WORLD HEART DAY - SEPTEMBER 29
DR AMIT DIAS, MD
There is one sound we must never take for granted: the beating of our heart. September 29 is World Heart Day and a reminder to one and all to adopt a heart healthy lifestyle.
Cardiovascular disease remains the world's biggest killer. Nearly 20 million people died from cardiovascular diseases in 2022, according to the World Health Organisation, with heart attacks and strokes accounting for about 85% of these deaths. That translates to roughly 39 lives lost every minute.
Rising burden of heart disease
India carries a huge share of the world's cardiovascular burden. Millions of Indians live with hypertension, diabetes, obesity and abnormal cholesterol—often without knowing it.
The worrying part is that cardiovascular disease is no longer simply an illness of old age. Heart attacks are occurring in people in the prime of their working and family lives.
The absence of symptoms does not mean the absence of risk.
Research conducted at GMC through the ICMR-INDIAB study has provided an important window into the metabolic health of Goa.
The national study, involving more than 113,000 adults, found diabetes in 11.4% of Indians and hypertension in 35.5%.
The prevalence of diabetes in Goa was 26.4%—the highest among the states in the national ICMR-INDIAB report published in the Lancet Endocrinology.
Diabetes and hypertension often occur together. Add smoking, obesity, physical inactivity, unhealthy diets, high cholesterol and stress, and the arteries gradually pay the price.
The heart may be remarkably resilient.....But it is not invincible.
Heart disease in younger adults
Years ago, we studied acute myocardial infarction in young people in Goa. In our study of 355 patients with myocardial infarction, 22.25% were aged 45 years or younger.
Smoking and alcohol were more commonly seen among younger patients, while diabetes and hypertension were more prominent among older patients.
A 35-year-old who smokes, has abdominal obesity and undiagnosed metabolic risk factors cannot assume that a heart attack is something that happens only after retirement.
Heart disease in children in Goa
Our work conducted by Dr Ankush Desai and Dr Kedar Narvenkar (GMC), Dr Ana Karina, and me in collaboration with Dr Anita Saxena (AIIMS) gave us insights in the hearts of children in Goa.
While we screened school children, we found several children with congenital heart disease and even rheumatic heart disease that were previously undetected.
The e-RHEUMATIC study, involving 16,294 schoolchildren aged 5–15 years across four regions of India, including Goa, used echocardiography and World Heart Federation criteria to look for rheumatic heart disease.
The study detected rheumatic heart disease by echocardiography in 7.7 per 1,000 children, while clinically evident disease was only 0.36 per 1,000.
In other words, much of the disease could remain hidden if we relied only on clinical examination.
Goa's STEMI lesson
Goa’s STEMI initiative is a strong example of how technology, early detection and a well networked healthcare system can save lives. With 20 spokes across Goa, more than 4.5 lakh ECGs conducted and 11,000+ STEMI critical cases identified. Early mortality has been reduced from 7.2% to 2.4%.
But no health system can save a heart if the patient waits at home. That is why recognising the symptoms is so important.
Know the signs:
* Pressure, heaviness, squeezing or pain in the centre of the chest
* Pain spreading to the arm, shoulder, back, neck or jaw
* Breathlessness
* Cold sweating
* Nausea or vomiting
* Sudden weakness, dizziness or fainting
* Unexplained extreme fatigue
* Women, older adults and people with diabetes may sometimes experience less typical symptoms.
Do not wait for the pain to become unbearable. If a heart attack is suspected, seek emergency medical care immediately. Do not wait for the symptoms to “settle down”. Do not drive yourself if emergency transport is available.
I always stress that prevention is better than cure. Adopt a heart healthy lifestyle, exercise regularly, screen for risk factors and stop smoking,
Eat heart healthy food: more vegetables, fruits, whole grains, pulses and nuts; less salt, trans-fat, excess sugar and ultra-processed food. Maintain a healthy weight, sleep well, manage stress.
To my people in Goa, my message this World Heart Day is simple: Don't wait for the heart attack to teach you about your heart.
Every heartbeat is precious and sometimes, the difference between life and death is not a miracle. It is simply arriving in time.
[The writer is Assistant Professor in Preventive & Social Medicine at Goa Medical College with interests in lifestyle diseases. He was the Co Principal Investigator for the ICMR-INDIAB study and e-Rheumatic study on Goa.]
