“Heart attacks linked to cognitive decline”, expert shares advice on how to protect yourself

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As shared by Dr Kaushal Chhatrapati, MD DM, FACC FSCAI FESC, interventional cardiologist, a new study published in JAMA Neurology examined the link between heart attacks and cognitive decline. More than 30,000 patients were studied in this meta-analysis from 1971 to 2019.

Cognitive decline refers to a fall in an individual's ability to remember facts and perform simple learned tasks efficiently. Stroke and Alzheimer's disease are common causes of dementia in the elderly. However, many survivors of heart attacks had neither of these diseases and yet demonstrated intellectual decline around six years after the heart attacks. Evidently, some other factors are at play here.

What leads to this cognitive decline?
There are several explanations for why there would be intellectual deterioration after a heart attack. Minimal brain dysfunction which leads to cognitive decline is common in post bypass surgery patients. Many patients with heart diseases might have undergone bypass in the past which could explain the cognitive decline.

Further, if there was a fall in blood pressure or a history of heart-stopping which was revived with cardiopulmonary resuscitation, such patients will have residual cognitive decline several years later.

Depression too, is closely linked to heart attacks. It has been conclusively proven that long-standing depression leads to significant memory loss. This is suspected to be a major cause.

Hypertension is common in patients with heart diseases. Chronic hypertension is associated with many silent subclinical strokes. These may present in later life with only cognitive decline.

Small vessel disease (also called arteriosclerosis) is another reason for memory loss in patients with heart issues. Controlling blood pressure and diabetes is paramount for preventing small vessel disease.

Lastly, regular stress, lack of sleep, consumption of junk food, high blood sugars, and high blood pressure, all conspire to cause a chronic inflammatory state in our body. This inflammatory state can cause heart attacks by rupturing vulnerable cholesterol plaques in the arteries. The same inflammatory state over years can slowly gnaw away at the brain cells causing over the years a dementia-like state.

How can cognitive decline be prevented after a heart attack?
1. Avoid pump bypass surgery. Angioplasty or off-pump bypass surgery causes less brain damage.
2. Treat heart attacks quickly, minimizing periods of low blood pressure.
3. Look for and treat depression. Subclinical depression may not be evident unless one is careful.
4. Avoid Junk food, especially after a heart attack.
5. Treat cholesterol, blood pressure and diabetes religiously after heart attacks
6. Statins have broad anti-inflammatory effects. Taking statins for a long time after a heart attack has proven benefits in quelling the insidious chronic inflammation in the individual.
7. Exercise regularly. Exercising offers a plethora of benefits in preserving mental health. It releases endorphins and controls depression. Regular exercising can prevent arteriosclerosis and lower cholesterol, diabetes and high blood pressure. Even the simple act of walking 8000 steps a day twice a week can lower cardiovascular mortality significantly.

It is not enough to live long. It's important to live a healthy life that is in full control of all your mental faculties. It is imperative to practice a healthy lifestyle, especially after a heart attack to be fully mentally alert and sharp.

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