Muscat: Fast or not to fast? That is the general question heart patients often ask themselves. As the incidence of heart diseases is on the rise, many heart patients wonder what they should do during fasting. To fast or not to fast.
"Generally for people with stable condition there is no harm in fasting during Ramadan. In fact fasting may improve the cholesterol level and lead to weight loss if observed in a healthy way as some recent studies showed. However, it is always worthwhile to ask the doctor before a heart patient starts fasting. There are certain situations where fasting is not advisable," said Dr Benny Panakkal, Senior Consultant Cardiologist at Badr Al Samaa Hospital, Ruwi.
In July 2013 Badr Al Samaa established the state-of-the-art Cathlab (GE Innova ) in the Ruwi hospital. After the introduction of interventional cardiology services including coronary angiography, angioplasty and stenting from August 2013 more than 300 procedures have already been performed.
All the patients are under regular follow-ups and many of these patients are doing their first Ramadan fasting after their procedure safely.
"But it is important to continue taking the prescribed medications meticulously. The timing of the medicines may be altered to suit the fasting time. All patients who had undergone stenting, especially medicated stents that we routinely implant, need to continue two medications to prevent blood clotting namely Aspirin and the other drug Clopidogrel at least for a period of one year. After one year of the procedure Clopidogrel may be generally stopped but Aspirin should be continued lifelong unless otherwise deemed by the cardiologist or physician," he added.
Dr Benny advised that Aspirin may be taken after breaking the fast because it is always desirable to take it after food to prevent stomach problems. Clopidogrel may be taken before starting the fast or after iftar.
"Cholesterol lowering medications may be taken as usual at bedtime. Patients who had undergone a recent angioplasty should consult their doctor before starting fasting," he cautioned.
Fasting may also affect patients who have suffered acute heart attacks. These patients cannot fast within the six weeks following the heart attack.
"Patients who are getting treatment for heart failure and taking medicines like Lasix to remove water from the body should avoid fasting. If the balance of water intake and that being lost from the body is disturbed, such patients may develop problems. Loss of excessive water without replacement by drinking water may lead to dehydration and low blood pressure that may cause further problems," he said.
Similarly, open heart surgery patients should not fast within the six weeks following surgery.
"Cardiac patients who are on blood thinners or anticoagulants, patients on malignant arrhythmia medications and patients with heart condition that require constant professional observation should better avoid fasting unless their doctor allows them," he advised.
Patients and doctors may have to explore the possibility of substituting ordinary cardiac medications with long-lasting ones in order to compensate for the daily 15-hour fasting time.
However fasting has no negative impact on patients with stable heart conditions who have no recurrent symptoms such as chest pain or shortness of breath.
"In fact there are significant health benefits of fasting for patients with stable cardiovascular conditions. Lower food intake, abstaining from smoking for 15 hours per day and the stress-reduced atmosphere associated with the month of Ramadan will have a positive impact on the cardiovascular system in healthy individuals as well as in patients with stable heart conditions undergoing treatment," he added.
Individuals with heart conditions will benefit if after breaking the fast they consume smaller frequent portions of healthy food rather than rich, heavy meal that is full of fat and oils.
Dr Benny said more fruits, lean meat, chicken and fish should be preferred over fried and fatty meals. "High sugary drinks and sweets are better avoided.
"After two hours of breaking the fast (iftar), it is beneficial to have a little exercise by taking a short walk," he said.