Heart–related studies show that genetic factors have much to do with heart disease, but unhealthy lifestyles affect and cause death due to coronary heart disease in 80% to 90% people. Experts say these deaths can be prevented by controlling risk factors. Saturday is world heart day.

"The heart that quietly goes about its work is taken for granted or worse still ignored and abused. The consequences are obvious and apparent. Coronary heart disease (CHD) is the leading cause of death in India with more than 14 lakh deaths every year," said Amol Naikwadi who is into preventive health check–ups in Pune.

The world over, more than 72 lakh men and women die each year for CHD. According to estimates and current trends, almost 26 lakh Indians may die due to coronary heart disease by 2020.

"However, 80% to 90% of such cases can be prevented by controlling risk factors like tobacco consumption, alcohol abuse and following a healthy lifestyle that includes a healthy diet, control over high blood pressure,blood cholesterol and regular health checkups," said cardiologist Abhijit Vaidya.

Popular myths that heart diseases usually affect older people as a result of ageing, is fast losing ground. "In reality, the risks for cardiovascular diseases start in youth. It is estimated that around 1.8 crore children around the world under five years of age are overweight. Also, 14% of students aged 13 to 15 years around the world smoke cigarettes. The average age for the onset of such non–communicable diseases has also declined and younger people in the age bracket of 25–40 are increasingly becoming susceptible to heart–attacks and strokes," said Naikwadi.

According to a WHO report, "Of all coronary heart disease patients who die within 28 days of the onset of symptoms, about two–thirds die before reaching hospital. This highlights not only the need for early recognition of the warning signs of a heart attack, but also the need for prevention." Early warning signs can be detected through regular (at least once–a–year) health check–up. If any anomaly is detected, and depending on the stage of the damage done, remedial measures can be taken, said cardiac surgeon Chandrashekhar Kulkarni.

Cardiolo gist Jagdish Hiremath said that heart failure patients have symptoms of breathlessness on exertion and this breathlessness is likely to get worse as the heart failure worsens. "A breathless person even after rest indicates advanced form of heart failure.Heart failure also leads to swelling on the feet and swelling on the face and extreme weakness and lack of appetite," he added.

"Heart failure is correctly diagnosed with the help of an ECG, X–Ray of the chest and further investigative tools like echo colour doppler study, coronary angiography and PET scan of the heart. Hence, periodic health check–ups under guidance of an expert is a must," Hiremath said.

Radiologist Pooja Mehta of Poona Hospital and Research Centre who has specialised in cardiac CT said, the advent of multidetector CT scanners, has made it possible to evaluate the coronary vessels in a fast and non–invasive way.

"Cardiac CT is an excellent screening tool to rule out as well as to assess occult coronary artery disease. It can also grade disease into mild, moderate or severe blockages and helps to determine whether patients are to be treated conservatively or referred for invasive therapy," said Mehta.

Cardiovascular diseases,especially coronary heart disease and stroke may occur due to genetic predisposition or environmental influences. However, the rise of the incidence of CHD in India may be attributed mainly to unhealthy and altered lifestyles than to genetic factors.

Experts said mimicking foreign cultures and adopting lifestyles against healthy living is reflected in the India's physical and mental health.

Consumption of tobacco, alcohol and fast food, coupled with physical inactivity, obesity and low consumption of vegetables and fruits has led to high blood pressure, high cholesterol and stress eventually leading to cardiovascular diseases.

"Approximately 75% of cardiovascular diseases can be attributed to high blood pressure,high levels of cholesterol, tobacco use, physical inactivity, obesity and unhealthy diets. If only we could help ourselves from indulging in our vices,so many untimely deaths could have been prevented," said Naikwadi.

• Pipes called arteries make way for the blood to be pumped out of the heart, channeled throughout the body, and brought back. The arteries that lead it (blood) out of the heart to a finer group of pipes called capillaries decrease in size gradually while the ones that bring blood back keep increasing in size.
• This remarkable system becomes susceptible and vulnerable to assault, finally leading to a breakdown when the walls of the arteries supplying blood to the heart get clogged by waxy and oily substances commonly known as cholesterol and fatty deposits (or plaques).
• The decreasing levels of blood supply starve the heart of oxygen and vital nutrients required for it to work properly. This can cause chest pain, technically known as angina.
• However, if the blood supply to a portion of the heart muscle is cut off entirely or if the required energy of the heart becomes much greater than its actual blood supply, the most likely result is an injury to the heart muscle, commonly known as a heart attack.
• In most cases, the attack is usually not preceded by any visible symptom, thus leading the victim to a sudden death.

• Developed countries, where the death rates from coronary heart disease have decreased, implemented policies related to improved prevention, diagnosis and treatment. A significant change in lifestyle, in particular reduced smoking among adults and lower average levels of blood pressure and blood cholesterol, improved the mortality rate.
• City–based cardiologists have called for a national policy to curb cardiovascular diseases. The policy should deal with population–based preventive steps with participation of physicians and patients. The state and central governments and health insurance providers should reimburse the costs of preventive measures.
• Cardiologist Abhijit Vaidya said that the heart disease epidemic should be contained and slowed down. The need to minimise cardiovascular diseases toll is obvious and urgent. A national strategy must be developed and effectively implemented across the country, he added. Health being a state subject, the Maharashtra government should draft a policy and ensure implementation, Vaidya said.
• According to the preliminary findings of the Million Death Study (MDS), about 25 % of deaths between 25–69 years of age and 19 % of all deaths occur because of heart diseases. It included 33 per cent of deaths in urban areas and 23 per cent in the rural areas. The study is being conducted by the Centre for Global Health Research, Canada. It will track the lives and deaths of 1.1 million households throughout India until 2014, said Vaidya.

• The Indian Red Cross Society (IRCS), Pune district branch jointly with cardiologist Umesh Akkalkotkar will organise a free heart disease detection camp at Red Cross 11, M G Road between 10 am and 1 pm on October 6.
• Needy patients would be investigated at subsidized rates. Those requiring angiography would also be provided concession for same at reputed institutes in Pune.
• Through this, IRCS's Heart Care Centre, located at 593/2 in Rasta Peth, aims to provide costly cardiac treatment at affordable rates. The centre will start lifestyle diseases prevention programme.
• For registering, call 7304922244