or stroke
You can also see the blockage through the latest tech like CT scans
What can you do?
- Tests regularly. If you travel abroad, test for apoB/LDL-P
- If not, use LDL-C as a proxy. If high, bring it down. Speak to your cardiologist. Use medication like Statins or CPSK9 inhibitors.
- After age, big contributors = smoking & blood pressure.
- Exercise is the biggest weapon for heart health.
- Sleep for 8 hours. Under sleep even for 2 hours increases your risk of heart attack by 200%
- Eat less. Law of thermodynamics. All excess energy will be converted into fat (triglycerides). The more triglyceride, the more vehicles required.