The cardiovascular diseases have been globally claimed as major cause of death. Even as earlier killer diseases were successfully controlled, rapidly changing life styles have contributed to the increased incidence of heart disease. Medical science has contributed a lot towards reducing the disease and suffering by spectacular efforts of physicians and technology. Billions of dollars have been spent on research in heart disease but areas of ignorance also grow proportionately with the new knowledge.
Ideal solution remains prevention of heart disease by combining ancient wisdom with the latest knowledge of cardiac science. Unfortunately prevention receives much less attention. It is also true that despite aggressive control of risk factors in the general population, it is not possible to prevent coronary artery disease in all patients. It is, therefore, necessary that people know simple facts about the heart disease in their language. As Julius Comroe had said long time back that the doctors need to be bi-lingual, scientific for journals and scientific discussions but they should use simple language for public, medical terms in these articles have been simplified in everyday language of the readers.
Coronary Artery Disease (CAD)
Cardiovascular diseases (CVD) like hypertension or High B.P, coronary artery disease and stroke are amongst the most common causes of death worldwide. CVDs are the number one cause of death globally with an estimated 17.5 million deaths in 2012, representing 31% of all deaths as per WHO. Of these deaths, an estimated 7.4 million were due to coronary heart disease and 6.7 million were due to stroke.
Life style changes that affect the coronary artery disease can be classified into six stages of human development indices; increasing affluence or per capita income; increasing life expectancy, urbanization, increased intake of saturated fats, salt and smoking. Industrialization and globalization have resulted in enhancing these risk factors. We see an increase in stress levels, lack of exercise, high blood pressure and diabetes. Pressure to succeed in society too has emerged as an important risk factor. These risk factors often work in combination rather than in isolation.
There is further bad news for Indians. Indians are especially vulnerable to heart attacks as revealed by studies from several countries like Canada and United Kingdom that show a 1.5 to 8 fold excess risk of deaths due to coronary artery disease amongst populations of Indian origin compared to native population. Much of this is in younger age group and often the disease is in severe form. High costs of technology intensive diagnosis and treatment is unaffordable to those without an insurance cover and may be one reason for even under reporting of the disease at present.
Risk factors for heart disease:
1. Family history of Coronary heart disease or Stroke
2. Family history of Hypertension,Diabetes mellitus,Premature Deaths
3. Type A Personality; High Stress at Work place or Home
5. Abdominal Obesity
7. Diabetes, Hyperlipidemias or Bad Profile of Fats in the blood stream
Another risk factor is Sedentary Lifestyle, which leads to obesity, Diabetes, hypertension and bad dietary habits!
Without adding to the anxiety or panic, I hasten to share good news about CAD. There has been marked reduction in the incidence of coronary artery disease in the USA during last two decades or so. This decline has been possible due to a concerted effort to control the risk factors and community based programs that influence life styles like diet, physical activity and exercise, cessation of smoking, control and treatment of high blood pressure. Stress management, Gyms, meditation and Yoga have become a common feature in many work places. Readers should only benefit in knowing what are the common risk factors, how one can identify existing heart disease and prevent heart attacks. Readers will also appreciate that the facts presented are in a general population and there are wide individual variations.
We will talk more about Coronary Artery Disease, symptoms, diagnostics and treatment in future articles. We will also talk about preventive cardiology to try and answer some of the most commonly asked questions on heart disease…
Written byDr Ratna Magotra
Dr. Ratna Magotra is former Professor and Chief Cardio-Thoracic Surgery, KEM Hospital, Mumbai. She’s currently Consultant Cardiac Surgeon at Smt. S R Mehta & Sir K P Cardiac Institute, Mumbai, Trustee and Honorary Director of Cardiac Services, Gram Seva Trust, Kharel (Navsari District, Gujarat) working with marginalised communities. Trustee, Public Concern for Governance Trust, Mumbai