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CORONARY HEART DISEASE IN INDIA. The Prevalence of Coronary Heart Disease (CHD) “ HEART ATTACK” is rapidly increasing in India It has become an “ EPIDEMIC”. It is a major contributor for mortality and morbidity.
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The Prevalence of Coronary Heart Disease (CHD) “ HEART ATTACK” is rapidly increasing in India It has become an “ EPIDEMIC”. It is a major contributor for mortality and morbidity.
In the year 1990 cardiovascular disease was responsible for 2.39 million deaths and the Nation incurred a loss of 28.59 million disability adjusted life years.
It is expected that deaths due to HEART ATTACK will double in the next 10 years The death rate due to heart attack will be 295 per 1,00,000 population in the year 2015.
Cardiovascular disease will account for 33.5% of total deaths by the year 2015, would replace infectious diseases, as the number one killer in the Indian Population.
The Prevalence was 1% in the urban India (Delhi) in the year 1960. Now the prevalence is 10% (Delhi) Rural India has also witnessed 2% in 1974 to 4 – 6 % in 1994.
WHY IS CHD INCREASING IN INDIANS ? Urbanization Life Style Changes Smoking Higher Prevalence of Hypertension Diabetes Mellitus
6. Hyper Cholesterolemia 7. Obesity – Truncal 8. High fat Intake 9. Lack of Physical activity 10. Stress
GENETIC AND ETHNIC FACTORS “THRIFTY GENE HYPOTHESIS”
CARDIOVASCULAR DYSMETABOLIC SYNDROME Dyslipidemia TGL Insulin resistance Truncal Obesity waist : Hip = > 0.85 Hypertension
OTHER RISK FACTORS :- Lipoprotein ‘a’ Homocysteine
PATTERN OF CHD IN INDIANS :- 1. Heart attacks occur in Indians 10-15 years earlier than the western population 2. Malignant coronary artery disease 3. Multivessel disease and left main coronary artery disease 4. Smaller Coronary arteries?
WHY SHUOLD WE PREVENT? Loss of man power Economic Impact at the community as well as National level Cost of High Tech Treatment PTCA, By pass Surgery are costly Common man can not afford Health Insurance has not taken off yet!
HOW DO WE PREVENT ? Secondary Prevention Primary Prevention Primordial Prevention
Aspirin Statins
Primary & Primordial Prevention
Cessation of smoking Life style Modification Dietary Habits Regular Exercise Control of Obesity
6. Hypertension – Detection Effective control of BP 7. Early detection and control of diabetes 8. Cholesterol reduction TC < 150 LDL < 90 TGL < 170
9. Stress control 10. Yoga 11. Meditation 12. Relaxation Techniques
Much more before Hippocrates, Aristotle and Galen, a Couplet from Bhagawad Gita emphasised the importance of balanced food, exercise and other life style variables in disease prevention
GITA SAYS :- “ One who observes control over his diet, takes regular exercise, has time to relax, dose the right toil in discharge of his duties, observes proper hours of sleep and awakening and is balanced in his action and reaction, emotions and reason duties and rewards, conquers disease”.