HEART : Act, before you are late

Dr.Gurvinder Pal Singh
Sutlej Hospital & Tavleen Heart Centre, Phagwara (Punjab)


Prevention is better than cure - This very old but time tested dialogue , particularly stands true for Coronary Artery Disease/ Ischeamic Heart Disease. Sedentary life, lack of exercise, faulty dietary habits, mental stress are the few main causes for rapid progession of plaque. We should not forget the role of smoking, tobbacco and alcohol.

Do we ever think that how much total exercise per day we are doing in the form of walking, jogging, swimming, playing badminton/table tenis etc or all the time we are totaly sedentary, mentaly tense, busy, using lift rather than staires or parking the car at the door of building rather than parking it 100yards away from the building so we can walk a little bit in the busy schedule.

Are we aware of our eating habits and follow a dietary plan. How much do we eat from our own Kitchen ( know what I am eating ) and how much from the Bakery and Restuarent. How much is the total intake of Fresh Fruits, Fresh Vegetables and Fibres and how much is Fast food. Bakery products have high contents of Salt and Hydrogenated fat/Trans fat along with class - II preservatives and colors and has almost no fibres.

Primary prevention is aim to identify an indivisual with multiple risk factors. Risk factors responsible for rapid progression of Atherosclerosis and CAD are-
Modifiable Risk Factors - Sedentary life, smoking, Obesity, Hypertension, Dyslipidemia, Diabetes and Insulin Resistance, Mental Stress.
Non Modifiable Risk Factors - Age , Sex, Family history, Genetic profile.
Atherosclerosis Risk Factors - Homocysteine, Fibrinogen, Lipoprotein-'a', LDL-C, Marker of fibrinolytic function, Marker of Inflamation( hs-CRP, ICAM & IL-6, PAI).

Universal screenig of all indians should be carried out for the purpose of of early detection of high risk indivisuals. A Screening Protocol should be addopted for detecting early CAD involvement and document the following --
*Name , Age, Sex
*Family history of premature CAD & CVD.
*Personal history of CAD & CVD.
*Dietary history.
*Body weight, Hieght, BMI & Waist circumference.
*Extent of physical exercise.
*History of smoking / tobbacco.
*Blood Pressure.
*Fasting Blood Sugar.
*Fasting Lipid Profile.
*Evaluation of metabolic Syndrome.
*For high risk indivisuals specificaly sreen for Intima Media Thickness ( CIMT ), Flow Mediated Vasodilatation ( FMD ), Aortic Root Calcium by (Echo), Coronary Calcium by (EBCT).

A recent survey shows high prevelance of cardio-metabolic syndrome in young physicians of india (JAPI). So, the Medical Professionals need to follow healthy lifestyle with minimum mental stress.

Primary prevention can be acheived by Early Diagnosis by Mass Screening, devloping Awareness, doing Counselling and proper Evaluation. Government, Health authorities, Public educators, NGOs and Media should come forward to teach the public a healthy lifestyle which is the first and powerful instrument to fight against Non - communicable Diseases like Coronary Artery Disease, Hypertension and Diabetes. Emphasis should be given to Regular exercise, Weight reduction, healthy eating habits, nutritional supplement, correcting dyslipidemia, controlling hypertension, cessation of smoking, overcome the mental depression and practice of Yoga by doing proper exercises of yoga.

Life Style management plays important role in the prevention of CAD. Life Style management should start from child hood. Fatty steaks /atherosclerotic leisons start devloping irreverisibly in early childhood and progress to in adoloscence and adulthood. A healthy childhood planning is essential to have a healthy adulthood. We should be beware of childhood obesity and eating habits of our kids. We can change our life style by changing our routine activities from sedentary to active life, food habits from refined to crude, control on risk factors and reducing mental stress for healthy future.