Maintaining a healthy weight is more than just a matter of appearance. DR MICHAEL ROSS MACDONALD, a senior consultant cardiologist at The Harley Street Heart & Vascular Centre, shares his views on what causes heart attacks and how high blood pressure and weight loss can effect heart health.
Can excess weight and high blood pressure affect the heart?
Carrying extra pounds, especially around the midsection, can lead to several health issues that put your heart at risk:
- High blood pressure: Weight is closely correlated with blood pressure. High blood pressure can silently damage the heart and arteries.
- Elevated cholesterol levels: Obesity is often linked to higher levels of bad cholesterol (LDL) and triglycerides, which can accumulate in the arteries and cause heart attacks and strokes.
- Type 2 diabetes: Excess weight can cause insulin resistance, leading to elevated blood sugar levels that damage blood vessels and nerves all over the body.
- Inflammation: Fat tissue releases substances that promote inflammation, contributing to atherosclerosis – the build-up of plaques in artery walls.
Can reducing weight improve heart health?
Losing even a small amount of weight can make a significant difference to your risk of heart attack, high blood pressure and stroke. As we all know, weight loss is difficult! I believe that obesity needs to be viewed as a chronic disease and managed in a similar way to diabetes and hypertension.
Here are some strategies to help you achieve a healthier weight:
- Diet: This can be very personal. There is no single “best diet” for weight loss. Focus on protein intake to reduce hunger and reduce muscle loss when in a calorie deficit. Avoid calorie-dense foods like dessert!
- Exercise: Important for health, but generally not effective as a sole treatment for weight loss. As the saying goes, “You can’t out-exercise your mouth.”
- Behavioural change: Incorporate healthy habits like mindful eating, not buying trigger foods, stress management and adequate sleep to support weight loss efforts.
- Medical support: Consult with healthcare professionals for personalised advice.
What medical interventions are available for weight loss?
For some individuals, lifestyle changes may not be enough. Medical interventions can help:
GLP-1 receptor agonists: Originally developed to treat type 2 diabetes, these medications can aid in weight loss. Clinical trials have shown weight loss of 6 to 22 percent. In addition, some have been shown to reduce the risk of heart attack and stroke. There are limited serious side effects, however gastric side effects like nausea, constipation and reflux are common. In addition, there can often be rebound weight gain when you stop them, and in a lot of cases insurance does not cover the cost.
Surgical options: Procedures like gastric bypass can lead to significant weight loss and reduce heart disease risk but come with surgical risks and require lifelong dietary changes.
How can a cardiologist help?
Improving heart health and preventing heart attacks and strokes isn’t just about losing weight. It’s about adopting a comprehensive approach. Regular preventative checkups can identify issues with high blood pressure, cholesterol and blood sugar levels at an early stage before the damage is done. Modern scans such as cardiac CT and carotid ultrasound can directly visualise the arteries and spot plaque before it causes heart attacks.
Before starting any new weight loss regimen or medication, it’s important to discuss your plans with a healthcare professional. They can help tailor a programme that considers your medical history, current health status and personal preferences.
Harley Street Heart & Vascular Centre (Mount Elizabeth Medical Centre)
#11-07, 3 Mount Elizabeth
6235 5300 | harleystreet.sg/heart
This article about high blood pressure, weight loss and what causes heart attacks first appeared in the December 2024 edition of Expat Living. You can purchase the latest issue or subscribe so you never miss a copy!
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