The heart is a complex structure – both figuratively and literally. Each element of this organ presents its own common health challenges. There are several risk factors for heart disease; some you can control and others you can’t. So what are the risk factors? And what steps can be taken to reduce cardiovascular health risks that could lead to a heart attack? We sat down with cardiologist Dr Hung Yu Tak to learn about how expats can prevent, identify and manage heart disease.
Do you have to worry about heart disease if you have a family history?
Yes. In more and more clinical experience we have found that family history is very important. As it increases the risk of different heart diseases, it’s a must to know your family history. While it’s particularly important with coronary heart disease, for heart disease in general, we’ve found that if there are other family members being affected, the patient has more likelihood of suffering too.
I recommend you get to know your family history – ask about everything and note even simple things like hypertension. If you know your history and are treated appropriately, it’s not that difficult to manage.
What are the lifestyle factors that can contribute to the disease?
There are risk factors we always investigate for heart disease, the first of which is smoking. We also check for hypertension (also known as high blood pressure), diabetes, and hyperlipidemia (also known as high cholesterol). These factors are investigated on top of family history.
In terms of diabetes, hypertension and hyperlipidemia, these are related to sugar, salt, saturated and trans fat intake. Smoking is definitely one of the most correctable risk factors. I tell my patients, if you love your family, and love your current standard of living and lifestyle, think seriously about giving up smoking.
What are some of the common heart diseases affecting expats in Hong Kong?
The most common is coronary heart disease. To know if you’re at risk, you need to be tested for cholesterol, know if you’re diabetic, and try not to smoke. The so-called degenerative or valvular disease, and arrhythmia problems are relatively less common. The majority of diabetes cases are maturity onset diabetes, with onset of the disease at about 30 to 40 years of age. So, if you check your cholesterol, you should be encouraged to check your blood sugar at the same time.
If you have any of these issues, it’s important to manage them early rather than late, because all these risk factors contribute to the development of vascular problems in the future.
What are some of the signs and symptoms of these conditions?
A classic symptom of coronary heart disease is some sort of chest discomfort. This discomfort is classically presented when exercising; as you exercise, you feel a pressure on your chest that can be relieved by rest. In medical terms, this is typical angina. The other common symptoms are shortness of breath and palpitations.
For patients suffering from acute heart attack, typically the degree of the discomfort is much more severe. It’s often associated with other symptoms too; if sweating and nausea are present with severe chest discomfort, usually this can be assumed to be an acute heart attack until proven otherwise.
What health services are available to Hong Kong residents if they suspect they might have heart problems?
If you move to Hong Kong and have a family history, you should attend a family doctor who can manage and monitor you. If you have further symptoms, your family doctor will refer you to a specialist – usually a cardiologist.
What about in the event of an emergency?
For treatment of symptoms, it’s hard to have a hard and fast rule, but I normally tell my patients to respect their own feelings. So, if you feel it’s an emergency, then head to an A&E department or your private outpatient hospital. If your symptoms aren’t that disabling, you could call an accessible family doctor and get an opinion on where to go. If the symptoms are disabling, don’t wait and see; attend whatever hospital you can get access to. In the case of an emergency, call 999.
Should everyone see a doctor to be assessed for heart disease risk? If so, what age would you recommend this happens and how frequently?
All adults should know their blood sugar, cholesterol and blood pressure, especially those patients with a family history of heart disease. Adults embarking on new exercise routines, especially competitive sports, are recommended to check their hearts. Their doctor will advise whether they are high risk and should be checked for underlying heart disease.
It’s important that all expats understand the details of their health cover policy, too. With heart issues, every minute counts, so know your coverage, understand the fee structure in Hong; and know the financial ramifications of treatment.
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This article first appeared in the December/January 2018/19 issue of Expat Living magazine. Subscribe now so you never miss an issue.
