Dr Arvind Kohli
As we celebrate this year’s world heart day all thoughts move around to dramatic rise in heart disease cases in India. India will soon bear the largest burden of heart disease globally; In India, out of the estimated population of more than 1.27 billion dispersed across various geographical regions, about 45 million people suffer from coronary artery disease. ‘According to current estimates, India will soon have the highest number of cases of cardiovascular disease in the world. It is estimated to account for 35.9 percent deaths by the year 2030.
Heart diseases in the past considered to be the disease of late middle age and old age with people getting cardiac events but recently heart disease has escalated among the younger generation with a significant risk in both males and females. ‘More and more number of young Indians are suffering from coronary artery disease, owing to their poor lifestyle, and if this continues the future looks even more dangerous. Now, there is surge in cases where people in the 25-35 age group are diagnosed with heart disease’.
The risk of heart disease is highest in urban population : A 2013 study concluded that over 70 per cent of the urban Indian population is at the risk of being diagnosed with heart disease. This is mainly due to unhealthy eating habits, lack of physical activity and stress.
Diabetes and hypertension have increased heart disease cases : ‘The population of diabetics in India is about 50.8 million, making India the diabetic capital of the world. The prevalence is higher in urban areas (6-8 percent) compared to rural areas (2-3 percent). Indians fall prey to diabetes at a relatively young age (about 45 years), which increases their lifetime risk of heart disease. Apart from diabetes, high blood pressure is also responsible for increased number heart disease cases. The increase in hypertension prevalence has been steady over the last 50 years, more in urban than in rurla areas. Hypertension is 25-30 percent in urban and 10-15 percent in rural subjects.’
Sedentary lifestyle is a major cause of death due to heart dieases.
‘Physical inactivity doubles the risk of cardiovascular disease, type 2 diabetes and obesity. It also increases the risk of high blood pressure, imbalance in lipid levels and anxiety, which individually contribute to heart disease.
Coronary heart disease is mainly responsble for heart disease deaths: ‘ One fifth of the population dying due to heart disease suffers from coronary heart disease (CHD). By 2020, about one third of all deaths will be caused due to CHD. Sadly, most of them will be dying at a very young age.
This nation has the tools to substantially reduce the devastating impact that heart disease and stroke have on individuals, their families, and the nation’s economy. We can take significant steps toward a heart-healthy India through several actions. These include early and continuous health education that focuses on prevention and healthy lifestyle choices; medical services that provide the most effective drugs and therapies without disparity; and environmental policies in schools, work sites, and communities that promote good nutrition, regular physical activity, and abstinence from smoking.
To identify individuals at risk of coronary heart disease (CHD) much earlier and improve its prevention, a new genetic risk tool has been developed by an Indian-origin researcher. Genetic factors have long been known to make a significant contribution to CHD risk. Recent advances in genetics have led to the identification of many Single Nucleotide Polymorphisms, or SNPs- very small differences in our DNA that vary from person to person. The research, published in the European Heart Journal, shows how using this new knowledge could pave the way for earlier and more personalized preventative interventions. By looking at over 49,000 SNPs the researchers created a score, known as a genomic risk score (GRS), and showed that the higher the GRS the higher the future risk of CHD. People with a GRS in the top 20 percent had an over five-fold higher lifetime risk of CHD. The clinical risk scores are based on known risk factors for CHD such as cholesterol level, having high blood pressure or diabetes and smoking. But such scores are imprecise and unable to identify a large proportion of people who develop CHD.
A vegetarian diet, meditation, yoga and massages experienced measurable decreases in a set of blood-based metabolites associated with inflammation, cardiovascular disease risk and cholesterol regulation.
Prevention
The best prevention against heart disease is to understand the risks and treatment options. The greatest risk is ignorance or misinformation. The first step is to take responsibility for your health. Know your risks and information about the prevalence of heart disease in your family.
Do not smoke or expose yourself to second hand smoke. Maintain a healthy blood pressure. Monitor your blood lipids and keep them under check by exercising diet control or use of statins. Limit your calorie intake and maintain a very good drink slim policy. Make exercise a daily habit. Exercise activates genes which are beneficial to health in many ways. It reduces depression and anxiety also. Destressing is also very important component for preventing a cardiac event.
Stay informed :
The only constant is change. This is especially true in medicine as new techniques and new insights develop constantly.
(The author is Cardiac Surgeon)
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