Cardiac specialist stresses the importance of exercise

PUBLISHED : Thursday, 08 October, 2009, 12:00am
UPDATED : Thursday, 08 October, 2009, 12:00am

Many Hongkongers are experiencing stress in these uncertain financial times - the byproducts of which have definite physiological effects, especially on one's overall cardiovascular health and likelihood of developing coronary artery disease.

More stress can lead to higher blood pressure and a greater chance of coronary heart disease, and irregular heart rhythms - a condition called arrhythmia. Stress also exposes people to unhealthy levels of stress hormones such as adrenaline and cortisol.

Over the long run, apart from experiencing irregular heart rates, symptoms can also include a higher rate of blood clotting and elevated heart attack risk. According to Dr Adam Leung, a cardiac specialist at Hong Kong Adventist Hospital, other risk factors associated with increased stress are that people tend to eat more and exercise less, leading to cardiovascular problems because of greater cortisol in blood lipids and more cholesterol deposits in the arteries resulting in arterial sclerosis.

Leung has seen more stress-related cardiovascular cases in the year since the financial crisis. Some of his patients have symptoms simulating heart problems such as breathing difficulties and chest pains.

Although some people have prior health issues, Leung and his colleagues had noticed new cases of patients suffering from hypertension, heart palpitations and arrhythmia. 'Sometimes heart palpitations can be benign. But they can also be because of coronary artery disease which can cause heart attacks,' he said.

Leung has seen a spike in more patients with cardiovascular problems since last November and December. 'People can tolerate stress for a few months, but after a while problems in the body build up.'

Poor cardiovascular health also has consequences for other aspects of a person's life. Prolonged stress causes people to become more worried during tumultuous times which can disrupt their circadian rhythms - preventing them from sleeping well.

The ripple effects are pernicious because sleep deprivation and stress can cause problems with concentration and memory.

'All of which can affect [workplace] productivity, your ability to make decisions and relationships with friends, co-workers and family,' Leung said.

Traditionally, the age group most afflicted by cardiovascular problems and coronary artery disease tends to be people over 50. However, local physicians have noticed a changing trend in the past 20 years: more young professionals in their 20s and 30s have experienced such symptoms.

Leung attributes such maladies among young people to lifestyle and workstyle changes, and the stress associated with them. He believes it is a new trend - the effects of which are the culmination of 'several factors such as stress, [poor] diet, smoking and less exercise'.

Men are more affected by cardiovascular problems. However, Leung cautions that women after menopause are catching up. Similar symptoms associated with panic attacks, such as heart palpitations, are more common in women.

'Mood disorders simulate many heart disease symptoms and women tend to suffer more from those,' Leung said.

Conventional wisdom holds that prevention is better than cure. But it is debatable whether such notions resonate with Hongkongers gripped by recession.

Many people put off preventative medical care, such as annual checkups, angiographies and electrocardiograms, thinking it is better to delay spending money until they are genuinely ill.

However, such an attitude is imprudent, according to Leung, who believes early prevention and detection is always better.

Treating health problems later can require more expensive and invasive treatment such as balloon angioplasties, radiofrequency ablation or surgery to implant a pacemaker.

'When you look back on a heart patient's quality of life, you see that many of their risk factors could have been controlled early on such as high cholesterol and high blood pressure. Such things can be prevented from happening,' he said.

He recommends that everyone exercise regularly, at least three times a week for 30 minutes per session.

Leung suggests aerobic exercise for its release of endorphins - 'feel good' hormones which aid stress management and help maintain a positive disposition. However, he said that people should set 'reasonable goals' for working out and not overexert themselves.

For example, while local gym memberships are often expensive, jogging, fast walking or swimming are all free and provide ample salutary benefits.

Similarly, although supplements and fresh or organic produce can be costly, Leung believes a wide variety of healthy foods are locally available for every budget.

'You don't need organic food,' he said.

For good overall health, it is important to consume cereals and vegetables for their high fibre content, while limiting daily fat, salt, sugar and cholesterol intake. Leung believes it is crucial that people 'consume 5-6 servings of fruit and vegetables daily' because many modern ailments stem from unsound nutrition.

As for preventative measures to maintain good cardiovascular health, Leung reckons a healthy adult male should have annual checkups when they are 40 and older. 'For women I would say about 45 and up.'

Checkups are beneficial because they enable physicians to conduct physical exams to gauge symptoms or signs of cardiac problems through blood tests to measure glucose and cardio-stress levels, and to inquire about a patient's medical history.

'For people with known cardiac risk factors, such as smoking or family history, they should have regular checkups even earlier,' Leung said.