Words with Cardiologist Dr Ong Sea Hing
Dr Ong Sea Hing is a Cardiologist from Farrer Park Hospital, Singapore. His subspecialty is in coronary artery angioplasty and stenting, including complex coronary interventions. He is also trained in structural heart interventions.
He recently visited Bangladesh thanks to the International Medical Consultants (IMC), a unique healthcare assistance centre in Bangladesh.
In an interview with Dr Ong Sea Hing, he has shared his views about lifestyle facts related to cardiac diseases and about living a healthy life exclusively for the readers of Star Lifestyle. The major takeaways of the interview are as follows:
What are the main risk factors of cardiovascular disease? The ones that are the most common?
Cardiovascular disease is a prevalent and common group of diseases including heart attacks and strokes. Technically it's a disease of the blood vessels of the heart that supply blood to the organ. There are five main risk factors of cardiovascular disease which include family history of heart disease, diabetes, tobacco smoking, hypertension and high cholesterol.
To minimise the risks of the particular disease is to manage the risk factors. I believe the family history, the genetic one, is the strongest one, the one we cannot control but the other four we can. We sometimes call these 5 the "royal flush" in jest.
How can each of these risk factors lead to cardiovascular disease?
The problem with cardiovascular disease is that over time, blood cholesterol infiltrates into the wall of the blood vessels supplying the heart muscle, slowly accumulating and eventually causing narrowing of these blood vessels and reduction in blood flow to the heart muscle.
These major risk factors lead to disease because they damage the integrity of the blood vessel walls allowing cholesterol to infiltrate into the wall itself. We call this damage to the wall "endothelial dysfunction." The blood vessel walls are damaged due to genetic pre-disposition, toxins from tobacco, high sugar in diabetics and physical stress from high blood pressure.
What are the dietary and lifestyle habits we should follow/avoid?
One of the major steps towards reducing the risk of heart diseases is through taking proper diet. By taking low carbohydrate and high fibre diets. In addition, we recommend patients to exercise for at least two and a half hours a week.
They are asked to undergo moderate intensity exercises. Basically getting their heart rate above 70 to 80% of their maximum heart rate. Pick the number 220 and deduct your age, and you get the expected maximum heart rate. So, you need to get to those heart rates for above 150 minutes a week in order to have the bona fide benefits of exercise.
Exercise enhances your heart and lung power and further assists in reducing calories, carbohydrate and sugar. In short, exercises and diets help you maintain cholesterol and diabetes. Another advice is to avoid smoking tobacco.
Vegetables with high fibre are strongly recommended. Brown rice, wholemeal bread and oats are better higher fibre options for carbohydrates.
Heart attack, stroke and kidney disease tend to manifest 5-7 years earlier in South Asians than in Caucasian/European populations. Why do you think that is?
I think genetics and diabetes are the strongest reasons of all. If your parents and siblings have heart diseases, I am afraid there is a high chance that you might inherit it as well. Secondly, South Asia has many diabetics which is one of the major risk factors of cardiovascular diseases.
How is early detection of cardiac diseases undertaken?
Common screening tests for heart disease are chest X-ray, exercise stress testing, echocardiography, and CT coronary angiography. Depending on your cardiac risk profile, your doctor will be able to advise the most suitable screening test. This may include treadmill exercise testing, stress echocardiography and CT coronaries.
What are the types of treatment available?
Early detection and treatment by a cardiologist will prevent escalation of the disease process. If there is significant disease a stent can be placed to reduce the narrowing of the arteries. If the condition is severe enough then surgery may be recommended. In cases of left main disease and severe triple vessel disease, bypass surgery not only reduces angina, it prolongs life and reduces the risk of sudden death.
For severe mitral valve leak, mitral valve repair restores the normal function of the valve and heart function. On the other hand, for severe aortic stenosis, aortic valve replacement will relieve the obstruction and restore normal heart function.
The quality of life after heart surgery is wholesome and should approach that of normal life span if the patient is able to maintain a healthy lifestyle.
Photo courtesy: International
Farrer Park Hospital, Singapore,
local office contact: Fazana Wali Liza
Phone: 01783 929292
International Medical Consultants