Cardiovascular disease (CVD) continues to be the leading cause of death across the world. Nearly 150,000 people die per day worldwide, based on the latest comprehensive research that was published in 2017. Of these 48,742 die of cardiovascular disease.
Studies have shown that there are significant variations between rich and poor nations. While in high income countries, death from cancer is twice that of CVD, in low income countries, including India, death from cardiac disease was three times that of cancer.
1 in 3 deaths globally are as a result of CVD, yet the majority of premature heart disease and stroke is preventable. An ICMR study showed that in India, 1 in every 10 persons in our population is affected by CVD. By 2021, 42 % of the population is expected to be under threat. MI in those under 40 years of age is seen to be at least 10 times more than in western countries.
Non-Communicable Diseases (NCDs), including CVDs, are estimated to account for 60% of total adult deaths in India. CVDs account for over a quarter (26%) of these deaths. In India, more than 10.5 million deaths occur annually. and it was reported that CVD led to 20.3% of these deaths in men and 16.9% of all deaths in women. These numbers continue to rise.
There are several risk factors which lead to cardiovascular disease. These can be broadly divided into two categories: modifiable and non-modifiable. Non Modifiable would be age, sex, and family history (Genetics). Modifiable would include smoking, hypertension, diabetes, sedentary lifestyle, stress, obesity and high cholesterol. The Principles of an ideal lifestyle include proper healthy diet, regular exercise, stress management (Yoga/Meditation) and regular medication with weight control.
However, lack of awareness about treatment often leads to death. It is important to remember that time is critical. Any delay causes more harm. The time when doctors have a chance to save most of the heart muscle is called ‘The Golden Hour’. Studies show that to avoid permanent heart damage the patient must be taken to a hospital as fast as possible. Fewer than 10 percent of patients get to a hospital that fast as mostly there is reluctance in acknowledging what is happening. Those who reach the hospital quickly, often do not receive the optimal treatment, why do people delay going to a hospital? Many people don’t recognize their symptoms as heart related. There are several misconceptions about heart attacks. People expect an AMI to be accompanied by a sudden, crushing chest pain, followed by unconsciousness - as portrayed by the media. Many times symptoms that don’t disrupt activities of daily living, tend to be dismissed.
The reality is only 5% of patients presently receive reperfusion therapy within the first crucial hour after symptom onset. This is primarily because patients arrive at the emergency department too late.