India Needs A Comprehensive Approach To Combating Heart Diseases : Dr. R.N. Kalra

India is seen as the coronary heart disease capital of the world. According to current estimates, India will soon have the highest number of heart disease cases in the world. About 50% of all heart attacks in Indians occur under 50 years of age and 25% of all heart attacks in Indians occur under 40 years of age. Heart disease is increasing in younger generation with a significant risk in both males and females. More and more number of young Indians are suffering from coronary artery disease, owing to their poor lifestyle, and if this continues the future looks even more dangerous.

Here’s an extract from an interview with Dr R.N. Kalra, Medical Director of Kalra Hospital, New Delhi. Dr. Kalra has worked in various prestigious hospitals of Delhi, including Dr. Ram Manohar Lohia Hospital (Faculty of Medicine & Cardiology).

How do you view the challenges of Indian healthcare sector in terms of failing drastically to improve the doctor-patient ratio?

This is huge challenge and India is doing too little and too late to improve the ratio. This reflects some of the apathy around healthcare development for years not in present scenario. We knew that one of the biggest challenges in coming days will be the healthcare because of the rising population. At that time all healthcare measures were abysmal. One would have worked hard to improve these measures. But it is only much later things started to improve. This is the reason why private healthcare grew. It grew because there was nothing else. We actually lagged behind quite a lot in delivering care to our public. Healthcare is huge priority. It figured very low on priority list. And therefore every ratio not only doctor patient, but nursing, district general hospitals, private hospitals everything is lagging far behind. And we never catch up with it. I believe more hospitals need to be opened, more medical colleges have to be created. Why we are pushing private medical colleges which charge huge money from students. Medical education shouldn’t be so expensive. We are actually fuelling private care by starting private medical colleges. Today we have more private colleges than government colleges. Why money shouldn’t be pumped into public medical colleges. Students should get admission according to their merit in these public medical colleges. There can’t be two parallel verticals which compete with each other. We should unite both private and public healthcare to deliver unified healthcare.Public sector has great intellect and reach but doesn’t have infrastructure and technology. The Government should realise that free treatment will never come but highly subsidized treatment of quality care can come. And that is what we should aim for. Both public and private healthcare should respect each other’s qualities. If we will concentrate each other’s pluses or qualities then we will be able to create greatest healthcare system.

Nowadays people irrespective of age keep suffering heart attacks despite being careful about a good diet in some cases. Then what causes heart attack despite all that even among youngsters? The 50 per cent of death across the world from heart disease are from India. Indians are prone, genetically predisposed to have heart diseases. While in the rest of the world, especially in Europe, the deaths from heart diseases have decreased in last 30 years, in India it has gone up. But among people aged under 45, the disease has grown to twice in last 15 years. People are addicted to other things than exercise now and exercise is also done to build muscle than having a good health. In addition, fast and packaged food has taken over the diet immensely. And that is how transfats seep into the body. More food joints and luxurious items have taken over life in cities. The space of playing has gone down. All of these factors are responsible for an increase in heart cases in India. Even women are falling victim of heart diseases nowadays because of the change in lifestyle. Death from heart disease is six times more common than the death from cancers among women. They have to be more cautious to get protected from the heart disease. Heart disease can attack anyone anytime. We are prone to it. Healthy living should be a standard of healthcare.

Why are youth these-days more susceptible to heart disease ?

Deaths caused due to heart disease are usually at¬tributed to the adult population. What is less known is that young adults are not spared of this main cause of death worldwide. The increase in heart disease in younger adults are caused due to habits of smoking, stress(work and non-work related), unhealthy diet, lack of sufficient physical activity and excess consump¬tion of salt and packaged food in some cases.

How Severe Air Quality Posing a Risk for our Heart ?

It has been observed that air pollution is significantly contributing to worsening of cardiovascular health as has been reported in recent studies. Particulate matter and nitrogen oxides have long-term adverse effects on your heart. Along with other lifestyle factors, pollution is now believed to play a significant role in proving harmful for your heart. Pollution is our collective responsibility and we have ways and means for reducing levels for instance by reducing vehicular emissions. While pollution extends its fangs to heart directly, fac¬tors such as obesity, blood sugar levels, lack of physical activity, and hypertension continue to put human heart and health in to major risk.

Are sedentary life is major causes for heart disease and other diseases?

Cardiovascular diseases and other non-communicable diseases thrive in the conditions provided by the modern sedentary lifestyle, with less physical activity and more dependence on unbalanced and processed food with high salt, sugar, and fat content. These are the major causes for heart ailments and other non-communicable diseases like hypertension and diabetes which can be controlled. Importance of physical ex¬ercise cannot be ignored, and to engage in an intense physical activity on a daily basis for even 1hour has proven to reduce risk for heart diseases by 30%. Also, increasing physical activity helps in preventing and managing diabetes and hypertension. ”

What should be done to minimise risks of Heart Diseases?

How To curb these issues, we need to first understand how to minimise these triggers. Parents should help their child to maintain healthy diet and motivate them to excise on a regular basis, so that they can control high blood pressure issues, since it is quiet common among who are overweight. They also need to help them maintain their salt intake. Warn them about the dangers about smoking and the effects nicotine has on the blood vessels, causing the blood vessels to narrow down and make it harder for the blood to flow through the vessels. If after many efforts of control-ling the diet and increasing the child’s physical activity it still doesn’t lower their blood pressure, a physician should be consulted to seek immediate intervention.

The numbers are not going to decrease unless drastic steps are taken. The problem is that we are leading a very sedentary lifestyle that doesn’t allow us much physical activity. Today’s youth is stressed out mentally as well as physically. A major solution to this is drastic lifestyle modification that will help prevent premature heart attacks. Thrive on healthy food instead of relying on junk food, this is simple to adopt and very effective. Despite having a busy schedule, try and make time to organise, prioritise and balance your lifestyle. Take up either yoga or dance or any other form of exercise that is therapeutic and helps in keeping you physically and mentally healthy. We would need a comprehensive approach to combat¬ing heart disease, with a focus on education and access to proper health facilities. For this both the public and the private sectors have to work together.

Dr. R.N. Kalra is an experienced cardiolo¬gist in Delhi, NCR having more than 30 years of experience as a cardiologist surgeon. He is Medi¬cal Director CEO R&D, Kalra Hospital & Sri Ram Cardio-Thoracic & Neurosciences Centre (SRCNC) Pvt. Ltd. CEO, Indian Heart Foundation (corporate social responsibility initiative by Kalra Hospital). He is also cardiologist to the Chief Minister, State of Arunachal Pradesh, India. He has been honored with numerous awards for his invaluable contributions to the community served by Kalra Hospital.

Vinod Kumar

Health Journalist & writer. Editor of monthly health magazine "Health Spectrum."

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