Hamad Medical Corporation’s (HMC) Cardiology expert has advised patients with heart problems to take extra measures while fasting during Ramadan, especially taking their medication timing into consideration, in order to avoid complications.

Dr Jihad Jaber, Senior Specialist of Cardiology at HMC, advised cardiac patients to consult their cardiologists on how medication dosage should be administered during Ramadan. Dr Jaber said:

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…A study has revealed that 20% of people on regular medication do not take them as scheduled in Ramadan and since they tend to take large quantities of food and beverages in the evening, fasting might in this case have a negative impact on their health, especially those with heart conditions.’

Dr Jaber stated that fasting would adversely affect some patients with various heart conditions such as:

  • cardiac patients who experience recurrent chest pain
  • patients with heart failure (atrial fibrillation) who experience fatigue or lack of energy  and shortness of breath, as they need frequent dosages of diuretic medications
  • patients who suffered acute heart attacks (these patients cannot fast within the six weeks following the heart attack incident. Similarly, open heart surgery patients should not fast within the six weeks following such surgery)
  • patients with acute valve stenosis or inflammation
  • cardiac patients who are on blood thinners or anticoagulants
  •  patients on malignant arrhythmia medications
  • patients with heart condition that require constant professional observation

However, citing a 2003 study conducted by Dr Jassim Al Suwaidi, Consultant of Cardiology at HMC, which found that fasting in Ramadan does not have any side effect on patients with heart disease, Dr Jaber noted that fasting has no negative impact on patients with stable heart conditions who have no recurrent symptoms such as chest pain or shortness of breath. He said:

During the study, we performed detailed clinical assessments of patients with heart disease, who are from various GCC countries, one month before Ramadan; during Ramadan; and one month after Ramadan. When we analyzed the results, it was revealed that most patients with stable cardiac disease can fast safely.’

Dr Jaber highlighted the health benefits of fasting for patients with cardiovascular conditions saying:

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 heart conditions.’

He reaffirmed that smoking has a devastating effect on the cardiovascular system and that abstention from such a habit during fasting hours will relieve the system of tobacco’s harmful effects. He said:

Similarly, stress, which is a major risk factor in heart condition, is generally lower during fasting time therefore, the risk of heart disease is very much reduced…Individuals with heart conditions tend to benefit due to the fact that smaller food portions trigger favorable hormonal and metabolic changes which will increase production of good cholesterol and decrease bad cholesterol. The outcome of these factors will be best if patients manage to reduce weight as a result.’

He advised cardiac patients to eat in small portions, and avoid fatty and salty foods. He said:

Their diets should comprise soups and fiber-rich food such as vegetables and fruit. Cardiac patients are also advised to split their meals whereby they consume four smaller meals instead of two large meals in Ramadan. These patients are warned not to drink large quantities of beverages at the time of breaking their fast (Iftar) as this could lead to shortness of breath. They can also exercise by taking a short walk.’

Patient with heart problems who experience any difficulties while fasting should seek urgent professional advice or dial 999 for HMC’s Ambulance Service.