Premature Coronary Artery Disease Most Commonly Found Among Indians

With World Heart Day coming up on September 29, Dr Brajesh Mittal, deputy medical director and consultant interventional cardiologist at Medcare Hospital, sheds light on the health concern along with his expert advice.

 
Dubai, September 28, 2020:  Medcare Hospitals & Medical Centres, the UAE’s premium healthcare provider, addresses the rise in coronary diseases in the younger generation of Indians. 

Health studies conducted globally have indicated that people from the Indian subcontinent (Bangladesh, India, Pakistan and Sri Lanka) have a genetic predisposition for Coronary Artery Disease (CAD) at a much younger age than others. Indians die 10 years earlier of heart disease than other populations in the world, according to these studies. 

“It is a well-known fact that Indians worldwide have a genetic propensity to heart disease. Sometimes, there are no symptoms at all and yet, an individual gets a sudden heart attack,” said Dr Brajesh Mittal, deputy medical director and consultant interventional cardiologist at Medcare Hospital. 

Commenting on this trend of premature CAD, Dr Mittal said: “The reason for a high incidence of premature heart disease among Indians is partly genetic and partly lifestyle related. Genetically, the cholesterol proportions are skewed, which is likely to be the culprit. 

Dr Mittal added: “Indians tend to have low High-Density Lipoprotein (HDL), which is the good cholesterol. In the West, Caucasians may have a high reading of the Low-Density Lipoprotein (LDL) or bad cholesterol, but their HDL is usually normal or high.” 
 
A heart attack is a sudden rupture of an existing blockage and clogging the artery with a clot that blocks off an artery, causing blood supply to the heart to considerably be reduced. Sometimes this blockage may not be significant and yet when it ruptures, it sends out the clot that blocks the artery. Immediate medical help can save a person’s life. 

During a heart attack, there could be a sudden rise in the heartbeat. That’s when an individual can feel dizzy and then, as blood supply is reduced, the person loses consciousness. These two-three minutes are known as the golden minutes when Cardio Pulmonary Resuscitation (CPR) and use of a defibrillator can immediately restart the heart. However, delay here can prove to be fatal. 

“Indians typically suffer from a cluster of symptoms — low HDL, high triglycerides, abdominal obesity, high fasting blood sugar — which together is called the metabolic syndrome. These factors highly accelerate CAD,” Dr Mittal explained. 

People from the Indian subcontinent are also low on physical activity in general along with an inclination towards meals rich in carbohydrates, dairy and fat, all of which add to heart disease. Additionally, high mental stress activates the release of cortisol in the blood stream, while the consumption of energy drinks, smoking, irregular sleeping hours and sleep deprivation become further triggers for heart disease. 

Dr Mittal advises people from the Indian subcontinent to do a complete lipid profile test and fasting blood glucose at least once in five years from the age of 20 and once a year after the age of 40. 

“If the reading is normal, they need not worry. If the reading shows some abnormalities, we follow a scoring system and analyse the risk factors,” Dr Mittal said. 

“If an individual of 30 years shows tendencies of hypertension, high triglycerides, impaired fasting glucose, has a family history of heart disease, then we can alert him well in advance. We can also provide dietary advice and exercise tips to tweak the lifestyle and monitor the individual with tests repeated every year.” 

The Road to a Healthy Heart:
According to the World Health Organization, health is a state of complete physical, mental and social wellbeing. Contrary to what most people believe, health is not merely the absence of disease or infirmity. Many people do not have any treatable (or otherwise) disease, and still are not healthy. Similarly, some people have known definable illnesses, but may still be healthy in terms of physical, mental and social wellbeing. 

For a positive life, one has to have positive health, and for positive health, one has to have a positive lifestyle. Important adaptations in all walks of life are needed to gain a healthful body and mind. These encompass the diet, physical activities, cessation of smoking, meditation and proper sleep. 

There is a saying that you are what you eat. The emphasis should be on balanced eating. The word ‘dieting’ is a misnomer. A more correct word is ‘healthy eating’. Low calorie, low fat, high fiber diet with a good amount of fresh vegetables and fruits, in addition to avoiding excess salt and excess alcohol intake make for a good eating pattern. 

The next important facet is regular physical activity. Thirty to forty minutes of brisk walking or equivalent activity minimum five times a week is recommended over and above routine work-related physical activities. Start with a light workout and build it up gradually. Simple measures like avoiding lifts and escalators do contribute, as do outdoor recreation instead of sedentary activities such as watching TV and playing indoor board games. 

Cessation of smoking and cutting drinks to moderation are very important principles of a healthy life. Those who smoke should certainly and wilfully get rid of the habit. 

Sleep is an activity in itself contrary to what people think it to be a state of inactivity. During sleep, the body remains active to mend, recuperate and relax itself. A good regular and adequate sleep rejuvenates the mind as well as body and provides extra energy. Good sleep and meditation are the tools which construct a positive mental health. 

A healthy mind stays in a healthy body. The state of mind and body are the forerunners of composite societal health. So, to live well, practise a healthy lifestyle.