Cardiovascular diseases (CVD) are the number one cause of deaths worldwide, accounting for 17.3 million deaths. Over 80% of these deaths take place in low and middle-income countries (LMICs). By 2030, 23.6 million people are predicted to die from CVD which places a burden on national economies.
Women have an important role to play as gatekeepers of the family and guardians of health, especially in lower and middle-income countries, where eight out of 10 CVD-related deaths occur. We are urging all women to adopt heart-healthy behaviours. Taking action to prevent exposure to risk factors will have a positive impact on children, as they learn by example.
Heart disease is the number one killer of women and more than 8.6 million women die of CVD including heart disease and stroke around the world each year. Heart attacks claim the lives of 3.3 million women every year, with another 3.2 million women dying from stroke and the remaining 2.1 million women succumbing to rheumatic heart disease, heart failure, hypertensive heart disease, inflammatory heart disease, and other CVDs.
This is more than the total number of women who die from all cancers, tuberculosis, HIV/AIDS and malaria combined and represents one-third of all deaths among women.
Risk factors in women
Age and family history play a role but it is estimated that the majority of CVD deaths are due to modifiable risk factors such as smoking, high cholesterol, unhealthy diet, high blood pressure, obesity and diabetes.
Women, like men, need to take preventive action to manage their risk factors. These includes monitoring blood pressure and taking appropriate steps to control it; monitoring blood glucose levels; eating healthily; avoiding tobacco; and participating in regular physical activity.
Types of heart disease observed in children
Children who have a birth weight less than 2.5 kg have approximately double the risk of dying prematurely from coronary heart disease.
Congenital heart disease (CHD) is the type of heart disease that a baby is born with. In reality, it is a defect or abnormality of the heart or blood vessels near the heart, and not a disease, so many people use the term “congenital heart defect.” A majority of the children born today with CHD will survive and with proper treatment be able to lead a normal or near-normal life.
Acquired heart disease
This type of heart disease is not present at birth. Two major types of acquired heart disease in children are rheumatic heart disease and Kawasaki disease.
Rheumatic heart disease
Rheumatic fever is caused by the streptococcal bacteria, and usually begins as a consequence of strep throat in children who were undiagnosed or were not treated or undertreated.
The global burden of disease caused by rheumatic fever and RHD currently falls disproportionately on children and young adults living in low-income countries and is responsible for about 2,33,000 deaths annually. Primary prevention of acute rheumatic fever (the prevention of initial attack) is achieved by treatment of acute throat infections, caused by group A streptococcus for up to 10 days with an oral antibiotic (usually penicillin) or single intramuscular penicillin injection. Surgery is often required to repair or replace heart valves in patients with severely damaged valves, the cost of which is very high and a drain on the limited health resources of poor countries.
Kawasaki disease
Kawasaki disease is characterised by fever, rash, swollen hands and feet, bloodshot eyes, swollen lymph nodes, a strawberry appearance to the tongue, and acute inflammation of blood vessels, especially coronary arteries. Its cause is unknown but maybe some kind of infectious agent occurs in young children — 80% or more are less than 5 years old, and occurs more in boys than in girls. In some children, especially those who are undiagnosed or untreated or not treated soon enough, serious heart damage can occur.
Other heart diseases observed in children, include:
Chagas disease — a parasite-borne infection that primarily affects rural populations in low-income countries — cardiomyopathy and infectious endocarditis. Children can also develop abnormal heart rhythms, especially those with certain kinds of CHD.
Childhood overweight/obesity can lead to heart disease risk in later life. The problem is global and steadily affecting many low and middle-income countries, particularly in urban settings. Globally, the number of overweight children under 5 is estimated to be over 42 million. Close to 35 million of these are living in developing countries.
Societal changes associated with economic growth, modernisation and globalisation, as well as changes in nutrition habits across the world, are driving the obesity epidemic.
Cities in developing countries are urbanising at a rapid rate without much foresight.
This has led to the creation of cities with unequal distribution of goods, with some areas having insubstantial housing conditions and low access to healthcare services, healthy foods and safe, green places for outdoor activity that are free of environmental toxins and pollutants.
Children in cities may be particularly susceptible to second-hand smoke, given the number of smokers in urban areas, along with crowded living conditions.
First-hand use of tobacco by children is on the rise and those residing in cities may be more vulnerable due to increased access to cigarettes and increased exposure to ads that encourage smoking.
On World Heart Day, September 29, the World Heart Federation is calling on people — specifically mothers who are gatekeepers to the home — to take action now to protect their own heart health, as well as that of their children and families to safeguard future generations.
(The writer is Medical Director & CEO, Kalra Hospital, New Delhi.Email: >dr_rnk@hotmail.com )
