In recent months, since the outbreak of the Iron Swords War, hospitals have reported an increase in cases of heart disease/ShutterStock
In the Western world, heart disease is the leading cause of death. In Israel, cancer opens the list, followed by heart disease. In recent months, since the outbreak of the Iron Swords War, hospitals have reported an increase in cases of heart disease. The security situation, stress and anxiety, as well as emotional eating and an increase in cholesterol and blood pressure indices, are some of the explanations for this increase. "The past few months have been very significant, not only due to the security situation. In situations of personal or national stress, people tend to neglect and ignore chronic diseases. It seems negligible to them compared to the situation, and there is a real fear of going to hospitals on days of alarms and bad news and fear of overloading the system," says Prof. Ronen Durst, a senior cardiologist at Hadassah Ein Kerem Hospital. "This time, in a unique way, certainly in relation to the days at the beginning of the COVID-19 pandemic, the HMOs and hospitals adapted very quickly and thoroughly. Tens of thousands left their homes and the mother's clinic, and health care centers prepared accordingly. The situation is similar to the coronavirus, even though there is no lockdown and the hospital is not considered a danger, but there is a national situation that causes personal things to be squeezed. It is important for me to emphasize that chronic treatments should not be neglected. People who stop taking medication get into complications."
"Even in times of crisis, it is important to adhere to medication as directed by your doctor." / ShutterStock
To what extent does the security situation and uncertainty contribute to the exacerbation of symptoms related to heart disease?
"There are situations that we are seeing an increase in, such as the 'broken heart' syndrome. Hospitals in Israel reported a greater number of people who were hospitalized and diagnosed with the syndrome. Overall, according to studies by international medical associations specializing in heart disease, prolonged stress causes heart disease. It is very possible that in a few months, we will see an increase in the number of heart patients, especially from people who were in extreme stressful situations."
Has the continuity of drug treatments been harmed as a result of the state of war? Tens of thousands of people have been evacuated from their homes and it can be assumed that this has an impact on daily conduct.
"Even in times of crisis, it is important to adhere to medication according to the doctor's instructions. Not only in cardiology. It's also important to make sure your blood pressure, cholesterol and sugar levels are balanced. These issues have consequences and failure to adhere to them can cause damage over the years. It is better to receive preventive treatment than to start treatment after the disease has erupted."
What are the red lights that should lead to clarification regarding a concern about heart disease?
"If anyone feels chest pain that lasts more than a minute or two or first appears while resting, go to hospital. There are populations with symptoms of shortness of breath and heartburn and there is a difference between women and men. The clinical manifestation in women differs from the preliminary signs in men. In principle, contrary to what is commonly thought, there are also heart diseases among women. The perception that they are protected is wrong. If there is a feeling of heartburn, jaw or back pain, it is important to seek medical clarification."
What are the main risk factors for heart disease?
"First and foremost, high cholesterol. This is one of the risk factors that we encourage people to diagnose their blood lipid profile as soon as possible. The 'bad' cholesterol, as it's called, can cause clotting and arterial blockage. In addition, if there is a family history of heart disease, especially at a young age or diabetes and high blood pressure in the background, it means that the person is at risk. Of course, smokers and overweight people also belong to this group, which we recommend seeking risk assessment. It's better to get preventive treatment at age 40 than medication at age 50."
"First and foremost, it's important to exercise carefully"/ShutterStock
What are the recommendations for people in these risk groups?
"First and foremost, it's important to exercise exercise, lose weight and control blood pressure. Proper nutrition also has great significance. At the same time, it is not enough to increase physical activity and diets in order to prevent heart disease. Cholesterol levels can only be reduced by 5-10 percent following diet. As a general rule, we recommend moderate physical activity, 150 minutes per week or at least 75 minutes of less moderate activity, such as cycling, divided over several days. In terms of nutrition, the firm recommendation of most experts in the field is a Mediterranean diet, meaning vegetable fat, lots of fresh vegetables and fruits and natural raw materials with minimal processed foods."
How else can you help treat or prevent heart disease?
"Most often, these are drugs that work to remove bad cholesterol from the blood. What's important is that people make sure to follow prescriptions and take medication regularly. Any break, even of a few weeks or months, can cause acute illness or worsen the condition. The economy and pharmaceutical companies in Israel are prepared for continued regular drug treatment. There are medicines that are given at larger intervals, there are those that are given once every two weeks and there are even medicines that should be taken once every six months, but this is usually equivalent to one daily treatment or another. Frequency is an important issue for caregivers, but it's not the only consideration. Regarding the continuum of care, I recommend to our patients a reminder service that pharmaceutical companies currently have, and it is a welcome service."
In conclusion, how do you see the future of research in the field?
"There are two parallel directions in medical research, the first of which is to improve interventional or drug treatment of an existing disease, heart failure, etc. The second direction is early detection through laboratory tests, genetic tests or imaging, designed to identify people at high risk and start preventive treatment that will delay the disease for many years. There is currently a breakthrough in early detection of diseases such as diabetes or high cholesterol and I estimate that in the near future, there will be established tests that will help identify risk factors for heart disease, such as genetic predisposition, mutations that cause a tendency to damage blood vessels and early atherosclerosis, or changes in the bone marrow in adults. In the coming years, we will begin screening older populations for this as well. Cardiology is an optimistic profession, because we have developed tools to prevent disease and save lives, and this is not taken for granted."
Dr. Bruria Rakach, Clinical Pharmacist in the Cardiac Department, Hadassah Ein Kerem, a member of the Israel Pharmacy Association, adds:
"Unlike pain or infection treatment, adherence to medication aimed at preventing diseases such as heart disease is challenging, because in the 'good' scenario, the patient does not feel any benefit in taking the treatment and in the 'bad' scenario he even pays a price in the form of side effects. In a study conducted among thousands of patients after myocardial infarction, it was found that for various reasons, about 20% of patients stopped taking medication a few months after the infarction. Compared to the group of patients who persisted with treatment, it was found that mortality among those who stopped treatment was about 80% higher! Despite the daily reality of uncertainty and concerns, it is important to remember that prevention is the best way to improve quality and life expectancy."
The choice of possible treatment is the decision of the therapist prescribing the prescription, in consultation with the patient.
Information is correct as of January 2024. For more information, contact your physician.
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