Kerala’s heart skips a beat

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A first of its kind scientific study released by a team of six doctors and commissioned by the Cardiological Society of India (CSI), Kerala chapter, to identify the prevalence of coronary artery disease (CAD), has found that 12 per cent of the Kerala population suffers from heart diseases against a national average of around seven per cent.

Another significant finding is that the prevalence is almost the same in Kerala’s rural and urban regions, confirming the social finding that the state is growing as a ‘single city’ unlike the other states in the country.

The study of randomly selected target sample groups in the age group of 20-79, was conducted in the rural and urban areas of Thrissur, Kozhikode and Thiruvanantha-puram, so that south, central and northern Kerala are all represented.

The sample study of 5,191 persons found that 15 per cent of the population has diabetes.
Some 31 per cent of the men are smokers. Hypertension is prevalent among 28 per cent of the population, while 45 per cent is affected with cholesterol related issues. Abdominal obesity is high — 73 per cent in women and 42 per cent in men.

The study, conducted as per the World Health Organisation manual, was led by cardiologists from several hospitals — Dr Geevar Zachariah of Mother Hospital, Thris-sur, Dr Harikrishnan S. and Dr Sanjay G., of the Sree Chitra Hospital, Thiruvananthapuram, Dr Krishnan M.N. of Kozhikode Medical College Hospital, Dr Mohanan P.P. of Westfort Hitech Hospital, Thrissur, and Dr Venugopal K. of the Amrita Institute of Medical Sciences, Kochi.

The CSI spent Rs18 lakh on the three-month study and hired Kudumbasree and Asha workers, B.Sc. nursing students and medical students and lecturers, resident post- graduate fellows and ECG, lab and data entry teams.

Co-operation was sought from local body councillors and other workers to complete this unique study.

Seventeen per cent of diabetes patients still smoke, increasing their risk of heart ailments, said the study.

“The so-called progress Kerala has made in heath indices, on a par with developed nations, like in infant mortality and maternal mortality, are reaching a point where we have to do some serious soul searching. We have conquered communicable diseases and also infection-related diseases to an extent and our life expectancy rate too has gone up. But when life expectancy is up, the population is confronted with lifestyle diseases and the task at hand is to conquer these diseases including CAD,” says Dr Sanjay G., cardiologist with Sree Chitra.

The study reveals that one in three persons is afflicted with hypertension, which is quite alarming.
The rise in heart diseases is from two or three per cent in the 1960s and 70s, when life expectancy was lower, to 12 per cent today, says Dr Jabir Abdullakutty, consultant cardiologist of Lisie Heart Institute, Kochi.

Dr Geevar Zachariah said that the only other authentic study in this regard was conducted in Thiruvananthapuram in 1993 in which 7.5 per cent of the population in the district was reported to have CAD.

Mending lifestyle only way to curb heart diseases

Dr Rajeev Gupta, chief of medicine and director of research, Fortis Escorts Hospital, Jaipur, who attended the national summit of epidemiology of coronary artery disease (CAD) in Kochi, is of the firm opinion that only lifestyle corrections can bring about a change in the situation related to CAD and other modern-day diseases.

“The mortality in this regard in higher in the South than North India, according to the ongoing millennium death study being undertaken by the Registrar General of India and the University of Toronto since 2003. Kerala ranks fourth with Andhra Pradesh, Tamil Nadu and Punjab in the top three positions,” says Dr Gupta.

Dr Gupta says that 30 to 40 per cent hypertension patients are in the habit of giving up medicines a year after starting it even without consulting a doctor, which is dangerous.

“There is a tendency to check pressure at home, but the user has to ensure that the device is government-approved and the life of the battery inside is sound,” he said.

Dr Gupta said heart diseases continue to be the single largest cause of mortality at 20 per cent and there should be caution on taking salty, sugary and fatty food and a regime of exercise is also needed.

Dr Prabhakaran Dorairaj, executive director, Centre for Chronic Disease Control, New Delhi, who also attended the meet said that in order to avoid lifestyle diseases, care should be taken from the foetal stage itself.

“Nutrition of the carrying mother itself is important and then a healthy childhood ensures a healthy life for an individual,” he said.