HEALTH CHALLENGES IN

NEW CENTURY

Ms TARIKA SHARMANursing Tutor

M M College Of NursingMaharishi Markandeshwar University, Ambala

Haryana (INDIA)

Global Scenario

Epidemiology and prevention of cardiovascular disease, a global perspective. Gaithersburg, MD: Aspen Publishers, Inc, 2011.

Epidemiology and prevention of cardiovascular disease, a global perspective. Gaithersburg, MD: Aspen Publishers, Inc, 2011.

The Situation In INDIA

India's no.1 killer: Heart disease

April 12, 2010 (INDIA TODAY)

US study : Heart disease is affecting Indians early

The ongoing study provided data of 85,295 patients of 15 hospitals from Mumbai

to Patna over the last 26 months.

Of these patients — including patients from urban centers as well as rural areas -

60,836 were found to have heart disease.

Almost every second patient has high blood pressure, every fourth has diabetes and

every fifth had plaque deposits in his/her arteries.

The average age of a heart patient in India is 52 years ( > 70 yrs in America : ACC's

American registry).

Clearly, Indians get hit earlier with the heart diseaseSep 30, 2014, TOI

Attention young India, take care of your heart

Four people die of heart attack every minute in India

and the age group is mainly between 30 and 50.

Twenty-five per cent of heart attack deaths occur in

people less than 40.

Nine hundred people under 30 die due to heart

disease in India every day.

India today, 24 July 2011

Reasons

Smoking

a fashion statement in college days

indispensable addiction.

India today, 24 July 2011

Reasons …

Hypercholesterolemia

Diabetes mellitus

Hypertension : Changing food habits, stress and a sedentary lifestyle

Obesity

Unhealthy food habits

Physical inactivity

Stress

Genetics

Lack of awareness India today, 24 July 2011

Coronary Heart Disease in Women: A Challenge for the 21st Century

The belief of women should not have coronary heart disease, it is not true.

Heart disease : first killer of women

Many professional responsibilities, in addition to traditional responsibilities.

An excess of fat and carbohydrates intake , not exercising regularly , smoking

and not having enough time to rest leading to overweight, dyslipidemia,

arterial hypertension, impaired glucose tolerance and diabetes.

Maria Cecília Solimene Clinics (Sao Paulo). 2010 Jan; 65(1): 99–106.

Cardiovascular diseases effecting women as young as 35

A massive section of country's population suffers cardio vascular

diseases.

Bangalore

- An alarming 10-15% rise in cardiovascular disease (CVD)

among young women

Hyderabad

- Women are more prone to problems caused by lack of estrogen

between the ages of 20 - 40.

Indus Health Plus Report, Feb 3, 2014, TOI

Cardiovascular diseases effecting women as young as 35…

Mumbai

- an increase in CVD cases between the age brackets of 24-30 years of which 58% of

the total cases were below 40 years of age and 30% were below 30 years.

New Delhi

- Out of 11% coronary heart diseases case, 35% have been observed in women.

- 23% of corporate employees are suffering from CVD.

- Out of 55 per cent, under the age bracket of 20 to 29 years, 15-20% of them are

females.

Reason: drastic lifestyle changes, Insufficient exercise, lack of sleep, poor eating habits

and stress.

Indus Health Plus Report, Feb 3, 2014, TOI

70% of the Urban Indian population at risk of heart disease!

In a three-year-long study conducted in 12 cities across India, it has been

found that :

- 51 % of Mumbaikars have low levels of the heart-protecting high-density

lipoprotein (HDL), also known as ‘good’ cholesterol.

- over 70% of the urban Indian population is at the risk of being diagnosed

with cardiovascular disease.

www.thehealthsite.com Sep 27, 2013

Heart failure in the 21st century: a Cardiogeriatric syndrome.

Chronic heart failure (CHF) is principally a cardiogeriatric syndrome, and it has become a major public health

problem in the 21st century due largely to the aging population. Age-related changes throughout the

cardiovascular system in combination with the high prevalence of cardiovascular diseases at older age

predispose older adults to the development of CHF. Features that distinguish CHF at advanced age from CHF

occurring during middle age include an increasing proportion of women, a shift from coronary heart disease

to hypertension as the most common etiology, and the high percentage of cases that occur in the setting of

preserved left ventricular systolic function. Although the pharmacotherapy of CHF is similar in older and

younger patients, the presence of multiple comorbidities in older patients mandates a multidisciplinary

approach to care. Manifest CHF is associated with a poor prognosis, especially in elderly persons, and there is

an urgent need to develop more effective strategies for the prevention and treatment of this increasingly

common disorder to reduce the individual and societal burden of this devastating illness in the decades

ahead.

• Rich MW J Gerontol A Biol Sci Med Sci. 2001 Feb;56(2):M88-96.

Additional genetic and lifestyle-related risk factors

High amount of Lipoprotein (a)

High amount of homocysteine

High amount of high sensitivity CRP

Abdominal Obesity

Metabolic Syndrome

DNA (BETA) June 12, 2015

Source: Cardiovascular diseases in India: Challenges and way ahead (ASSOCHAM, India International Heart Protection Summit September 2011 www.deloitte.com/in)

The Power of Prevention

Although chronic diseases are among the most

common and costly of all health problems, good news

is that they are also among the most preventable.

Prevention: Change of Policy

The development agencies, nongovernmental

organizations, and governments work toward two essential

goals:

- Creating environments that promote heart-healthy

lifestyle

- Building public health infrastructure and health systems

Prevention: Awareness

Creating awareness about preventive healthcare

Understanding preventative care requirements of

women.

Prevention: Life style modifications

Exercises, maintaining normal wt, managing obesity

Cutting down on consumption of alcohol, tobacco and greasy food

Load up on veggies and fruits, Reduce intake of saturated and trans-

fats

Reduce salt and sugar intake

Avoiding smoking

Engaging in stress bursting activities

Proper sleep

Prevention…

Preventive health check-ups

Early detection of diseases

Keeping hypertension and cholesterol under control

Getting more people to cardiac rehabilitation

ReferencesCardiovascular diseases in India: Challenges and way ahead (ASSOCHAM,

India International Heart Protection Summit September 2011

www.deloitte.com/in)

The burden of cardiovascular disease in the Indian subcontinent, Abhinav

Goyal & Salim Yusuf, Indian J Med Res 124, September 2006, pp 235-244Top

10 advances in heart disease and stroke science American Heart

Association/American Stroke Association Top 10 Research Report, January

02, 2014

Coronary Heart Disease Epidemiology in the 21st Century Labarthe DR.

Epidemiology and prevention of cardiovascular disease, a global perspective.

Gaithersburg, MD: Aspen Publishers, Inc, 2011.

References…

World Health Organization. Global status report on non-communicable diseases. 2010.

http://www.who.int nmh/publications/ncd_report2010/en/ (accessed Sep 2013).

Fuster V. Elucidation of the role of plaque instability and rupture in acute coronary events.

Am J Cardiol 1995;76, 24C-33C.

Patal SS, Cohn JN, Willerson JT. Handbook of cardiovascular clinical trials. New York, NY:

Churchill Livingstone, 1997.

The challenge of cardiovascular disease in developing economies, 2ND EDITION,

DECEMBER 2014

Prevalence of cardiovascular disease in India and it is economic impact- A review,

Shraddha Chauhan, Dr. Bani Tamber Aeri, International Journal of Scientific and Research

Publications, Volume 3, Issue 10, October 2013 1 ISSN 2250-3153 www.ijsrp.org

Thanks…