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Health & Fitness

Study reveals where in SA the risk of heart disease is highest




Cardiovascular disease (CVD) is the leading cause of death in SA, after HIV/Aids. Over 78 000 South Africans die each year from heart disease and there are no signs of a decrease in the foreseeable future.

It’s well known that SA has one of the highest rates of obesity, smoking and drinking in the world, which are all major contributing factors of cardiovascular disease, but the incidence of CVD also tends to vary based on where you live.

SA’s leading provider of generic cardiovascular medication, Pharma Dynamics, set out to determine people’s likely risk of suffering a heart attack based on where in SA they live. They did so by analysing the number of calls a top emergency response firm – which treats both medical aid and state patients – received for possible heart attacks across the country over a two-year period (May 2014 to April 2016). The study turned up some interesting results.

Based on the number of emergency calls received related to possible heart failures, the Northern region of the Western Cape, topped the list with 701 calls, while residents of Xtrata – a small mining town in Mpumalanga – seemed to have a very slim chance of suffering the same fate.
The second most heart-related emergency calls emanated from Vereeniging – arguably the town that boasts the most car dealerships per square metre in the country, which could be telling of the kind of stress car salespeople in the area are under since the global slump inautomotive sales.

Mariska van Aswegen, spokesperson for Pharma Dynamics says chronic job stress has a major impact on one’s heart-health and exposes the body to unhealthy, persistently elevated levels of stress hormones like adrenaline and cortisol, which puts additional strain on the heart.
“Studies also link stress to changes in the way blood clots, which increases the risk of a heart attack or stroke. High levels of stress could also make other risk factors, such as cholesterol or hypertension worse.”

According to Pharma Dynamics’ findings, overall the most calls originated from the larger metros in the country.
Van Aswegen remarks that in general those living in metropolitan areas struggle with chronic health problems such as high blood pressure, cholesterol, obesity and diabetes – all precursors for heart disease.
“Residents in the majority of these areas are among the least likely to exercise regularly and smoking rates also tend to be high, which further heightens their risk of heart disease. Poor diet is also commonly associated with heart conditions. Unfortunately, the demands of a fast-paced urban lifestyle doesn’t leave much room for nutritional meal planning and it’s increasingly putting people into contact with fast-food, which often carries a high fat, sugar and salt content,” she says.

Based on the report, here’s how South Africans’ risk of suffering a heart attack varies by province:

  • Gauteng residents are twice as likely to suffer from a heart attack than those living in KwaZulu-Natal, and have by far the highest risk overall as a whopping 3 359 emergency calls for heart-related conditions emanated from this part of the country
  • Despite the sun, surf and laid-back lifestyle Western Cape residents enjoy, the picture doesn’t look much rosier for them as about 2 320 emergency calls were made from this region
  • It’s still a code blue situation for Durbanites following the 1 692 calls that were recorded in KwaZulu-Natal
  • The Free State is also not in the clear after clocking 1 047 emergency calls related to possible ticker-problems
  • Residents in Mpumalanga seem to have a much lower likelihood of suffering a heart attack based on the 868 emergency calls that were made from the area
  • The risk however drops significantly for those in the Eastern Cape where about 552 emergency calls were logged
  • The vast open spaces of the Northern Cape might have something to do with its low heart-failure risk where only about 408 calls were made from
  • The Platinum Belt also seem to struggle with fewer heart-related conditions as a low 384 emergency calls originated from the North West Province
  • Folk in Limpopo – the fifth most populated province – are clearly doing something right as only 201 emergency calls were made from this region

According to the Heart and Stroke Foundation of SA, 75% of cardiovascular events occur in 5% – 10% of people who have suffered a previous heart attack or stroke.

“In the event of a heart attack, it’s critical to respond quickly,” says van Aswegen. “Immediately call an emergency response number so an ambulance with advanced life support can be sent for you. The most common heart attack symptom is chest pain or discomfort, but other symptoms, particularly shortness of breath, nausea and back or jaw pain may also be present.”

“To avoid a life-threatening incident such as a heart attack, people should inform themselves of the early signs and symptoms of heart disease in order to enable them to seek the necessary help while there’s still time. When treatment is started early – in combination with other lifestyle changes, such as quitting smoking – serious long-term complications can be prevented. As things stand, only about 40% of South Africans who have high blood pressure have their condition under control by taking medication.

“Promoting a healthy and active lifestyle cannot be overstated in the treatment of patients with heart conditions. This approach addresses all the risk factors present in a patient and can have an enormous impact on the patient’s quality of life and life-span,” she emphasises.
For more information about Pharma Dynamics’ national wellness campaign, called I Change for Health (iC4H), which aims to reduce deaths from heart disease and stroke,

“Knowing how people’s risk of heart disease break down by city or province could help healthcare researchers to redirect their focus in the areas where the risk is highest,” concludes van Aswegen.

Metrosmag,sa ( inspired by Mzansi Lifestyle ) Mzansi is rich in Lifestyle, a nation diverse in race and culture. Mzansi Magazine explores the rich heritage , versitile culture and the celebrations of Life in Mzansi. Metros Magazine, SA is South Africa's informative Metropolitan lifestlye magazine with all the fresh and important news in Mzansi.

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Health & Fitness

The Real Reason You’re Gaining Weight As You Get Older and how to prevent it.




Many of us have experienced it firsthand: As the years go by, the pounds become more difficult to keep off. But have you ever wondered exactly why we experience weight gain as we age? Hint: Your eating habits actually aren’t to blame.

There are a variety of reasons, explains Dr. Caroline Apovian, the Director of the Nutrition and Weight Management Center at the Boston Medical Center, professor at the Boston University School of Medicine, and the vice-president of The Obesity Society. A change in hormones, a more sedentary lifestyle, and an increase in stress and decrease in sleep due to added responsibilities are just a few.

“But a major reason for middle aged weight gain is the natural muscle loss we all experience,” Dr. Apovian, the author of The Age-Defying Diet and The Overnight Diet: The Proven Plan for Fast, Permanent Weight Loss, says. “The amount of lean muscle mass we have is the primary determinant of metabolic rate. In other words, the more muscle mass we have, the more calories we will burn. Our muscle mass naturally begins to decline around age 30, and that process, called sarcopenia, accelerates around age 40. Unless something is done to actively protect and build up that lean muscle mass, our bodies will require fewer calories, our metabolisms will slow, and the lost muscle will be replaced by fat.”

So, what can you do to prevent sarcopenia? Dr. Apovian offers three tips:

  1. “Exercise with weights at least twice per week, building up in both weight and intensity as you progress,” she says.
  2. “Eat a diet rich in lean protein sources, including protein smoothies.”
  3. “Get plenty of sleep,” Dr. Apovian concludes. “Amongst other health benefits, this gives the body time to repair and rebuild the muscles.”
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Race Recovery Tips with Caroline Wöstmann




Powerade’s ‘Power to Beat Your Best’ aims to provide athletes with the tools to achieve a personal best time and will be working with a number of South Africa’s foremost running, cycling and training experts to challenge athletes to beat their best in 2017.

Multiple Two Oceans Marathon and Comrades Marathon champion Caroline Wöstmann shares her tips on race recovery:

Like all things in life, finding the balance between training and recovery is incredibly important for a runner. When you lose that balance, you often end up injured. You will often find yourself looking at your training load and thinking “well, it is the same as it was last year, so I should manage it again”. But you do not take into account what is going on in the rest of your life and the effect that has on your body and you forget about rest and recovery. Training is only part of the formula.

If you are having a stressful week, rather back off on training – do less mileage or no high intensity speed work because your body can only deal with so much. Physical training is physical stress – if you have emotional stress as well, your body will not recover properly. If you are struggling to fall asleep at night or are waking up during the night, it is a sign you have too much stress. Listen to your body.

The scope of your recovery depends on how much your training load is. You do not have to do as intensive recovery if you are not training as intensely. Making sure you get enough sleep is important. If you are training 200km a week, you should ideally have a nap during the day, after getting a solid 8 hours at night. I take a 1-hour nap in the day between my morning and evening sessions.

The second most important thing after sleep, is nutrition. If you are expending huge amounts of energy and missing a meal, your body does not have anything to rebuild with. You need to replace what you are expending, being careful not to eat too much, which can mean you put on weight. I find it is important that I eat something immediately after my session – ideally within 15-45 minutes.

In an ideal world, you will be able to take some time off work to focus on training and recovery. If you have big goals, taking a couple of weeks off after your heaviest training load means you will have more time to recover – and the time away should lower all the other stresses in your life, too.

Having an ice bath after a quality session really helps recovery, but I would only recommend doing that after a hard race or a long run, because it is not fun for anyone. It is only for when you are pushing your body to extremes. The optimal time seems to be immersing yourself for 10 minutes, at 8-12 degrees. Sports massage works well too – a 30-60 min massage every week loosens up the muscles.

Tapering is important to the recovery process too. Once you’ve done all the training, tapering reduces the load and gives the body more time to recover – and recovery makes you stronger.

For more information on ‘Power to Beat Your Best’ visit , the official hydration partner of the Old Mutual Two Oceans Marathon and the Cape Town Cycle Tour.

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Health & Fitness

“Nocebo Effect” explains side effects when switching medicines




In the last three decades, countless blockbuster prescription medications for a host of chronic ailments have become available as generics. Currently, about 56% of prescriptions in South Africa are now for generics (IMS, March 2017).

This has shaved hundreds of billions of rands from the nation’s rising healthcare costs and has undoubtedly saved countless of lives by allowing more people to afford the medication they need.

Still, some people believe that more affordable medication can’t be as good as the brand name equivalents and fear that switching to a generic is risky.

Several studies found that generic substitution may be associated with a powerful phenomenon known as the nocebo effect where patients are so convinced that a medication disagrees with them that they start experiencing reduced efficacy and have imagined side effects. This possibly explains why switching from a brand-name medication to a generic version may cause people to report more side effects, even though both medications are chemically identical.

Mariska van Aswegen, spokesperson of leading SA generics firm, Pharma Dynamics says both the nocebo and placebo effects suggest the power of the mind, but should not be confused with one another.

“In placebo, our expectation of feeling better can lead to real physiological changes in our bodies, whilst patients who read about the negative side effects of a certain medication may be primed to notice these symptoms in their own bodies, described as the nocebo effect.”

A study conducted by the American Psychosomatic Society examined the effect that an apparent change in medication had on participants. Sixty-two university students participated in the mock study that tested the effectiveness of a supposedly “new” drug used to treat pre-exam anxiety. During the initial test, patients were told that they were being given the “brand name” drug, which was then supposedly switched to the “generic” version during the 2nd round of tests. Incredibly, researchers found that patients who thought they were being given the “generic” treatment reported more side effects along with a reduction in efficacy compared to when they took the “brand name” medication, even though all tablets were placebos.

“Once a brand-name product comes off patent, a generic medicine manufacturer must ensure that the medication they are producing contains the same active ingredient(s) as the brand-name product, in the same dosage form, at the same dose or concentration and for the same route of administration.

“It also has to prove that it is as stable and pure as the original by meeting certain pharmacokinetic parameters in the body, for example, dissolving at the same rate and extent as that of the brand-name medication.”

Van Aswegen goes on to explain that patients who are anxious or stressed are more likely to suffer from the nocebo effect, especially when asked about the adverse effects of a medication. “They can even be triggered by the manner and behaviour of the doctor prescribing the treatment,” she says.

Generic medication is however just as safe and effective as their brand-name equivalents, and can save you up to 80% on your medication bill. To find out if there is a generic equivalent for the brand-name medication you are taking, ask your doctor or pharmacist for their recommendations

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