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Look after
your heart
your
Look after
heart
Look after your heart
Look after your heart
H
eart disease and strokes are currently the main causes of death, leading to almost 18 million victims every year across the globe.
For some decades now, doctors have known with a certain degree of accuracy some people’s risk of
suffering from heart trouble because they possess special characteristics which are known as “risk
factors”.
Many of us are unaware that our lifestyle habits and our genetic make-up may be detrimental to
our health. Some factors which contribute to increasing our risk of having heart disease can be
controlled, for example high blood pressure, cholesterol, nicotine poisoning, sedentary lifestyles,
etc. Other factors, such as sex and family history, cannot be controlled.
Any of these risk factors, or a combination of them, may make us more likely to suffer from heart
disease or a stroke. The aim of this booklet is to inform you and to help you identify your risk
factors — the so-called “overall risk”— so you can take appropriate measures to control them.
Although most people seem to agree that calculating the overall risk factor is a necessary measure
for population groups and individuals, it is not a kind of “crystal ball” which accurately predicts
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when and how you are going to fall ill, but the data collected for each person provide valuable
indicators which can be used as a starting point for cardiovascular disease prevention campaigns
at an individual or a wider population level.
Prevention, the best measure
Heart disease not only kills but produces disabilities which force people to stop working and to
undergo lengthy, painful rehabilitation treatment. This grim reality could be avoided by implementing prevention policies for the people and population groups most at risk. There are two types
of prevention to consider:
l Primary prevention: this is geared towards controlling risk factors once they appear and before
they cause cardiovascular diseases. Although this strategy focuses on the wider population, it may
also be individually based in order to ensure that the overall risk is lower than five per cent after 10
years. It is performed at your primary health care centre.
l Secondary prevention: this is targeted at patients who already have heart or brain diseases in
order to extend or improve the
quality of their lives.
Now it is time to look at which
risk factors must be taken into
consideration when calculating the
“overall risk” and establishing the
rules for cardiovascular prevention
and health promotion.
The booklet entitled Look after
your heart which you are now holding in your hands describes the
keys to preventing heart disease,
through healthy habits from childhood, and how to properly control
the main risk factors.
w You are the main
person responsible
for your health and
the one who will
most benefit, so
take control today
Look after your heart
This is how your heart works
T
ry and imagine your body as a perfect machine which needs an “engine” to keep it running
and “fuel” to feed it and to meet all of its needs.
Each of the cells in our bodies requires oxygen and nutrients to live, and these nutrients are delivered through the blood thanks to the work of the circulatory system which consists of the arteries
and veins and the heart.
And how does this work?
Just imagine that your heart is a pump which, with each beat, with each contraction, generates the
necessary force for the blood to circulate around the body and do its job. Thanks to its momentum,
any blood that has already circulated around the body and is oxygen-poor (venous blood) can reach the lungs and have its oxygen replenished. When this blood is once again oxygen-rich (arterial
blood), the heart pumps it around the body so that it can continue to maintain the supply.
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What route does blood take?
Blood which has already delivered its oxygen reaches the right auricle of the heart. From there, it
pours through the right ventricle (through the tricuspid valve) and, through the pulmonary artery,
it reaches the lungs to “re-load” with the oxygen we take in with each breath. From the lungs, it
returns via the pulmonary veins to the left auricle. After passing through the mitral valve, it reaches the left ventricle which is the real engine that pumps the blood. From there, passing through
the aortic valve, it enters the aortic artery which is its gateway to our bodies.
Under normal conditions, a heart beats some 70 times and pumps five litres of blood per minute
(almost 100,000 beats and 7,500 litres of blood per day). These figures can even increase fourfold
in situations in which extra effort is required.
The body’s engine
The heart is an organ whose walls are formed by a muscle, the myocar¬dium, which,
by contracting and relaxing sets the blood in motion. The pericardium is the tissue
which surrounds the heart and which facilitates the movements of the heartbeat.
The heart is formed by two auricles and two ventricles. The mechanisms which
ensure that the blood circulates in one single direction are the valves: the tricuspid
connects the right auricle and the right ventricle, while the mitral valve connects
the left auricle and the left ventricle. For their part, the pulmonary and aortic valves
are responsible for driving the blood towards the pulmonary and aortic arteries,
respectively.
And the coronary
arteries?
As we have already explained, the
heart is a muscular organ with a
primordial function and, therefore,
it also needs oxygen and nutrients
to do its job. It is the coronary
arteries which maintain this supply. These arteries originate from
the aorta and cover the whole of
the external surface of the heart;
additional smaller vessels branch
off from these to supply the heart
muscle with blood.
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Look after your heart
Cardiovascular diseases
W
hen the arteries which supply blood
to the heart become narrowed they
cannot do their job properly. This may lead
to coronary disease or ischemic cardiopathy
(cardiopathy because it affects the heart and
ischemic because it implies a lack of blood). In
other words, heart trouble can occur because
the heart does not receive enough blood.
Why does this happen and what are
the signs?
The commonest cause is a process, called
arteriosclerosis or atherosclerosis, in which the
blood vessels gradually harden and narrow due
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to the accumulation of fat and other substances which are deposited on the artery walls
(atheromatous plaques). The two main signs
of coronary illness are chest pain or angina
(when there is a temporary shortage of blood
supply to the heart) and a heart attack (when
there is total obstruction of a coronary artery
and, as a consequence of the lack of blood
circulation, the heart’s muscle cells die).
What else causes heart trouble?
Other important cardiovascular diseases are those which affect the heart rate
(such as arrhythmias), the myocardium
(myocar¬diopathies), the pericardium (pericarditis) and the valves (valvopathies) and
heart failure (which occurs when the heart is
not capable of pumping the blood needed by
the body).
Recognising the
symptoms and
responding effectively
The symptoms of angina are pain,
oppression or discomfort which begins
in the centre of the chest. Its intensity is gradual and usually appears in
situations in which the heart’s work
is increased by exercise, work and
stress, for example.
A heart attack is not usually related
to external circumstances, it does not
ease off spontaneously and usually
begins with a chest pain which is similar to that of angina but which lasts
for longer than 30 minutes. It may be
accompanied by sweating, nausea,
vomiting, etc. The seriousness of the
heart attack is determined by the size
of the affected area, which is why it
is important for the patient to reach
hospital as soon as possible in order
to receive treatment which enables
the artery to be cleared.
w The commonest heart
complaints are angina and
heart attacks.
What is atherosclerosis?
We can compare the atherosclerosis
process to that of a pipe which gradually becomes obstructed on account
of the “debris” that accumulates on
its walls and which makes its diameter – which determines the volume
of blood it can transport — decrease
gradually until it may even become
blocked. This situation can affect not
only the arteries of the heart, but also
those of the kidney, the brain, the
abdomen, etc.
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Look after your heart
Cardiovascular risk factors
T
he development of cardiovascular diseases is influenced by the so-called “risk factors”, in
other words, health characteristics, habits or circumstances which are capable of increasing
the risk of having a heart attack. Different studies and tests have proven the effect of these factors
on our health, as well as the capacity that we have, or don’t have, to influence them. In this way,
factors exist that are uncontrollable (which indicate our predisposition or risk level, but which
cannot be changed) or controllable (those which are affected by our lifestyles and individual behaviour).
Furthermore, as the development of arteriosclerosis is so slow and symptom-free, knowing our risk
level and the factors which cause it is essential for effective cardiovascular prevention.
Risk factors you can’t change
There are circumstances that we can do nothing about and which have a significant impact on the
development of cardiovascular diseases. These are:
l Age. Being over 65 years of age.
l Sex. Being a man, although women’s risk increases with the menopause.
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l Genetic make-up. Having direct relatives
with heart disease should imply greater awareness of the need to prevent coronary illnesses,
as the risk of suffering from them is higher.
Accumulated effect
One of the most important
characteristics to be taken into
account as regards the risk
factors is their accumulative effect.
This means that the more risk factors
a person has, the greater the risk
of having cardiovascular disease.
Moreover, most of them are inter-connected: they may influence or even
cause the development of
other risk factors.
Accumulative effect
One of the most important characteristics to be
taken into account as regards the risk factors
is their accumulative effect. This means that
the more risk factors a person has, the greater
the risk of having cardiovascular disease. Moreover, most of them are inter-connected: they
may influence or even cause the development
of other contributing factors.
w It is essential for us to
know our risk level and the
factors which cause it.
Risk factors you can change
These are risk factors that we can act upon
if we “educate” ourselves for health, in other
words, if we lead a heart-healthy lifestyle which
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Look after your heart
prevents them and slows down their appearance
and if we make ourselves responsible for our
own wellbeing by properly following therapeutic
treatments if available. The most important
controllable risk factors are:
l High blood pressure.
l Hypercholesterolemia (high blood cholesterol).
l Diabetes
l Nicotine poisoning
l Obesity and overweight
l A sedentary lifestyle.
Stress and the abuse of substances such as
alcohol are also thought to contribute to the
development of heart disease.
On the following pages, we will look carefully
at what the effects of these controllable risk
factors are on the heart.
w High blood
pressure
increases the
effort our heart
has to make.
A gradual process from childhood
Don’t forget that the development of arteriosclerosis is a gradual and slow process
and for a long time may not give rise to diseases or symptoms which warn us of its
presence.
Risk factors you can change: high blood pressure
So that blood can circulate around our bodies the heart needs to pump it at a certain pressure:
blood pressure. This pressure is optimum when it allows the tissues to receive the blood they need
at each moment in time. Our blood pressure is low if it is below this optimum level. If it is higher,
it is known as high blood pressure (a person is considered to have high blood pressure when his or
her blood pressure figures are equal to or higher than 140-90 mmHg).
Effects on the heart
High blood pressure puts a strain on the arteries (which become hard and narrower thus hindering blood circulation) and increases the effort the heart is required to make. Consequently, it
significantly increases the risk of having a heart attack or a stroke.
The other great danger of high blood pressure is that it is a silent evil. It has no symptoms. That is
why it is important to know and monitor our blood pressure.
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Causes and diagnosis
There are a high number of people with high blood pressure whose cause is not
known. But its development involves diet, smoking, a sedentary lifestyle, obesity, etc.
It is diagnosed by measuring systolic pressure (which is at its highest when the
heart expels blood) and diastolic pressure (at its lowest when the heart rests in
between beats).
Its treatment is...
Always depending on the decision
of a specialist, treatment may be
non-pharmacological (diet and exercise) or pharmacological (beta-blockers, calcium channel antagonists,
diureti¬cs, ARA II or angiotensin
receptor antagonists). Do not selfmedicate or stop your treatment.
Always consult your doctor.
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Look after your heart
Risk factors you can change: hypercholesterolemia
(High blood cholesterol)
Cholesterol is a fat molecule which circulates around our blood and which is essential to life.
However, when the overall figures exceed suitable levels (200 mg/dl), hypercholesterolemia occurs:
an increase in the cholesterol in the blood which leads to cardiovascular disease and, in particular,
ischemic cardiopathy. Furthermore, it is very important for us to know our levels of LDL cholesterol, commonly known as “bad cholesterol” — related to the formation of atheromatous plaques
(it must be lower than 130 mg/dl) — and HDL or “good cholesterol” — which favours the
metabolisation of cholesterol by the liver and, therefore, reduces the risk of the arteries becoming
obstructed (it should be higher than 60 mg/dl) —.
Effects on the heart
High cholesterol is directly related to the development of atherosclerosis (fat plaques in the arteries) which obstructs the blood vessels and may lead to coronary disease.
Causes and diagnosis
Cholesterol in the body originates from two main sources: production in the liver
and absorption by the intestine of both biliary and dietary cholesterol. Its increase
may be due to factors such as age, family background, diet, obesity, etc. It is diagnosed by measuring its presence in a blood sample.
Its treatment is...
Once its origin has been diagnosed, the doctor will prescribe a treatment based on
diet (low in saturated fatty acids and cholesterol), exercise and weight control and, if
necessary, medicines, such as statins and resins. Do not self-medicate or stop your
treatment. Always consult your doctor.
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Risk factors you can change:
diabetes
Causes and diagnosis
This is a chronic disease which is characterized
by an increase in glucose in the blood. The figures that are considered normal in healthy people
on an empty stomach stand at between 60 and
110 mg/dl. In some cases, it may not cause any
symptoms whilst in others, hunger and excessive thirst, an abundance of urine, itchiness
and the poor healing of wounds may make
us suspicious of its presence. Its origin may be
genetic predisposition or the presence of obesity,
a sedentary lifestyle, an unsuitable diet, etc.
Diabetes may be caused by an
insufficient production of insulin by
the pancreas or because the insulin is
not working properly in the body. This
disease is diagnosed very easily by
measuring the level of glucose in the
blood, although sometimes several
measurements are needed to reach a
final diagnosis.
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Look after your heart
There are two types of diabetes: Type I (the person does not produce insulin, which is why it must
be administered) and Type II, also known as adult diabetes (in which the use of insulin is not
initially needed).
Effects on the heart
Diabetes causes small lesions in the blood vessels (especially in the heart, brain, kidney and
retina). It is related to other coronary risk factors (high blood pressure, obesity, etc.) and causes
serious cardiovascular and kidney complications.
Its treatment is...
Diabetes should always be treated in an individualised manner by a specialist.
Treatment ranges from diet and physical exercise to the use of insulin and oral
hypoglucemia¬nts.
… Everything needed to normalize the glycemia and to ensure that the complications which may stem from diabetes do not appear or that their appearance is
slowed down.
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Risk factors you can change: obesity
This is one of the most serious risk factors faced by 21st century society. Obesity, which is a weight
increase caused by a rise in body fat and is closely related to diabetes, high blood pressure and
heart failure, has doubled in our country and is alarming among young people. Its origin lies in
genetic factors and a worsening of lifestyle habits (fat rich diets and a lack of physical exercise, as
well as an increase in sedentary leisure activities).
Effects on the heart
Obesity not only worsens the quality of life of anyone who has it but also increases their risk of
suffering from cardiovascular, chronic, metabolic and bone diseases. As regards the cardiovascular system, obesity has an enormous impact on the development of atherosclerosis and on the
progression of high blood pressure, diabetes and high cholesterol, especially if the fat is deposited
in the abdominal area.
w Obesity is a very serious
problem faced by 21st
century society.
Causes and diagnosis
The body mass index (BMI) is found
by dividing weight in kilos by height
in m2. If the resulting figure stands
between 20 and 25, it is normal;
between 25 and 29.9, you are
overweight; between 30 and 34.9,
it is Type II obesity; between 35
and 39.9, it is Type III obesity; and
above 40 it is morbid obesity.
Its treatment is...
Leaving aside cases in which the
specialist may consider medication
is necessary, obesity is fought by
leading an active lifestyle in which
exercise is done on a regular basis
and daily calorie intake is controlled through a diet which is low in
saturated fats and rich in products
which are proper to the Mediterranean diet.
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Look after your heart
Risk factors you can change: smoking
Smoking causes all kinds of respiratory and cardiovascular diseases (smokers are three times more
likely to have a heart attack), yet it is the risk factor with the most obvious solution: not smoking or
giving up the habit. Yes, you can do it! Support therapies exist, even pharmacological ones, to help
you overcome the symptoms of anxiety and irritability which are frequently caused by withdrawal.
Effects on the heart
Nicotine causes damage to the internal walls of the arteries, it alters coagulation and increases
cholesterol levels. For its part, carbon monoxide reduces the supply of oxygen to the myocardium
and increases the risk of thrombus formation. Furthermore, don’t forget that this damage extends
to passive smokers.
You can give up smoking
Set a date to give up. Get ready by drawing up a list of reasons for giving up smoking
and note down how many cigarettes you smoke and under what circumstances. The
day before you stop smoking, throw away your cigarettes, ashtrays, etc. at home and
at work. Once you have stopped smoking, take more exercise, ease your anxiety by
drinking water and juices or by eating fruit or sweets and ask for and accept the help of
the people around you. Ask your doctor about the pharmacological support available.
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What happens if I give up?
Risk factors you can change:
alcohol
r After 20 minutes, your blood
pressure and heart rate go back to
normal.
r After eight hours, the concentration
of oxygen rises and that of carbon
monoxide falls.
r After two weeks to three months,
your circulation improves and your
pul¬monary function increases up to
30 per cent.
r From one to nine months, coughing
and a lack of breath decreases.
r After one year, the risk of having
heart failure halves.
Consuming alcohol may cause cancer and digestive, cerebral and cardio¬vascular diseases
(such as myocardiopathy, arrhythmias and
sudden death), not forgetting that it also has
a lot of calories and is related to obesity, high
blood pressure and diabetes.
The paradox
A small amount of alcohol every day
may be beneficial but in higher quantities its harmful effects increase until
they outweigh the benefits.
w Support therapies exist to help you overcome the
symptoms of anxiety and irritability which are usually caused
by giving up smoking.
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Look after your heart
Risk factors you can change:
stress
Anxiety is a natural reaction which enables
us to face and respond to alarming situations.
The problem with stress arises when it persists
over time, when the body is not capable of
recovering its balance and the physiological
“activation” is excessive and chronic. It is then
when it affects our health.
Effects on the heart
Stress causes a rise in blood pressure and
heartbeat frequency which increases the
oxygen needs of the myocardium causing
excess effort by the heart, influencing blood
cholesterol levels, changing coagulation of the
blood (which facilitates thrombus formation)
and damaging the arteries.
w Anxiety is a natural
reaction which enables us
to face and respond to
alarming situations.
Warning signs
Stress “symptoms” include drinking,
smoking and overeating, depression,
digestive and intestinal upsets, concentration difficulties, headaches, insomnia, irritability and bad moods, the
deterioration of family and workplace
relations, muscle tension, etc.
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Risk factors you can change:
a sedentary lifestyle
A sedentary lifestyle is one of the evils of our
century and it means much more than a lack
of physical exercise. It is a lifestyle marked by
physical inactivity: people barely walk anywhere
and new leisure, work and communication
formulae mean long hours are spent in front of
the television, the computer or the video console.
Consequently, an increase in activity must be
considered at three levels: at home (even doing
the housework vigorously can improve your
physical condition), at work (moving every now
and again, doing little exercises, etc.) and in leisure (walk when you have to go a short distance,
look for outdoor hobbies, etc.). The seriousness
of physical inactivity is caused by the connection
between a sedentary lifestyle and risk factors as
important for the health of our hearts as obesity,
high blood pressure and cholesterol, as well as
respiratory diseases.
w Increasing physical activity must be considered at three
levels: at home, at work and in leisure.
Consult your doctor
Don’t forget about
children!
If you decide to take up exercise
again after a long period of inactivity
and you have a risk factor, it may be
advisable to ask your doctor which activities are more suitable for your age
and your state of health. Launching
into the intense, uncontrolled practice
of exercise is just as harmful as not
doing any.
Another of the most worrying aspects
about sedentary lifestyles is that
young people are adopting this way
of life. Together with poorer diets,
physical inactivity makes a decisive
contribution to the worrying increase
in obesity figures (and other risk factors such as cholesterol) in children
and adolescents.
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Look after your heart
Primary and secondary
prevention
A
s we explained above, risk factors are involved in the development of cardiovascular
diseases. Primary prevention should therefore aim at preventing such diseases (if we do
not have them), diagnosing them in the early stages and monitoring them properly (if they are
already present in our lives). In this way, we can reduce the likelihood of having a heart attack.
How can we best achieve this? Primary prevention is essentially based on four basic principles
which are:
A balanced diet
Sayings as sensible as “We are what we eat” and “Let food be your medicine” summarize to a
tee the role of food in our health. A varied and balanced diet — rich in vegetables, fruits, fish,
pulses, cereals and olive oil and low in saturated fats, alcohol and salt — can help us not only to
keep our cholesterol, blood pressure and glucose levels in check, but also to maintain our ideal
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weight. Heart-healthy diets use wholesome
ways of cooking, choose fresh products, avoid
junk food and are based on the idea that it is
not necessary to prohibit but to moderate the
consumption of certain foods.
Doing exercise
Exercising regularly (at least three times a
week) improves your heart function and the
respiratory system, reduces cholesterol and
triglycerides, helps to control diabetes and
high blood pressure, prevents obesity and has
undeniable psychosocial benefits (it reduces
stress, teaches people how to live together,
etc.). The exercises which are most beneficial
for the heart are aerobic or dynamic exercises
(those which mobilize large muscle groups
for a long period of time: walking, swimming,
dancing, cycling…). If you are unsure how to
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Look after your heart
begin a training program, consult your doctor
(he will recommend the exercise which is most
suitable for you). But remember that a sport
exists which is simple, easy to do at any time
and which does not require any type of kit:
walking.
Controlling our blood pressure, glucose and cholesterol levels
Checking periodically what our blood pressure,
glucose and cholesterol figures are helps to
monitor their development and to react effectively if there is any significant change. Knowing
is preventing.
Avoiding overweight and obesity
A balanced diet and exercise help to maintain an
ideal weight. Remember that cardiovascular risk
increases especially if excess weight is located in
the abdominal region (the waistline should not be
greater than 102 cm in men and 88 in women).
Learn to handle stress
Don’t let life get the better of you: your emotional and psychological state also influences
your heart. Avoid alcohol, smoking, coffee, tea,
etc. and learn techniques which help you to
relax in times of stress.
w A balanced diet and
exercise help in maintaining
an ideal weight. Cardiovascular risk increases if excess
weight is located in the
abdominal region.
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w Walking is a simple sport
which is easy to do at any
time and does not require
any type of kit.
Secondary prevention
This is prevention which can and must
be undertaken by people who have
already had a heart attack or have
been diagnosed as being at risk. As
a rule, it is a question of following the
recommendations already explained
in primary prevention, but being more
demanding in their results, as the aim
is to prevent a new episode and to
slow down or prevent the progress of
the illness:
r Blood pressure figures should not
exceed 135/85 mmHg.
r LDL or bad cholesterol must be
below 100 mg/dl (overall cholesterol
must be lower than 200 mg/dl).
r Stop smoking (giving up smoking
reduces second heart attack and
sudden death rates by up to 50 per
cent).
r If you have diabetes, monitor it
more carefully and follow your prescribed diet and medication.
r If you have to face stressful situations, relaxation and stress control
techniques exist which you can learn
and which have shown to improve
patients’ prognosis.
You can give up smoking
Smoking is the only risk factor which
depends on the will of the person.
If, in spite of knowing all the damage it does to your body you cannot
stop smoking, ask for help (there are
programmes, with or without pharmacological help, which you can follow).
Moreover, don’t forget that a healthy
lifestyle will help you in your decision
to stop smoking (if you do exercise,
avoid drinking too much and cut down
on heavy meals, you will be less likely
to want to smoke).
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Look after your heart
Practical tips for a healthy
lifestyle
C
hanging our lifestyles is not something we can do overnight. That is why the first and most
practical tip is to look at yourself and your habits. It is important to recognize which habits you
are willing to change and which ones you might need some help with. Here is a series of very simple and
practical tips which could turn your everyday routine into a much more heart-healthy lifestyle.
How can I exercise if I have no time, no money and I don’t like exercising
that much?
You can walk more (by using the car less, by getting off public transport one stop before your regular
one, by forgetting about the lift, by walking to the shops, etc.), learn to dance (from ballet to ballroom
dancing, it will help you to improve your physical shape and is likely to reduce your stress), use a
static exercise bicycle (some people say you can watch TV or read while you are exercising) and foster
outdoor hobbies (there is a wide range of possibilities from gardening to hiking).
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How can I stop smoking?
By accepting it as a challenge and not being discouraged by failures, by asking your doctor for
pharmacological or psychological help, by remembering the advantages gained from giving up
smoking, by keeping yourself busy and by doing exercise.
Healthy hearts when shopping and cooking
r Choose fresh foods rather than pre-cooked or ready-made dishes (in this way, you will
reduce the amount of preservatives, colouring, hydrogenated fats, thickeners, etc.).
r Use recipes which require grilling, steaming or baking. Remove the grease from
stews before eating and avoid coating food in batter or breadcrumbs or frying.
r Choose olive oil, lemon and spices rather than sauces, too much salt and manufactured condiments.
r Bring back traditional sandwiches for your children (and, therefore, do not give
them too many manufactured pastries or sweets).
r Make a healthy-heart breakfast (it takes ten minutes longer and you will be able
to face the day with much more energy. Include bread, olive oil, fruit, milk, cereals
and sugar).
r Don’t eat standing up, or walking, or watching television or reading. Concentrate
on eating: you will get full quicker and will be more aware of the kind and quantity of
food you eat.
r Remember that no foods are prohibited in a balanced diet: you only need moderation.
You can even do exercise in the office
Yes, you can! Working eight hours
non-stop sitting at a table is no longer
an excuse for not doing any exercising.
You can stretch your limbs, rotate your
ankles, do heel-toe exercises, do rotation
movements to relieve the tension in your
neck and shoulders, flex your joints…
and, of course, circumstances permitting,
you can walk up the stairs instead of
using the lift, walk when you have to do
errands, go for a stroll round the block at
break time, etc.
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Look after your heart
Watch out for dehydration!
W
ater and electrolytes are essential for the development of life. Drinks with a certain mineral salt and sugar content which are correctly used can make a significant contribution
to preventing and solving mild dehydration.
Climate change and new lifestyles are altering beverage consumption habits. For example, the
consumption of drinks containing mineral salts and sugars to improve hydration during physical
activity is becoming more recognised. Several scientific societies, including the Spanish Society of
Digestive Pathology, have recently drawn up a consensus document which offers advice and recommendations on hydration and mineral salt requirements which may be useful for the general
population as well as for different age groups.
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What are these recommendations?
During physical exercise
l Approximately 2 to 2.5 litres of liquids
should be consumed daily, including water
contained in food. The recommended amount
should be drunk even though you are not
thirsty. In hot climates, the amount of liquid
drunk needs to be increased.
l Thirst is a sign that warns us that you have
to drink liquids. It is not healthy to “hold on”
without drinking; on the contrary, it is advisable to drink without waiting to be thirsty.
l Very special attention has to be paid to
situations which may cause dehydration, such
as heat and abnormally high environmental
dryness, fever, diarrhoeas, vomiting, etc. It is
not advisable to carry out physical activities at
midday on hot days, wear too many outdoor
clothes, or spend too long in the sun, etc.
l The symptoms of dehydration include thirst,
dry skin and mucous membranes, a reduction
in the amount of urine, a loss of weight, dark,
concentrated urine, drowsiness, headaches and
fatigue.
l Water and other drinks are pivotal to
ensuring good hydration. In mild dehydration
situations such as those mentioned above,
drinks containing quickly-absorbed mineral
salts and sugars can facilitate better hydration.
l Alcoholic drinks are not suitable for preventing dehydration and may even cause it.
l In addition to liquids, certain foods with
a high percentage of water can help us to
maintain a good hydration level: fruits and
vegetables (melon, water melon, strawberries,
grapefruit, grapes, oranges, tomatoes, etc.).
l Heavy meals require an additional supply of
drink. If you are on some kind of diet, consult
your doctor about your specific hydration
needs.
Exercising causes water and mineral
salt losses to increase. Furthermore,
this loss may be greater depending on
the environmental conditions (temperature, humidity and wind), previous
physical condition (training level),
intensity and exercise type.
r Without overdoing it, it is advisable
to hydrate yourself before, during
and after exercise, as any physical
exercise, however moderate, causes
the loss of a certain amount of water
and mineral salts in addition to energy
expenditure. That is why the intake of
water is necessary and that of sugar
and mineral salts is advisable so that
muscular activity functions correctly.
r In the case of prolonged exercise
(approximately 45 minutes or longer)
it is advisable to replenish water with
mineral salts and a certain amount of
sugar.
w When used correctly,
drinks with a certain
mineral salt and sugar
content can help to
prevent or solve mild
dehydration problems.
29
Look after your heart
l Water has no calories so it does not affect
the gaining of fat mass. However, it does have
an impact on weight as in dehydration weight
is lost and in rehydration the weight lost by
dehydration is recovered.
l The habitual use of certain medicines
(diu¬retics, for example) may affect the state
of hydration. Consult your doctor.
l In order to stay correctly hydrated and to
prevent mild dehydration, a variety of flavours
may contribute to a suitable daily liquid intake.
l Special care must be taken during physical exercise and by children and the elderly
as these groups are more likely to become
dehydrated.
l These recommendations are targeted at the
population in general as drinking too much
liquid may be unadvisable for people with
certain illnesses, such as kidney, heart and liver
complaints, or other circumstances, which
is why you must consult your doctor before
changing your hydration patterns.
Children and the elderly
r Breastfed babies and children need a proportionally higher liquid intake than
adults and are at greater risk of dehydration.
r Nursing mothers must increase their liquid intake and cover their liquid requirements freely.
r In the elderly, there is a reduction in the intake of liquids and an increase in
losses, which is why a higher water intake is required.
r It is advisable to consume liquids without waiting until you are thirsty as a reduction in the sensation of thirst in the elderly is one of the main causes of dehydration.
r In order to prevent dehydration in the elderly it is better to offer drinks frequently
in small amounts.
30
The Heart Decalogue
1
6
A healthy-heart diet is essential to
keeping your heart healthy. Ensure
your diet is rich in vegetables, fruits, cereals,
pulses, fish and olive oil and moderate in
saturated fats and sugars. In other words,
follow a Mediterranean diet which is plentiful
in vitamins, minerals, fibres and healthy fatty
acids and has undeniable gastronomic value.
Don’t forget your glucose level in
your check-ups. Diabetes is a severe risk
factor which must be kept under control. Do
not neglect your diet and if treatment has been
prescribed for you, follow it closely.
7
Learn to control stress and anxiety.
For the sake of your heart, learn to control
stressful situations.
2
Doing exercise regularly ensures
that your heart keeps fit. There is a
physical activity for each age, state of health,
capabilities, likings… Fight against a sedentary lifestyle by leading an active life which
includes sport and outdoor activities.
8
Check-ups from the age of 45
upwards. In order to find out the state of
your heart and, if necessary, to take the appropriate medical and lifestyle-change decisions.
9
Make up your mind to stop smoking,
for the present and future wellbeing
of your heart. Nothing positive can be said
about smoking, except that if you give it up
you will reduce your cardiovascular risk and
your body will thank you for it.
And if you are a woman, don’t forget
your female uniqueness. There are
three moments in a woman’s life when it is necessary to pay special attention to the health of
your heart: if you are of fertile age and taking
contraceptives and during pregnancy and the
menopause.
4
10
3
Maintain your ideal weight: avoid
being overweight and obesity. The fat
which is situated in the abdominal region is
especially dangerous for your heart. It is not
only a question of appearance. It is a serious
health problem which can be controlled via a
balanced diet, exercise and an active lifestyle.
Take control of your health. You
are the main person responsible for
your health and the one who will most benefit.
5
Keep an eye on your blood pressure and
cholesterol. In order to keep them in check,
find out periodically what your blood pressure and
blood cholesterol levels are. Not knowing your own
state of health is also a risk factor for your heart.
31
Publisher: The Spanish Heart Foundation.
www.fundaciondelcorazon.com
Text: Laura Cristóbal.
Collaboration: Drs. José María Cruz, Alfonso del Río,
José Luis Lledó and Javier Ortigosa.
Publishing Coordination: Grupo Editorial ICM.
www.grupoicm.net
Managing Director: Ángel Salmador.
Publishing Director: Rosalía Torres.
Design and Layout: Magdalena González.
Publication: Laura Saiz.
Legal Deposit: M-13886-2009
ISBN: 978-84-937033-1-8
Published with the collaboration of: