CORONARY HEART DISEASE IN INDIA by 1lBVcR

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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. Dyslipidemia TGL
2. Insulin resistance
3. Truncal Obesity waist : Hip = > 0.85
4. Hypertension
OTHER RISK FACTORS :-

 1. Lipoprotein ‘a’
 2. Homocysteine
     PATTERN OF CHD IN INDIANS :-

1. Heart attacks occur in Indians 10-15
   years earlier than the western population
2. Malignant coronary artery disease
3.  Multivessel disease and left main
   coronary artery disease
4. 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 ?

1. Secondary Prevention
2. Primary Prevention
3. Primordial Prevention
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
   TGL < 170
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

								
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