In our last blog article, we discussed how CHD can affect anyone with an unhealthy lifestyle, and how easy it is to combat it. Few lifestyle changes are what it takes to lead a healthy heart-problem free life. However, recent studies have shown that among all the ethnicities in the world, Indians are most prone to heart disease. With this article, we plan to dig a bit deeper into this issue and present to you the various reasons for this increase in Coronary Artery Disease among Indians.
The rise of CHD:
In the last couple of decades, there has been a significant decrease in the spread of communicable diseases, also known as infectious diseases. That indeed is good news! But, while we managed to make progress with the control of communicable disease, we suffered a major setback where non-communicable diseases were concerned, specifically CHD. Within the last 40 years, CHD prevalence has increased 4-fold among Indians!
“India has the dubious distinction of being known as the coronary and diabetes capital of the world,” said Prof. Prakash Deedwania, University of California, San Francisco, USA. Think that statement sums it all.
Since 1959, researchers from Singapore recorded a high precedence of heart disease among Indians. Taking this research forward, various notable professors and researchers found that, not just within India, but all across Asia, Indians topped the charts where contracting heart disease was concerned. CADI (Coronary Artery Disease among Asian Indians) research foundation, headed by American-Indian doctor Enas. A. Enas, also found that within the United States, South Asians have three times the incidence of heart disease when compared to the overall US population. And, while over the years the age limit for the first heart attack among individuals has been increasing for residents of the US, it has been decreasing at an alarming rate for Indians!
So, now, it is an established fact that Indians are more likely to develop heart diseases, but the question here is, ‘Why so?’ What makes an Indian heart so fragile – Genes or Lifestyle? Nature or Nurture? Let’s find out.
The role of genes:
For years now, heart disease was constantly linked to poor genes and our unfortunate ancestors were burdened with the blame of passing it on to us along with other things. Indeed, genes do play a role here. High level of the bad cholesterol (LDL), combined with a low level of the good cholesterol (HDL), and lipoprotein are the main culprits that cause CHD. A 1996 study on 1000 newborn babies in Singapore suggested that Indian babies are generally born with higher levels of cholesterol and lipoprotein, as compared to their Chinese counterparts.
Genetically, Indians are also born with low HDL 2b sub fraction, elevated Homocysteine and a predisposition to DM. The gun is already loaded for them!
Another study conducted at the University of Maryland Medical Centre suggests that Indians have a genetic abnormality in triglyceride regulation, which prevents blood fats from being broken down. Triglyceride is a kind of fat which needs to be broken down after every meal we have. When this process does not work properly, the triglyceride is partially broken and causes fat to get accumulated in blood vessels leading to CHD.
All of this information may cause you to think, that genetics is the perpetrator here and that there is no way anyone can get out of this. Is that right? Wrong! Genetics contribute to only 20%-60% chance that anyone may get a heart disease – and it can easily be set right by a lifestyle change affecting one’s diet and physical fitness. That’s right! Even if you feel you are genetically inclined to get a heart attack, it does not mean you will get one for sure!
The counterattack of lifestyle:
We have already discussed some factors which facilitate heart disease in our previous blog. Let us note them down again, but in an Indian context, which means we will be adding few more triggers here:
- Atherogenic Dyslipidemia
- Physical Inactivity
- Urbanization (on a rapid scale)
- Change in lifestyle and eating habits
As you can see, the original culprits are being aided by the kind of lifestyle we have now started leading. Urbanization at a rapid pace has led us to change the way we live, drastically, quite different from what we have been used to. Our eating habits have changed too and we have given our body, our system too little time to acclimatize to these changes. We have almost given up on proactive lifestyles and physical activities and our consumption of fruits and fresh vegetables are decidedly lower than that of other countries.
One of the foremost studies conducted, which proved that genetics or no genetics, Indians are prone to heart diseases due to various non-genetic factors, was the INTERHEART study.
The Interheart study conclusively explained the role behavioral and conventional risk factors played when enumerating the risk factors which trigger CHD among Indians. The Interheart study was conducted in 52 countries involving 30,000 participants (including, of course, a high number of Indians). This study was to check the measure of association between known risk factors like smoking, hypertension, diabetes, waist/hip ratio, dietary patterns, physical activity, consumption of alcohol and psychosocial factors, with the incidence of heart attacks. The results showed a strong association!
Apart from lifestyle changes, India is also the hotspot for diabetes, excessive usage of tobacco and of course, the low education level, which results in the lack of knowledge among people and an increase in AMI (Acute Myocardial Infarction). Here are some statistics which should help you understand this well:
- The prevalence of type2 diabetes in urban Indian adults has been reported to have increased from less than 3.0% in 1970 to about 12.0% in 2000.
- The count of hypertensive individuals is expected to rise from 118 million in 2000 to 214 million in 2025.
- Of the 1.1 billion smokers worldwide, 182 million live in India.
- High blood pressure was observed in nearly 30% of individuals evaluated in a recent large study in Kerala.
So, who are at risk?
The answer is: Everyone! Yes, everyone is at risk of getting a heart attack and everyone can avoid it, just as easily. According to renowned cardiologists, to evade heart diseases everyone has to break a sweat for at least 30 minutes a day, five times a week – a concept which has become alien to most Indians.
If you are smoking, then stop; if you are obese, then lose some weight. Adopt a healthy diet. Sleep well and meditate or practice yoga to reduce stress.
Indian or not, these are some basic lifestyle changes everyone needs to make if they would like to enjoy a healthy, heart-disease free life. As Indians, we may be prone to heart diseases but that’s where it should end. Let’s adopt a healthy lifestyle and enjoy a long & vigorous life.
Remember: “Your genetics load the gun. Your lifestyle pulls the trigger.” – Mehmet Oz.
|CHD||Coronary Heart Disease|
|CADI||Coronary Artery Disease among Asian Indians|
|LDL||Low Density Lipoprotein|
|HDL||High Density Lipoprotein|
|AMI||Acute Myocardial Infarction|