Coronary Heart Disease – The Sudden Killer - Coronary heart disease kills more than 70 lakh people each year. Most of these deaths are in developing countries like India. Unhealthy lifestyle influences 80% - 90% dying of CHD, and are therefore preventable.
The strongest muscle in the human body is only the size of a human fist. Yet the amount of energy produced by that muscle over a lifetime of 80 years is enough to light up 30 lakh wooden matches, or cook 7500 hamburgers, or keep a 60 watt light bulb continuously lit for one-and-a-half years! That is the power of an average human heart. Imagine the possibilities that could be attained by such a powerful organ if trained and nurtured properly. Sadly though, this wonderful gift of nature, that quietly goes about its work, is taken for granted or worse still ignored and abused.
The consequences are obvious and apparent. In 2004, ignorance coupled with abuse resulted in 72 lakh deaths worldwide as a result of a dysfunctional heart. Coronary heart disease (CHD), the name by which it is known formally, was the leading cause of death and accounted for 12.2% of the total number of deaths that year. The statistics are no different for India; the same year 14.6 lakh deaths out of a total of 1.3 crore occurred because of coronary heart disease. Presently more than 72 lakh men and women die each year of CHD, the world over. According to estimates and current trends, almost 26 lakh Indians are predicted to die due to coronary heart disease by 2020.
How does it kill?
Pipes called arteries make way for the blood to be pumped out of the heart, channeled throughout the body, and brought back. The arteries that lead it (blood) out of the heart to a finer group of pipes called capillaries decrease in size gradually while the ones that bring blood back keep increasing in size. This remarkable system becomes susceptible and vulnerable to assault, finally leading to a breakdown when the walls of the arteries supplying blood to the heart get clogged by waxy and oily substances commonly known as cholesterol and fatty deposits (or plaques).
The decreasing levels of blood supply starve the heart of oxygen and vital nutrients required for it to work properly. This can cause chest pain, technically known as angina. However, if the blood supply to a portion of the heart muscle is cut off entirely or if the required energy of the heart becomes much greater than its actual blood supply, the most likely result is an injury to the heart muscle, commonly known as a heart attack. In most cases, the attack is usually not preceded by any visible symptom, thus leading the victim to a sudden death!
Who gets killed?
Contrary to popular assumptions that non-communicable diseases (NCD) affect wealthy nations, latest statistics suggest that over 80% deaths caused by cardiovascular diseases (CVD) take place in low and middle-income countries. Also the occurrence is almost equal among men and women. Unless intensive and comprehensive measures in prevention, diagnosis and treatment are adopted, it is expected that 82% of the future increase in Coronary heart disease will occur in developing countries like India.
“The gods are just and our pleasant vices/ Make instruments to plague us.” William Shakespeare’s wise articulation holds true for our present predicament. Cardiovascular diseases, especially coronary heart disease and stroke may occur due to genetic predisposition or environmental influences. However, the rise of the incidence of CHD in India may be attributed mainly to unhealthy and altered lifestyles than to genetic factors. Our insistent need to mimic foreign cultures and adopt lifestyles inimical to healthy living is duly reflected in the current scenario of physical and mental health in India.
Consumption of tobacco, alcohol and fast food, coupled with physical inactivity, obesity and low consumption of vegetables and fruits has led to high blood pressure, high cholesterol and higher levels of stress eventually ending up with cardiovascular diseases. Approximately 75% of cardiovascular diseases can be attributed to high blood pressure, high levels of cholesterol, tobacco use, physical inactivity, obesity and unhealthy diets. If only we could help ourselves from indulging in our vices, so many untimely deaths could have been prevented.
When does it kill?
A Chinese proverb says, “Encased in fat in youth, encased in a coffin in middle age.” Popular myths that heart diseases usually affect older people as a result of ageing, is fast losing ground. In reality, the risks for cardiovascular diseases start in youth. It is estimated that around 1.8 crore children around the world under five years of age are overweight. Also, 14% of students aged 13 to 15 years around the world smoke cigarettes. The average age for the onset of such non-communicable diseases has also declined and younger people in the age bracket of 25 -40 are increasingly becoming susceptible to heart-attacks and strokes.
Can it be prevented?
Old habits die hard. However, it is preferable that habits die instead of living, breathing human beings! Intensive studies have revealed that while genetic factors play a part, an unhealthy lifestyle affects and influences 80% to 90% people dying of coronary heart disease. Developed countries in the West – where the death rates from coronary heart disease have decreased – implemented policies related to improved prevention, diagnosis and treatment. A significant change in lifestyle, in particular reduced smoking among adults and lower average levels of blood pressure and blood cholesterol improved the mortality rate.
According to a report published by WHO, “of all coronary heart disease patients who die within 28 days of the onset of symptoms, about two-thirds die before reaching hospital. This highlights not only the need for early recognition of the warning signs of a heart attack, but also the need for prevention.” The early warning signs can be detected through regular (at least once-a-year) preventive medical health checkups. If any anomaly is detected, and depending on the stage of the damage done, remedial measures may range from adopting a healthier lifestyle to surgical interventions like angioplasty, coronary artery bypass, heart transplant etc.
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