Heart Disease-Preventive Cardiology
Heart disease describes a range of conditions that affect your heart. The term “heart disease” is often used interchangeably with the term “cardiovascular disease.” Cardiovascular disease generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke
Preventive Cardiology the Prevalence of Heart Disease 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 disease 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.
The various factors leading to heart disease are
Urbanization, Life Style Changes, Smoking, Higher Prevalence of Hypertension, Diabetes Mellitus, Hyper Cholesterolemia, Obesity – Truncal, High fat Intake, Lack of Physical activity, Stress, genetic + ethnic factors and cardiovascular dysmetabolic syndrome.
Other risk factors include Lipoprotein a, Homocysteine.
Preventive cardiology includes
- Secondary Prevention
- Primary Prevention
- Primordial Prevention
The aim of assessment and management of risk factors for heart disease is the reduction of premature coronary events. Primary prevention involves reduction of these events in asymptomatic individuals. Secondary prevention focuses on those with established heart disease. The presence of risk factors in an individual increases his or her relative risk of a coronary event .The absolute risk of a coronary event depends on the individual’s total number of risk factors and their severity i.e. total risk. Risk factor assessment and modification is an important aspect of preventive cardiology. The patients most likely to benefit from risk factor reduction are:
- Those with established heart disease or other manifestation of CHD.
- Asymptomatic individuals with multiple risk factors or target organ damage.
- Close relatives of those with early onset heart disease or populations at increased risk.
Aggressive treatment of solitary risk factor may provide less benefit than modest reduction in several risk factors.
Manage risk factors by
- Cessation of smoking
- Life style Modification
- Undertaking Dietary Modification-ensure dietary fat is less than 30% of total intake and less than 30% of total saturated fat, increase intake of fish and plant oil, restrict calorie if person is overweight, and reduce salt and alcohol in hypertensive patients. Habits
- Regular Exercise
- Control of Obesity
- Hypertension – Detection
- Effective control of BP
- Early detection and control of diabetes
- Cholesterol reduction
TC < 150
LDL < 90
TGL < 170
- Stress control- Yoga, Meditation, Relaxation Techniques
- Using prophylactic drugs in high risk patients.
- Screening relatives of high risk patients.
- Regular follow up and reviewing new risk factors, compliance, complications of disease and side effects of treatment.
“ 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”