The heart of the matter

On World Heart Day, September 29, random thoughts on keeping the ticker ticking

We were flying to Dubai on a Boeing 777. As we boarded the huge aircraft, my wife was impressed by the bright, clean, well-kept interiors. “New plane,” she commented.

An airline buff, I knew from the jet’s tail number that it was 18 years old. Aircraft components come with a clear and rigorous replacement timeline, which airlines have to follow meticulously.

For our car, we wait till the tread turns bald to change the tyre, fill petrol only when the fuel-gauge goes submarine, and change battery only when the ignition misfires. But aircraft parts are changed routinely on a standard timeline, not when they wear out. Not just tyres, the philosophy remains in place for engine parts, fuel pumps, all such critical components. These are done routinely, and all aircraft should be certified safe to be airworthy. A discoloured seat or a frayed floor carpet, however, does not mean that the plane is unsafe.

Now, write the number 37, and add 12 zeros. That makes it 37 trillion. That insane value is the number of cells in your body. Take a 10-year-old child or a 50-year-old man; the skin cells of both are just two weeks old. Skin cells live for roughly two weeks, give and take a few days, for both. Similarly, the red blood cells (RBC), those that give blood the red colour and carry oxygen all over the body, live for roughly 120 days and are replaced by a new crop of cells. The liver cells live and die after 10 months, replaced by new ones.

The turnover rates of some of these cells are mind boggling. Roughly two million RBCs are manufactured every second. Beats the airline maintenance, by a long haul.

Human heart stands out as an exception. The cardiac cells do not generally regenerate. Perhaps, the architect of our body thought that the heart would never need to regenerate in our lifetime. Sealed in a double-layered protective jacket called the pericardium and armed with a hoard of sensors and receptors, the beating heart adjusts to the needs of daily stress.

It is incredible to understand how far we, humans, go to bypass these natural safety measures. Tobacco leaves are dried, cured, processed and packed inside paper rolls and marketed to make sure that nicotine reaches the heart and damage the blood vessels. Hydrogen gas is passed through harmless vegetable oil to create trans-fat. Cheap potato is machine-sliced and fried in trans-fat to mass-produce snacks, which are specifically harmful to the heart. Spiced up with salt and tangy flavour, garnished by cartoon-characters, these are targeted at children, the most vulnerable cohort.

Those who escaped being couch-potatoes on the invasion of television were later netted by smartphones to ensure a pandemic of obesity. Our social system made sure that the human heart, which by design is meant to be non-user serviceable, is slowly poisoned. Then we spent billions on healthcare, and brought in technology to correct the damage, repair the most severe blocks, replace the damaged valve, or transplant the heart. Then we realised that this strategy will not work.

In 1999, the World Heart Federation decided to celebrate World Heart Day on September 29. Initially focusing on awareness, detection and treatment of cardiovascular disease, it later shifted focus to prevention, but this year we changed tack. For World Heart Day, 2024, the theme is “Use heart for action” — meaning put your heart and soul into building a strong strategy, an action plan, that as a community will focus on prevention of cardiovascular disease.

No vendor can put bad fuel into an aircraft; the system in place prevents it. In the same way, society as a whole should draw up plans to avoid poisoning the heart with tobacco, fast food, trans fat, environmental pollution; the list go on.

A petition to reissue the lifetime warranty for the heart can then be uploaded to the cloud for the manufacturer to consider.

(The writer is a cardiologist based in Thiruvananthapuram)

tinynair@gmail.com

Published - September 29, 2024 03:25 am IST