Skip to main content

Young Hearts are Under Attack

Image
By
What is causing considerable concern to cardiologists in recent years is the observation that young, apparently healthy men in their 30s and 40s are falling prey to heart disease. Once considered a malady of the elderly, it is emerging as a major health problem in young Indians.
When Shailender, a cheerful 41-year-old clerk of our department complained of “gas” and heaviness in the upper abdomen one morning 2 years ago, he was prescribed the customary Digene tablets. When he insisted on showing the cardiologist, his colleagues called him a hypochondriac. A day later, we were startled on hearing that he had to undergo an emergency angiography and stenting the previous evening for an acute myocardial infarction!
There are 9 conventional risk factors for heart disease that cardiologists talk about: obesity, diabetes, smoking, high blood pressure, alcohol, lack of physical exercise, abnormal blood lipids, strong family history of heart disease, and stress. The interesting fact is that the risk increases from 2 fold for 1 risk factor to 300 fold for all 9, implying that as risk factors get added, the actual risk literally multiplies! The optimist would however realize that with the exception of family history, all the other risks could be controlled with life style changes or medicines!
 There were however no obvious risk factors in Shailender’s case. He looked and weighed normal (Body mass index 23), had a normal blood pressure, was a vegetarian and did not have diabetes. Like many, he had been a smoker for 5 years but had quit since marriage. His blood lipids were normal. Why then did he have a heart problem?
The rather common occurence these days of heart disease in young people without any of the conventional risks is challenging this neat theory of 40 years. The country was shocked a few months ago on the sudden death of one of the youngest CEOs and health freaks Mr Ranjan Das at 42 in Mumbai. He ate right, was a marathon runner, had regular executive health check-ups and was considered a model of perfect health in the corporate world.
Indian cardilogists admit that the frequency of heart disease in India is one of the highest in the world; further, it occurs around 10 years earlier, is more often fatal at 1st presentation, and tends to be more severe (all 3 coronary arteries affected).
Three theories are doing the rounds. Some “pundits” are driving down the upper limits of lipids, claiming that blood levels of cholesterol and triglyceride exceeding 160 and 150 could damage Indian hearts. Also an LDL-Cholesterol of more than 70 or a HDL-Cholesterol of less than 40, or increase apolopoprotein A could be damaging.
Physicians that are more pragmatic have however started to look beyond. Stress and sleep deprivation are emerging as a major contributors, with lack of reliable methods of quantifying them posing major hurdles to scientific research. 7 hours of sleep every night might help the stress related body changes to revert to normal, and protect our hearts. It is time we got ourselves more sleep!
As published in HT City ( Hindustan Times)
Labels:

Comments

Post a Comment

Popular posts from this blog

The Doctor’s Dress

By
The familiar white coat worn by physicians as their distinctive dress for over 100 years, has started generating  murmurs  of controversy. It is not uncommon to find the blood pressure to be higher when measured by a white-coat-wearing-doctor in the hospital or clinic than the readings obtained at home by relatives.  This is due to the anxiety that the white coat and the hospital setting evokes in patients, and has been termed “White Coat Hypertension”. Mature clinicians often routinely subtract a few points from these measurements when entering records in case charts or calculating the dose of anti-hypertensive medications to be prescribed. The white coat scares children too.  Kids often express their dislike for this dress by crying and screaming and by denying access to their bellies or chest for examination by paediatricians in this attire. Many pediatricians across the world have folded up their white coats and taken to informal colourful dressing to...
2 comments
Read more

Food Fads in Liver Disorders

By
In an attempt at trying to do well to those they love, spouses and parents often enforce diets on patients of liver diseases that often turn out to be detrimental. The commonest food fad is pale insipid boiled cabbage being doled out to nauseous patients suffering from hepatitis that makes them puke even more.  The liver, in a way, is a buzzing manufacturing unit that requires lots of energy to keep its multiple functions going. And it derives all this from the food we eat. During disease, such as during an attack of jaundice, when many of the liver cells get killed, the liver attemptsdamage control by trying to regenerate quickly. For its cells to multiply however, it requires a generous supply of energy that comes from carbohydrates, and protein, the building block for its cells and tissues. Boiled green vegetables unfortunately have neither of these. Hence the situation often progresses to that of a starved liver unable to recuperate due to cut-off food suppl...
2 comments
Read more

Questions from a Doctor’s Life

By
There is hardly any person in Uttar Pradesh who has not heard of Dr D K Chhabra, a senior neurosurgeon, who died recently. Over the decades his expertise, pragmatic advice and popularity had broken the shackles of his narrow surgical field coming to be known as a “brain-specialist”and a genuine adviser for all health problems. I got to know him in 1987 when I joined the upcoming Sanjay Gandhi PG Institute of Medical Sciences (SGPGI) in Lucknow as a young member of the faculty in Gastroenterology. He had moved from his alma mater the KG Medical College where he is still regarded as a legend. An omnipresent bachelor doctor living in the duty room readily available to help anybody anytime.He was tasked to heading and developing Neurosciences at SGPGI. He had an eye for detail and was tasked additionally by the director to set up not just his department, but the whole hospital, the building, equipment and the campus. DKC was a tall and handsome man who spoke little. But when he did inl...
1 comment
Read more