Discussion in 'Health and medical' started by Dr. Jai Maharaj, Nov 21, 2003.

  1. 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

    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:

    Jai Maharaj
    Om Shanti

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