Kerala

Heart failure, a major cause of mortality

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Patients in India at least a decade younger; primary prevention of heart diseases mooted

The five-year outcome data from Trivandrum Heart Failure Registry (THFR), an ICMR-supported initiative coordinated by Sree Chitra Tirunal Institute for Medical Sciences and Technology, has reported one of the highest mortality rates among heart failure patients at 58.8%.

The data, the first long-term follow-up study of a cohort of heart failure patients in the country, reveals that heart failure patients in India are at least a decade younger (mean age 61.2 years). More than half of the patients had diabetes and hypertension. One in six suffered from chronic kidney diseases.

The data was presented at the Sixth World Congress on Acute Heart Failure, organised by the European Society of Cardiology, recently. “Heart failure is emerging as a major cause of mortality amongst our population and the commonest cause seems to be ischemic heart disease or coronary artery disease (CAD) at 72%. Public health interventions, focussing on primary prevention of heart diseases, are the need of the hour,” says S. Harikrishnan, Professor of Cardiology, SCTIMST.

The THFR data is also indicative of the fact that heart attacks, their late presentation in hospitals, and less than optimal follow-up treatment, are some of the reasons for the increasing burden of CAD-related heart failure.

There are some 140 Cath labs in the State and, most people should be able to access these facilities within 30 minutes. But people continue to ignore symptoms and reach hospitals late, by which time irreparable damage would have occurred to the heart muscles.

Data from the Kerala ACS (Acute Coronary Syndrome) Registry show that more than one-third of patients in the State reach hospitals more than six hours from symptom onset.

“Heart attack symptoms might be atypical. Sometimes if the symptom onset is late at night, people might decide to wait till morning to visit the hospital. More awareness should be created amongst the public on the importance of seeking treatment without delay. Hospitals should also ensure that there are no process delays at their end,” says Dr. Harikrishnan.

On an average, nearly one in three adults in Kerala over 18 years of age suffer from hypertension and one in five from diabetes. Among adults in the age group of 45-69 years, 67.7%, are either diabetic or prediabetic. Hypertension prevalence in the population is over 30%.

Urgent policy action

This disproportionately high proportion of CAD risk factors calls for urgent policy action for early risk factor control, so that people can be prevented from developing CAD and later on, heart failure. Heart failure is a chronic, progressive condition and its treatment, expensive. Though a host of innovative, implantable devices are available, these are unaffordable to most.

Any strategy to reduce the burden of heart failure should focus on awareness creation on CAD risk factors and interventions to prevent these risk factors establishing itself, right from Plus Two level, experts say.

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Printable version | Jan 28, 2020 8:46:15 AM | https://www.thehindu.com/news/national/kerala/heart-failure-a-major-cause-of-mortality/article29544295.ece

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