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Ramadan fasting: recommendations for patients with cardiovascular disease

Ramadan fasting is observed by most of the 1.8 billion Muslims around the world. It lasts for 1 month per the lunar calendar year and is the abstention from any food and drink from dawn to sunset. While recommendations on ‘safe’ fasting exist for patients with some chronic conditions, such as diabet...

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Autores principales: Akhtar, Abid Mohammed, Ghouri, Nazim, Chahal, C. Anwar A, Patel, Riyaz, Ricci, Fabrizio, Sattar, Naveed, Waqar, Salman, Khanji, Mohammed Yunus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8819657/
https://www.ncbi.nlm.nih.gov/pubmed/33990414
http://dx.doi.org/10.1136/heartjnl-2021-319273
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author Akhtar, Abid Mohammed
Ghouri, Nazim
Chahal, C. Anwar A
Patel, Riyaz
Ricci, Fabrizio
Sattar, Naveed
Waqar, Salman
Khanji, Mohammed Yunus
author_facet Akhtar, Abid Mohammed
Ghouri, Nazim
Chahal, C. Anwar A
Patel, Riyaz
Ricci, Fabrizio
Sattar, Naveed
Waqar, Salman
Khanji, Mohammed Yunus
author_sort Akhtar, Abid Mohammed
collection PubMed
description Ramadan fasting is observed by most of the 1.8 billion Muslims around the world. It lasts for 1 month per the lunar calendar year and is the abstention from any food and drink from dawn to sunset. While recommendations on ‘safe’ fasting exist for patients with some chronic conditions, such as diabetes mellitus, guidance for patients with cardiovascular disease is lacking. We reviewed the literature to help healthcare professionals educate, discuss and manage patients with cardiovascular conditions, who are considering fasting. Studies on the safety of Ramadan fasting in patients with cardiac disease are sparse, observational, of small sample size and have short follow-up. Using expert consensus and a recognised framework, we risk stratified patients into ‘low or moderate risk’, for example, stable angina or non-severe heart failure; ‘high risk’, for example, poorly controlled arrhythmias or recent myocardial infarction; and ‘very high risk’, for example, advanced heart failure. The ‘low-moderate risk’ group may fast, provided their medications and clinical conditions allow. The ‘high’ or ‘very high risk’ groups should not fast and may consider safe alternatives such as non-consecutive fasts or fasting shorter days, for example, during winter. All patients who are fasting should be educated before Ramadan on their risk and management (including the risk of dehydration, fluid overload and terminating the fast if they become unwell) and reviewed after Ramadan to reassess their risk status and condition. Further studies to clarify the benefits and risks of fasting on the cardiovascular system in patients with different cardiovascular conditions should help refine these recommendations.
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spelling pubmed-88196572022-02-16 Ramadan fasting: recommendations for patients with cardiovascular disease Akhtar, Abid Mohammed Ghouri, Nazim Chahal, C. Anwar A Patel, Riyaz Ricci, Fabrizio Sattar, Naveed Waqar, Salman Khanji, Mohammed Yunus Heart Review Ramadan fasting is observed by most of the 1.8 billion Muslims around the world. It lasts for 1 month per the lunar calendar year and is the abstention from any food and drink from dawn to sunset. While recommendations on ‘safe’ fasting exist for patients with some chronic conditions, such as diabetes mellitus, guidance for patients with cardiovascular disease is lacking. We reviewed the literature to help healthcare professionals educate, discuss and manage patients with cardiovascular conditions, who are considering fasting. Studies on the safety of Ramadan fasting in patients with cardiac disease are sparse, observational, of small sample size and have short follow-up. Using expert consensus and a recognised framework, we risk stratified patients into ‘low or moderate risk’, for example, stable angina or non-severe heart failure; ‘high risk’, for example, poorly controlled arrhythmias or recent myocardial infarction; and ‘very high risk’, for example, advanced heart failure. The ‘low-moderate risk’ group may fast, provided their medications and clinical conditions allow. The ‘high’ or ‘very high risk’ groups should not fast and may consider safe alternatives such as non-consecutive fasts or fasting shorter days, for example, during winter. All patients who are fasting should be educated before Ramadan on their risk and management (including the risk of dehydration, fluid overload and terminating the fast if they become unwell) and reviewed after Ramadan to reassess their risk status and condition. Further studies to clarify the benefits and risks of fasting on the cardiovascular system in patients with different cardiovascular conditions should help refine these recommendations. BMJ Publishing Group 2022-02 2021-05-14 /pmc/articles/PMC8819657/ /pubmed/33990414 http://dx.doi.org/10.1136/heartjnl-2021-319273 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Review
Akhtar, Abid Mohammed
Ghouri, Nazim
Chahal, C. Anwar A
Patel, Riyaz
Ricci, Fabrizio
Sattar, Naveed
Waqar, Salman
Khanji, Mohammed Yunus
Ramadan fasting: recommendations for patients with cardiovascular disease
title Ramadan fasting: recommendations for patients with cardiovascular disease
title_full Ramadan fasting: recommendations for patients with cardiovascular disease
title_fullStr Ramadan fasting: recommendations for patients with cardiovascular disease
title_full_unstemmed Ramadan fasting: recommendations for patients with cardiovascular disease
title_short Ramadan fasting: recommendations for patients with cardiovascular disease
title_sort ramadan fasting: recommendations for patients with cardiovascular disease
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8819657/
https://www.ncbi.nlm.nih.gov/pubmed/33990414
http://dx.doi.org/10.1136/heartjnl-2021-319273
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