Heart to heart
By Manash Pratim Gohain
The Pioneer
Monday, September 29, 2003
At this rate, India will emerge to be a hereditary
heartless! As was observed this September 28 - on World
Heart Day. There are more than two million patients
suffering from rheumatic heart diseases in India. Nearly
1.5 lakh Indian children suffer from congenital heart
diseases but only two per cent get treated. The rest die
of complications or suffer throughout their life. Of the
total 50,000 children suffering from congenital heart
diseases and requiring surgery, less than 1,000 are in a
position to afford it in the country.
Projections by WHO and ICMR indicate that India will
emerge as the heart attack capital by 2020. As for the
West, it was as early as 1960s that Finland and the US
topped in coronary artery disease. These countries have
brought down the rate to 60 per cent through lifestyle
management. We asked Dr Prabhu D Nigam, former HOD
cardiology at Ram Manohar Lohia Hospital and serving
presently as senior consultant with the Apollo group as
to how true are these reports.
The doctor said research world over has established that
coronary heart disease, heart attack and angina are
increasing in Asian-Indians, specially in our region. "We
are seeing maximum number of heart attacks and angina
cases in India and nearby countries than other parts of
the world. Earlier, it was highest in Europe and Finland.
And now it is South-East Asia with a prominence in
India," he added.
Q: What are the common heart diseases among Indians?
A: The most common heart related problems are heart
attacks, coronary artery diseases, high BP and rheumatic
heart disease in which the heart valves are involved.
Q: Why are we witnessing this trend?
A: Reasons are many: Genetic, food habits, sedentary
lifestyle involving less physical activities and factors
like smoking. Patients may suffer heart diseases, attacks
and angina even if these factors are not present. But
presence of these factors makes them all the more
susceptible. Therefore, we must lay emphasis on
prevention rather than cure.
Q: What preventive measures can you suggest?
A: We must modify our lifestyle and keep ourselves
physically fit through exercises, keep our weight in
check, avoid smoking and company of smokers. If we get
regular medical check-ups annually in the form of
physical examination, blood examination - blood sugar
level, lipid profile and blood pressure etc done then we
can ourselves monitor our condition. But tests do not
provide a 100 per cent precautionary measure.
Q: Why are even the young so susceptible to heart
diseases nowadays?
A: A decade ago, heart disease happened in 50-60 age
group. While in the West, the high probability is still
between 40-60 years, in India it has dipped to the early
30s. The younger generation is suffering mainly due to
junk food. Other reasons include habits like smoking.
Plus there is diabetes, high blood pressure and high
cholesterol. Mainly, this disease occurs due to
deposition of cholesterol in the blood vessels which
supply the heart muscles. This starts as early as at 10
years of age and takes seven years to grow. In Indians,
there has been an acceleration in this process as
compared to other countries. This is related to the
genes.
Q: How are the genes responsible for this increase in
heart diseases among Indians?
A: If you go into molecular biology, there are certain
types of bad lypoproteins and other bio-chemical
abnormalities which are more found in Indians or Asian-
Indians anywhere in the world than in other ethnic
groups. These are probably related to genes and are under
study. If we are able to localise the genes for their
abnormal presentation in human body, we will be able to
tackle the problem and prevent it. The future for any
disease including heart is gene therapy. In a couple of
years, we may be able to prevent them by gene therapy
rather than using pharmaco therapy and surgery.
Q: What is the relation between heart disease and
diabetes as they are following a parallel pattern in
their increasing trend?
A: About 60 per cent of diabetics develop heart disease
and about the same per cent of heart patients (I mean
coronary artery disease which results in the form of
angina and heart attacks) are diabetics. Diabetes is also
an expanding disease not only in our country but all over
the world. Heart disease has attained an epidemic
proportion in our country. Again in diabetes, there is a
molecular level abnormality. Cholesterol gets deposited
in the blood vessels. Bad cholesterol damage the
functioning of the cell lining of the blood vessel that
supply the heart and other organs like kidney, eyes and
brain. Another trend is young women now being prone to
heart disorders. There was a time when females were
considered more or less protected from coronary heart
diseases till they were menstruating. But diabetes
reverses this and nullifies the protective effect in
menstruating women, again more prevalent in Indians and
Asians. It must also be at the molecular level... some
genes may be responsible.
Q: What is the most recent technology in cardiology?
A: When the heart muscle is damaged, it has no power to
recover. Other muscles in our body can recover and
regenerate, stem cells are the cells taken from the bone
marrow. Stem cells have the property of developing the
cell type wherever they are inoculated. If they are
inoculated in the heart, they will develop into heart
cells. There is a hope that this is the future therapy by
which you can develop the muscles, blood vessels of the
diseased heart.
Q: Despite best doctors and facilities, why is India's
health sector still ranked among the lowest rung?
A: Medical treatment is very expensive. No government in
the world can offer free treatment. This should be
understood by everybody. Which is why in America only the
elderly and the very poor are supported by the
government. We should make health insurance mandatory.
Government hospitals alone cannot take up this burden.
The government spends huge amount in hospitals but there
is a lack of will in the workers there. Everyone has got
the power of not to work!
Read the complete news at:
http://www.dailypioneer.com
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