Cardiologist Dr KHOO KAH LIN answers some common questions about heart health.
I AM a 41-year-old executive. I have a highly demanding job. I heard that stress could cause a rise in my blood cholesterol level and this may lead to heart disease in the long term. Is this true? Isn’t increase in the blood cholesterol level caused by too many calories instead?
Stress does not raise blood cholesterol. High blood cholesterol is due to taking food high in total fat, saturated fat or cholesterol. It is not due to taking too much calories from other sources.
I have just turned 40. At what age does my risk of getting heart disease increase? Do I need to start taking preventive action now? Though I may not be very careful with what I eat, I normally do not skip meals. Please advise.
The risk of heart disease increases with age. This is due to atherosclerosis. This is a process in which cholesterol is deposited in the vessel wall. There are two types of risk factors for atherosclerosis: non-modifiable risk factors namely age, sex, and modifiable risk factors, which include hypertension, diabetes, high cholesterol, smoking and overweight problems
It is recommended that preventive measures be taken, such as an annual medical exam to identify the risk factors mentioned above and treat them.
How often does one need to go for a heart health medical check-up? I am 35 years old. What type of check-up is important for me? Can you also recommend a suitable medical check-up for my 57-year-old mother?
A medical check up once a year is normally recommended. The check up consists of physical exam, X-ray chart, ECG, blood and urine examination. If the doctor thinks a 35 year old requires a treadmill test (exercise ECG) because of chest pain, he would recommend it. Otherwise, a treadmill test is recommended for people over the age of 40 years such as your mother. The medical check-up for your mother and yourself are the same.
I am a retired civil servant and have just turned 60. Do I need to worry about lowering my blood cholesterol? And will lowering my blood cholesterol help me live a better life?
Blood cholesterol is a vascular risk factor and the problem has to be addressed. This can be done by monitoring the blood cholesterol annually. According to the National Cholesterol Education Programme (NCEP) Adult Treatment Panel III (2001), the most important fraction is the LDL cholesterol.
Ideally the LDL cholesterol should be at optimal level to prevent vascular disease such as heart attack, stroke and peripheral vascular disease. The treatment of high LDL consists of therapeutic lifestyle changes such as regular daily exercise (brisk walk 30 minutes daily), weight reduction to desirable body weight, low fat, low saturated fat and low cholesterol diet.
Lipid lowering medication should be added if LDL levels are not achieved with the above lifestyle changes. Your doctor will advise you on the type of medicine to take.
I am in my early 40s, and a working mother with two children. I would like to know what could cause an increase in cholesterol level? And how does adding fibre to my diet help in lowering my cholesterol level?
Cholesterol level may increase through increased consumption of high fat food, increased body weight per se, such as taking high caloric food like sugar, carbohydrate or even taking the same quantity of food but lack of exercise.
Levels may also increase with diseases such as diabetes, thyroid, liver and kidney disease.
There are two types of fibre – water insoluble and water-soluble fibre. The insoluble fibre is good for providing bulk and preventing constipation and colon cancer. Soluble fibre from wheat bran, oat bran, beans and psyllium seeds inhibit cholesterol absorption and lowers serum cholesterol. It is not very effective if the cholesterol is high. It will lower cholesterol only by 10% to 15%. However, combined with other lifestyles changes, it is quite good.
I’m a 46-year-old father of three teenage kids and I’ve recently been promoted to Managing Director of an international company. Lately I suffer from drowsiness and headaches after my usual brisk walk in the mornings. My brisk walks last for about 15-20 minutes. My doctor also said that my blood pressure is high. I would like to know – does stress cause hypertension as well? What are the symptoms of hypertension?
Stress does not cause hypertension. Hypertension may be classified into two groups according to the cause:
This is due to unknown causes, also known as essential hypertension. This comprises 85% of hypertension cases.
This is due to known causes. The word “secondary” means “as a result of some illness”. The common illness in this category is kidney disease. A total of 15% of hypertension case falls into this group.
Hypertension does not give rise to any symptoms. Hence it is frequently called a “silent killer”. It is frequently detected during routine medical examinations, pre-employment examinations, insurance examinations and health screening programmes. It may be detected late when the patient presents with complications of hypertension such as stroke, heart attack, angina pectoris, heart failure and kidney failure.
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