Fuel your heart and power your life...

Shobha Shukla *

This is the message of the World Heart Federation for this year's World Heart Day, which is observed on September 29 every year to raise awareness about cardiovascular diseases (CVDs), which include heart disease and stroke. The CVDs, along with cancer, diabetes and chronic lung disease, form the 4 major non-communicable diseases (NCDs) and together account for 82% of the 38 million deaths caused by NCDs every year.

Over 17.5 million deaths due to CVDs every year!

CVDs are responsible for most NCD deaths, killing 17.5 million people (7.4 million from heart attacks and 6.7 million from strokes) every year, followed by cancers (8.2 million), respiratory diseases (4 million), and diabetes (1.5 million). Yet at least 80% of premature deaths from CVDs can be avoided by controlling tobacco consumption, unhealthy diet, physical inactivity and harmful use of alcohol.

Hypertension is the biggest risk factor for CVD, followed by tobacco use, diabetes, physical inactivity and obesity. 13% of global CVD deaths are attributed to raised blood pressure, 9% to tobacco use, 6% each to diabetes, and physical inactivity, and 5% to obesity.

In an exclusive media webinar (www.bit.ly/sep16-webinar), organised by CNS (Citizen News Service) and the International Union Against Tuberculosis and Lung Disease (The Union), Professor (Dr) Rishi Sethi from the Department of Cardiology at King George's Medical University (KGMU), shared the findings of the biggest nationwide blood pressure (BP) survey organised by The Cardiology Society of India on 21st September 2015, in which the BPs of around 0.15 million respondents were measured simultaneously, at 700 sites in 100 Indian cities spanning 24 states, over an 8 hours period.

The initial findings (based on a sample of 74,520) are startling indeed. 33% of the respondents were found to be hypertensive, out of whom 25% were between 31-45 years and 13% between 18-30 years. So it is no longer an old age disease. Also 62% of people with hypertension (HTN) were unaware of their condition, which points to a lack of awareness and good screening tests. Despite medications, 42% of hypertensive people had uncontrolled blood pressure, putting them at high risk for heart disease. Thus the findings reveal that 1/3 of Indians above 18 years have hypertension; 2/3 of those with high BP are not aware of their disease; and in nearly 1/2 of the known cases, HTN is not well controlled.

Dr Sethi called for aggressive cardio-preventive measures, saying that an optimal blood pressure of less then 120/80 mm Hg and HbA1C more than 7% of blood glucose level should be maintained through lifestyle approaches.

Other emerging risk factors are obesity, unhealthy diet, physical inactivity and stress/depression. Dr Sethi advised that, "The median BMI for adult populations should be in the range of 21-23 kg/m2. Elimination of trans-fat and replacement of saturated with polyunsaturated vegetable oils, along with moderate exercise for 30 minutes 5 days a week, will lower coronary heart disease risk. Stress and depression should be avoided as they almost double the risk of coronary artery disease in previously healthy adults".

Alice Grainger Gasser, Programme Development Manager, World Heart Federation called for strengthening implementation of the FCTC to curb tobacco use, which is a major risk factor for many diseases, including CVD.

"CVDs are a huge barrier to human and economic development. Yet, in the past CVD has been neglected by the development agenda. We cannot reduce NCDs without substantially reducing CVD. A specific target in SDGs is to reduce by 33% premature NCD mortality by 2030. The NCD targets and SDGs offer an unprecedented opportunity mandate for countries to tackle CVD", she said.

On 22nd September, 2016, on the margins of the UN General Assembly, the WHO and CDC (US Centres for Disease Control), along with other partners, launched 'The Global Hearts', a new initiative to scale up prevention and control of CVD, especially in developing countries. The initiative will initially be rolled out in 12 countries (Barbados, Colombia, Ethiopia, India, Iran, Jordan, Nepal, Nigeria, Philippines, Tajikistan, Thailand and Uganda) to help them implement its 3 technical packages:

(i) HEARTS (CVD management at the primary health care level to reduce cardiovascular risk factors like high blood pressure and high blood cholesterol)
(ii) SHAKE (reduce salt intake in populations); and raise commitment to implement the
(iii) MPOWER (use the 6 powerful tobacco control measures to help implement the WHO Framework Convention on Tobacco Control)

WHO Director General Dr Margaret Chan said that this initiative can save millions of lives through ramping up proven measures to prevent CVDs in communities and countries, including tobacco taxation, reducing salt in food, detecting and treating people at high risk and strengthening primary health care level services.

Let us all take our heart seriously and fuel it properly to drive our life, instead of burning it out. The heart is at the heart of our health and needs the care it deserves.