Download PDF
CC BY-NC-ND 4.0 · Avicenna J Med 2016; 06(02): 33-38
DOI: 10.4103/2231-0770.179547
REVIEW ARTICLE

The cardiac patient in Ramadan

Majed Chamsi Pasha
Department of Medicine, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
,
Hassan Chamsi Pasha
Department of Cardiology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
  PDF Download Permissions and Reprints

Abstract

Ramadan is one of the five fundamental pillars of Islam. During this month, the majority of the 1.6 billion Muslims worldwide observe an absolute fast from dawn to sunset without any drink or food. Our review shows that the impact of fasting during Ramadan on patients with stable cardiac disease is minimal and does not lead to any increase in acute events. Most patients with the stable cardiac disease can fast safely. Most of the drug doses and their regimen are easily manageable during this month and may need not to be changed. Ramadan fasting is a healthy nonpharmacological means for improving cardiovascular risk factors. Most of the Muslims, who suffer from chronic diseases, insist on fasting Ramadan despite being exempted by religion. The Holy Quran specifically exempts the sick from fasting. This is particularly relevant if fasting worsens one's illness or delays recovery. Patients with unstable angina, recent myocardial infarction, uncontrolled hypertension, decompensated heart failure, recent cardiac intervention or cardiac surgery or any debilitating diseases should avoid fasting.

Keywords

Cardiac - coronary artery disease - fasting - Ramadan - hypertension


Publication History

Article published online:
09 August 2021

© 2016. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Norouzy A, Salehi M, Philippou E, Arabi H, Shiva F, Mehrnoosh S, et al. Effect of fasting in Ramadan on body composition and nutritional intake: A prospective study. J Hum Nutr Diet 2013;26 Suppl 1:97-104.
  • 2 Salim I, Al Suwaidi J, Ghadban W, Alkilani H, Salam AM. Impact of religious Ramadan fasting on cardiovascular disease: A systematic review of the literature. Curr Med Res Opin 2013;29:343-54.
  • 3 Chamsi-Pasha H, Ahmed WH. The effect of fasting in Ramadan on patients with heart disease. Saudi Med J 2004;25:47-51.
  • 4 Al Suwaidi J, Zubaid M, Al-Mahmeed WA, Al-Rashdan I, Amin H, Bener A, et al. Impact of fasting in Ramadan in patients with cardiac disease. Saudi Med J 2005;26:1579-83.
  • 5 Khafaji HA, Bener A, Osman M, Al Merri A, Al Suwaidi J. The impact of diurnal fasting during Ramadan on the lipid profile, hs-CRP, and serum leptin in stable cardiac patients. Vasc Health Risk Manag 2012;8:7-14.
  • 6 Mousavi M, Mirkarimi S, Rahmani G, Hosseinzadeh E, Salahi N. Ramadan fast in patients with coronary artery disease. Iran Red Crescent Med J 2014;16:e7887.
  • 7 Temizhan A, Dönderici O, Ouz D, Demirbas B. Is there any effect of Ramadan fasting on acute coronary heart disease events? Int J Cardiol 1999;70:149-53.
  • 8 Al Suwaidi J, Bener A, Suliman A, Hajar R, Salam AM, Numan MT, et al. A population based study of Ramadan fasting and acute coronary syndromes. Heart 2004;90:695-6.
  • 9 Pekdemir M, Ersel M, Yilmaz S, Uygun M. No significant alteration in admissions to emergency departments during Ramadan. J Emerg Med 2010;38:253-6.
  • 10 Al Suwaidi J, Bener A, Hajar HA, Numan MT. Does hospitalization for congestive heart failure occur more frequently in Ramadan: A population-based study (1991-2001). Int J Cardiol 2004;96:217-21.
  • 11 Chamsi-Pasha H. Islam and the cardiovascular patient – Pragmatism in practice. Br J Cardiol 2013;20:1-2.
  • 12 Habbal R, Azzouzi L, Adnan K, Tahiri A, Chraibi N. Variations of blood pressure during the month of Ramadan. Arch Mal Coeur Vaiss 1998;91:995-8.
  • 13 Perk G, Ghanem J, Aamar S, Ben-Ishay D, Bursztyn M. The effect of the fast of Ramadan on ambulatory blood pressure in treated hypertensives. J Hum Hypertens 2001;15:723-5.
  • 14 Ural E, Kozdag G, Kilic T, Ural D, Sahin T, Celebi O, et al. The effect of Ramadan fasting on ambulatory blood pressure in hypertensive patients using combination drug therapy. J Hum Hypertens 2008;22:208-10.
  • 15 Saudi Hypertension Management Group. Saudi hypertension management guidelines, 2007: Executive summary/Saudi Arabia. Riyadh: Saudi Hypertension Management Group; 2007. p. 26-7.
  • 16 Hypertension during Ramadan and Hajj. In: Guidelines for Management of Hypertension in Primary care Settings and Outpatient Clinics in the Kingdom of Bahrain. Bahrain: Ministry of Health, Health Promotion Council; 2008. p. 35-6.
  • 17 Beshyah SA, Fathalla W, Saleh A, Al Kaddour A, Noshi M, Al Hateethi H, et al. Ramadan fasting and the medical patient: An overview for clinicians. Ibnosina J Med Biomed Sci 2010;2:240-57.
  • 18 Khan IA. Coronary artery disease and diabetes – Management during Ramadan. J Pak Med Assoc 2015;65 5 Suppl 1:S62-4.
  • 19 Saour JN, Sieck J, Khan M, Mammo L. Does Ramadan fasting complicate anticoagulation therapy? Ann Saudi Med 1989;9:538-40.
  • 20 Skaik Y, Chamsi-Pasha H. The effects of fasting in Muslim patients taking warfarin: Comment. J Thromb Haemost 2014;12:807-8.
  • 21 Al-Hilali MT, Khan MM. The Translation of the Meanings of the Noble Quran 2:185. Madina (KSA): King Fahd Complex for the Printing of the Holy Quran; 2005.
  • 22 Al-Albani MN, Sahih Al Jamae. Hadith No: 1885. Dar Almaktab Alislami. Damascus, Syria. 2002.
  • 23 Turgut O, Yalta K, Tandogan I. Islamic legacy of cardiology: Inspirations from the holy sources. Int J Cardiol 2010;145:496.
  • 24 Al-Hilali MT, Khan MM. The Translation of the Meanings of the Noble Quran 7:31. Madina (KSA): King Fahd Complex for the Printing of the Holy Quran; 2005.
  • 25 Nematy M, Alinezhad-Namaghi M, Rashed MM, Mozhdehifard M, Sajjadi SS, Akhlaghi S, et al. Effects of Ramadan fasting on cardiovascular risk factors: A prospective observational study. Nutr J 2012;11:69.
  • 26 Yousefi B, Faghfoori Z, Samadi N, Karami H, Ahmadi Y, Badalzadeh R, et al. The effects of Ramadan fasting on endothelial function in patients with cardiovascular diseases. Eur J Clin Nutr 2014;68:835-9.
  • 27 Adlouni A, Ghalim N, Benslimane A, Lecerf JM, Saile R. Fasting during Ramadan induces a marked increase in high-density lipoprotein cholesterol and decrease in low-density lipoprotein cholesterol. Ann Nutr Metab 1997;41:242-9.
  • 28 Shehab A, Abdulle A, El Issa A, Al Suwaidi J, Nagelkerke N. Favorable changes in lipid profile: The effects of fasting after Ramadan. PLoS One 2012;7:e47615.
  • 29 Kul S, Savas E, Öztürk ZA, Karadag G. Does Ramadan fasting alter body weight and blood lipids and fasting blood glucose in a healthy population? A meta-analysis. J Relig Health 2014;53:929-42.
  • 30 Sethi BK, Nagesh VS. Weight management in Ramadan. J Pak Med Assoc 2015;65 5 Suppl 1:S54-6.
  • 31 Meo SA, Hassan A. Physiological changes during fasting in Ramadan. J Pak Med Assoc 2015;65 5 Suppl 1:S6-14.
  • 32 Sadeghirad B, Motaghipisheh S, Kolahdooz F, Zahedi MJ, Haghdoost AA. Islamic fasting and weight loss: A systematic review and meta-analysis. Public Health Nutr 2014;17:396-406.
  • 33 Bakhotmah BA. The puzzle of self-reported weight gain in a month of fasting (Ramadan) among a cohort of Saudi families in Jeddah, Western Saudi Arabia. Nutr J 2011;10:84.
  • 34 Saedeghi H, Omar-Fauzee MS, Jahromi MK, Abdullah MN, Rosli MH. The effects of Ramadan fasting on the body fat percent among adults. Ann Biol Res 2012;3:3958-61.
  • 35 El Ati J, Beji C, Danguir J. Increased fat oxidation during Ramadan fasting in healthy women: An adaptative mechanism for body-weight maintenance. Am J Clin Nutr 1995;62:302-7.
  • 36 Loukas M, Saad Y, Tubbs RS, Shoja MM. The heart and cardiovascular system in the Qur'an and Hadeeth. Int J Cardiol 2010;140:19-23.
  • 37 Ghouri N, Atcha M, Sheikh A. Influence of Islam on smoking among Muslims. BMJ 2006;332:291-4.
  • 38 Aveyard P, Begh R, Sheikh A, Amos A. Promoting smoking cessation through smoking reduction during Ramadan. Addiction 2011;106:1379-80.