Dr. Muhammad Mahtab Hossain Mazed 

29th September is World Heart Day 2023. This year the theme of the day is 'Use Heart, Know Heart'. Concerned with the Bengali translation: Care for every heart with love. The day is also celebrated in Bangladesh along with other countries of the world to increase public awareness about heart disease. One of the health related days is World Heart Day. It is one of the World Heart Federation's biggest day to raise awareness about heart disease.

The first World Heart Day was celebrated on September 24, 2000 and was celebrated on the last Sunday of September every year until 2010. Later, from 2011, September 29 was celebrated as World Heart Day. Currently, heart disease has been identified as the number one killer disease in the world. Along with 194 countries of the world, Bangladesh will also celebrate the day with due dignity. Many of us may not know that heart disease is the number one killer in the world. Heart disease takes life at any time without any predictability. Around 1.86 million people die of cardiovascular disease every year in the world. There are 62 million heart patients worldwide. More than 30 million people die of non-communicable diseases worldwide every year.

In Bangladesh, 277,000 people die of heart disease every year, of which 24 percent is caused by tobacco. High blood pressure, diabetes, excess fat in the blood, cigarettes and tobacco-like products, obesity, lack of physical activity, unhealthy diet increase the risk of heart disease. Most of them are low and middle class. Once a heart attack occurs, almost 40 percent of patients die before receiving hospital treatment. But if the patient with heart attack can be transferred to the hospital in time, it is possible to cure him with modern treatment. But if the heart disease is not detected earlier, in many cases the patient dies before treatment. So prevention is the most important.

In this situation, in order to reduce the severity of the disease, along with better treatment, the most importance should be given to the prevention of the disease, the people of Bangladesh are also at risk. Compared to developed countries, relatively young people in Bangladesh are suffering from heart disease. Someone is walking around healthy, without any problem, one day suddenly it is heard that he has a 'massive heart attack'. The problem is that nothing is often known before such an event occurs. Such a heart attack results in immediate death or life-threatening incapacitation. So be careful before heart disease.

> How do you know you're at risk?

There's no reason to think that feeling no problem, never having chest pains, and being able to work hard means you won't have a heart attack one day. However, if you know the extent of the risk, taking the doctor's advice can avoid premature death or serious consequencesTo know your risk You can find out your risk level by answering the following questions. If the answer to most of the questions is 'yes', then your risk of heart attack is high do you smoke Is there a history of heart attack or sudden death at a young age in your family? Do you have high blood pressure, diabetes, high blood fat levels? Do you live without manual labor? Are you obese or are you overweight? Is your stress severe?

> Early symptoms of heart attack:-
* Most heart attacks are characterized by a feeling of pressure in the chest, which lasts for more than a few minutes. The pain sometimes goes away, then comes back. An uncomfortable pressure and jolt is felt.
* Sometimes discomfort is felt in arms, back, neck, jaw or stomach.
* Sometimes chest discomfort comes with shortness of breath.
* Other symptoms may include sweating, chills, nausea or light-headedness, back or jaw pain.

> Causes of heart disease:-
Many factors are responsible for heart disease. Such as age, sex, smoking, excessive alcohol consumption, family history, obesity, low physical activity, unconsciousness in food, high blood pressure, high lipids, diabetes etc. The risk of heart disease can be greatly reduced by making some changes in lifestyle, regular walking or physical activity, being a little conscious about food and preventing diseases like high blood pressure, high lipids, diabetes etc.

> At what age can it be?

Heart disease can occur at any age. But generally, elderly people are more vulnerable to this disease. Serum cholesterol levels generally increase with age. 82 percent of people over the age of 65 with heart disease die from heart disease. After the age of 55, the risk of having a stroke doubles. Again, the elasticity of the arteries decreases with age, resulting in coronary artery disease.

> Who could it be?
Men have a higher risk of heart disease than reproductive women. After the reproductive period, men and women are equally likely to develop heart disease. If a woman has diabetes, she is more likely to develop heart disease than a man with diabetes. In middle-aged people, men are about 5 times more likely to develop coronary heart disease than women. Gender disparity in heart disease is mainly due to hormonal differences.

> Signs and symptoms of heart disease:-

Pain in the chest, back, stomach, throat, left arm, pain in the neck or jaw and discomfort may be felt. Shortness of breath. Excruciating pain in the upper part of the stomach. Head may feel lightheaded.

> What to do to prevent heart disease:-
Heart disease can be of various types, such as congenital heart disease, rheumatic heart disease, hypertensive heart disease, heart disease due to low blood circulation in the heart, heart disease due to weakness of the heart muscle, etc. Being careful to prevent heart disease has much better results. Here are some things you can do to prevent congenital heart disease and other heart problems:

> What can be done to prevent congenital heart disease:-
MMR Injection should be given to the mother at least three months before conception, if the pregnant mother has high blood pressure or diabetes must be treatedIf you are in the habit of smoking and drinking alcohol, you must give it up. Before taking any medicine during pregnancy, you must consult an experienced doctor.

> Other heart prevention measures:-

If a young boy or girl has a fever with a sore throat, treating him with belladonna for a week will greatly reduce the risk of future heart attacks. Again, the prevalence of this disease can be reduced by living a healthy lifestyle. Blood flow to the heart can cause serious problems like heart attack. Some changes in diet and lifestyle should be made to prevent this problem. For example, at least one specific time every day should be walking or exercise or physical activity. It is very effective in preventing heart disease. Eat plenty of fruits, vegetables, curries, sour fruits. On the other hand, salt and sugar should be eaten lessFood rich in calories should be avoided. Alcohol, drugs, tobacco, smoking, etc. should be stopped. The risk of heart disease remains up to 10 years after quitting smoking. Fast food, canned and dry food should be reduced. Tea, coffee and soft drinks should be avoided in excessSmoking, alcohol or drugs of any kind should be avoided. Women's birth control pills and some drugs can be dangerous for heart disease. Fat should not be allowed to accumulate in the body. It is very risky for heart disease. For people above 40 years of age, a balanced diet should be taken.

Animal fats should not be consumed, but vegetable oils such as soybean, sunflower, mustard oil etc. should be consumed. Eat sea fish. Almonds are beneficial for heart disease. Almonds are rich in protein, folic acid, potassium, magnesium, flavonoids, selenium and vitamin-E which are very beneficial for heart healthOne should try to be happy in married life and should be focused on religious activities. Mental stress i.e. insomnia, tension, fear, anger, depression, anger, vindictive tendencies, violence etc. should be avoided. If hypertension and diabetes should be kept under control. Blood pressure should be checked at least once a week and diabetes should be checked once a month.

Finally, I would like to say that the death rate due to heart disease is the highest all over the world including Bangladesh. Excess of fat or cholesterol in the blood, anxiety or mental stress, uncontrolled high blood pressure, diabetes, lack of physical work are identified as one of the causes of heart disease. Therefore, if you want to live, you must do regular physical work. Processed foods, animal meats and salt should be kept out of the food list. At the same time, life should be taken as positive. "As there are good sides in life, there will also be bad sides - we have to remember and accept it." Life should be beautiful. Then you will get relief from anxiety. Reduce mental stress, don't get depressed in any way, only then you can stay away from heart disease.

The writer is a Physician, columnist and researcher Founder Chairman, Jatiya Rogi Kallyan Society