Cardiovascular Disease: Indian Perspective.....by Dr. Navneet Maini
Cardiovascular diseases include various heart diseases including heart attacks and cerebrovascular disorders like stroke. They are the leading cause of death and globally result in about 18 million deaths every year. And unfortunately, India contributes to one-fifth of all these fatalities. We come across a more serious form of the disease in India with multiple and long diffuse blockades which are sometimes not amenable to even surgery.
The disease comes a decade earlier and engulfs people during the prime time of their life. Another thing unique about heart disease in India is that our patients hardly get any warning symptoms like chest pain on exertion or breathlessness before it could be diagnosed and treated, but it usually presents in the form of heart attack and sudden death so that the patient is not able to reach the hospital for treatment.
The reason for such an epidemic is attributable to the prevalence of risk factors in our population. There is more occurrence of major risk factors like Diabetes mellitus, Hypertension, obesity, hyperlipidemia, smoking and lack of exercise, stress, etc.
We have the maximum number of diabetic patients in the world and there is a continuous rise in the incidence of diabetes and hypertension for the last few decades in India. Although the overall prevalence of tobacco consumption has decreased since the nineties, still we have more smokers than in other developed countries.
There are also some nonconventional risk factors like homocysteinemia, ambient pollution, extremes of weather, increase in high sensitivity CRP a marker of inflammation, high Lp(a) levels, etc. which are associated with the high prevalence of heart disease. But all this doesn’t explain the occurrence of the disease in such a proportion.
This is also hypothesized that as a race we might have become more prone to developing the disease. Some genetic factors may explain this phenomenon, but we are not able to identify any genes particularly responsible for this.
Unfortunately, there is no definite cure for the disease. Coronary artery bypass surgery and stenting are just one-time procedures to tide over the acute crisis. But the good news is that we have to take simple measures like regular exercise, avoiding high carbohydrates, high unsaturated fats and refined foods , and quitting of smoking if present.
We should also get ourselves regularly screened for the presence of risk factors and some screening tests for early detection of disease like an exercise stress test or stress echocardiography at regular intervals so that we can know our status and adopt the aggressive preventable program. All these small measures can go a long way to keep your heart healthy throughout your lifetime.
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