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Times Of India
18 july 2012

Mumbai: Shiv Sena leader Uddhav Thackeray’s heart condition has turned the spotlight on an issue that few choose to confront directly: The right age to start looking at your heart much more closely.

"Earlier I would ask people over 40 years of age to undergo yearly cardiac checks, but I now ask people over 30 years of age to be careful," said senior heart surgeon Ramakanta Panda and founder of Asian Heart Hospital in the Bandra-Kurla Complex. The young face of India’s cardiac epidemic is well illustrated by the fact that Panda’s consultation room on Monday had a patient who was only 31 years old.

The consensus among the medical fraternity is that one of the best ways for urban Indians to dodge heart attacks would be to start cardiac health checks right in their thirties. Dr Pavan Kumar, who heads the cardiac surgery department at Nanavati Hospital in Juhu, said Indians should be on their guard from the age of 35. "People should undergo a stress test annually and, perhaps, even a CT angiography every three years," he said. A CT angio, he said, clearly shows calcium deposit and each test is valid for three years.

Preventive cardiac checks are the only prudent option considering that heart diseases hit Indians much earlier than other ethnic populations, said experts. This trend was first noticed a few years ago when the most comprehensive study worldwide on the risk factors for heart diseases showed that Indians were prone to heart attacks a decade earlier than their Western counterparts who are affected in their sixties.

Dr Prafulla Kerkar, head of KEM Hospital’s cardiology department who contributed to the worldwide study, said it’s time Indian families started educating their children about preventive measures. "If a family has a history of heart disease, it is best to tell children about the importance of a healthy lifestyle, eating right and staying physically active," Kerkar said.

The Indian Journal of Medical Research stated in November 2010: "Among adults over 20 years of age, the estimated prevalence of coronary heart disease is around 3-4% in rural areas and 8-10% in urban areas, representing a two-fold rise in rural areas and a sixfold rise in urban areas between the years 1960 and 2000."

The reasons are not too difficult to find. Said Dr Panda, "Earlier it was thought that the Indian gene is the main cause for the epidemic of heart diseases, but new research suggests that stress play a very big role." Urban Indians have high levels of stress and low levels of physical activity. "Moreover, the Indian diet has drastically changed. All these are contributing to a higher incidence of heart disease among Indians," he added.

The only silver lining is that with regular monitoring of cholesterol, blood sugar, hypertension and an annual stress test, people should be able to catch any discrepancy. "This regular monitoring would ensure that in 80-90% of the cases, any heart problem is noticed at the earliest," said Dr Panda.

There are some doctors who beg to differ. One senior doctor said heart problems are an enigma. "Although we know so much more about heart disease than before, there is no way of pinpointing when who will get a coronary syndrome attack," he said. He, however, said that modern medicine has evolved so much that even a person with advanced disease could live comfortably for decades after undergoing an intervention.

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