07 September 2008
By Dr. J. Shiv Kumar
With heart disease assuming epidemic proportions, it is essential to do what we have to save ourselves
Sedentary habits: Exercise regularly to protect your heartPhoto: M. Vedhan One Sunday morning a 24–year–old executive went to a fitness centre for the first time. After working for half an hour, he complained of pain in the left shoulder. The trainer asked him to continue, as it was his first day.
After about 20 minutes this young executive suffered severe chest pain when he was rushed to hospital. He collapsed and cardiac resuscitation was done. His ECG showed Extensive Heart Attack for which an emergency angioplasty was done and patient survived. After investigations his LPA levels were 130mg.
Hence a word of caution for all fitness freaks. Heart disease and heart attacks have assumed epidemic proportion in India over the past two decades. It is one of the leading causes of death and long–term disability. Based on the evidence, heart diseases will double by 2015 and become the single largest contributor to mortality, accounting for almost one–third of all deaths.
Early manifestation
Not only is the incidence of heart attacks increasing significantly, but the blockage of coronary arteries manifests at least a decade earlier. Every sixth patient with heart attack is below 40 years of age. Young Indians have a five to 10 fold higher rate of heart attacks and deaths as compared to Western population. Indians all over the world have the highest rate of mortality and morbidity for heart attacks whereas the incidence of heart attack have halved in the West during the past 30 years. Irrespective of gender, religion and social class, the high rates of heart attacks in Indians are in sharp contrast to very low rates in other Asians such as Japanese and Chinese.
The most important reason is a combination of nature and nurture – genetic pre–disposition (nature), urbanisation with affluence (nurture). Genetic pre–disposition is reflected by levels of Lipoprotein–A (LPA), which is higher in Indians. Sedentary habits and western lifestyle leads to decreased physical activity, increased consumption of junk food results in obesity, insulin resistance and atherogenic lipid abnormalities. High LP (A), high triglycerides, high levels of bad cholesterol and low levels of good cholesterol predispose heart diseases and heart attacks.
What you can do
Lifestyle modification is of prime importance. One should walk about five kilometres in 45 minutes at least five days a week. Unaccustomed exercises should be avoided. Preventive measures should be undertaken in those with risk factors but without established disease i.e., counselling for tobacco use, early diagnosis and treatment of high blood pressure, diabetes mellitus and dietary measures to treat lipid abnormalities. All these are important in those individuals who have a family history of heart diseases.
The family physician should be trained to recognise signs and symptoms and ECG evidence of heart attacks and institute first aid measures and prompt referral to a hospital where definite therapy can be given.
The writer is a Consultant Cardiologist based in Secunderabad.
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