In the last century, life expectancy increased dramatically and there was a major shift in the cause of illness and death. During this transition Cardiovascular Disease (CVD) became the most common cause of death. Strangely, a century ago CVD accounted for less than 10 per cent of all deaths. Today it accounts for approximately 30 per cent of deaths. Driven by industrialisation, urbanisation and associated life style changes, this ongoing transition is occurring at an even faster rate now.
Hearty issues
The 21st century began with CVD as the leading cause of death. Despite improved nutrition and public health measures, the impact of smoking, high fat diets and other risk factors have combined to make CVD the leading cause of death. Continued improvement in economic circumstances combined with urbanisation, industrialisation and radical changes in the nature of work led to changes in diets, and increased smoking. Easier access to food rich in fats and carbohydrates, low level of physical activity and sedentary lifestyles added fuel to the fire. This has resulted in higher mean body mass index, blood pressure, high levels of plasma and blood sugar.
As the incidence of coronary artery disease increases, the epidemic is affecting Indians even at a relatively young age. Acute heart attack was rare in teenagers and young adults but is now becoming common. Recently a 24-year- old boy came to the emergency room complaining of chest pain associated with nausea. The pain had started nine hours prior to arrival and he had ignored it not connecting it with heart trouble. He was a non-smoker with no family history of heart disease. An electrocardiogram (ECG) showed acute heart attack. A coronary angiograph showed total 100 per cent block of the artery with loads of blood clot. Despite the blood clots being aspirated several times and the artery being stented, the blood flow was not established. Finally a big clot, which was sticking to aspiration tube, was removed and his vital parameters became stable. Other tests including echocardiography were done and the patient was started on optimal medication. He was later discharged and is on follow up and has since remained well and asymptomatic. This shows that risk evaluation must start earlier. Investigations such as treadmill, stress echo and coronary angiography should be done regularly.
Youngsters must be made aware of conventional risk factors like hypertension, diabetes mellitus, smoking, high cholesterol, tobacco consumption and obesity and be encouraged to modify their lifestyle accordingly.
Stay fit
Eat right
Exercise regularly
Learn to cope with stress
Go for regular BP, blood sugar, Cholesterol checkups
Avoid smoking and drinking
Sleep for a minimum of 7 hours
Consult a doctor when you have symptoms chest pain, palpitation, excessive sweating or pain of the left side of chest and arms
Dr. G. Sengottuvelu, is a Interventional Cardiologist at Apollo Hospitals in Chennai.
