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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.

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 ?
1.

Urbanization

2.

Life Style Changes

3.

Smoking

4.

Higher Prevalence of
Hypertension

5.

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
1.
2.
3.
4.

Dyslipidemia TGL
Insulin resistance
Truncal Obesity waist : Hip = > 0.85
Hypertension

OTHER RISK FACTORS :-

Lipoprotein a
2. Homocysteine
1.

PATTERN OF CHD IN INDIANS :1.


2.
3.
4.

Heart attacks occur in Indians 10-15


years earlier than the western population
Malignant coronary artery disease
Multivessel disease and left main
coronary artery disease
Smaller Coronary arteries?

WHY SHUOLD WE PREVENT?


1.

Loss of man power

2.

Economic Impact at the community as well


as National level

3.

Cost of High Tech Treatment

4.

PTCA, By pass Surgery are costly

5.

Common man can not afford

6.

Health Insurance has not taken off yet!

HOW DO WE PREVENT ?
Secondary Prevention
2. Primary Prevention
3. Primordial Prevention
1.

Aspirin
Statins

Primary & Primordial


Prevention

More emphasis to be given


for Preventive Cardiology

1.

Cessation of smoking

2.

Life style Modification

3.

Dietary Habits

4.

Regular Exercise

5.

Control of Obesity

6. Hypertension Detection
Effective control of BP
7. Early detection and control of
diabetes
8. Cholesterol reduction
TC < 150
LDL < 90

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.

PREVENTION IS THE
BEST POLICY

THANK YOU