Latest statistics suggest that in our country there are roughly 30 million heart patients and three lakh coronary angioplasties and surgeries are being performed every year. We would need a comprehensive approach to combat 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.
Currently, the key challenges that face cardiac care in India are inadequate facilities, accessibility, the price tag attached to efficient and effective treatment and lack of awareness of cardiovascular diseases.
Not unexpectedly, demographic projections suggest a major increase in cardiovascular disease mortality as life expectancy increases and the age structure of the growing population changes. Of the 30 million heart patients in India, 14 million reside in urban areas and 16 million in rural areas. If the current trend continues, by the year 2020, the burden of cardiovascular diseases in India will surpass that of any other country in the world.
The growth of heart diseases is dependent on a number of interlinked factors such as ageing, changing lifestyles, bad eating habits and rapidly evolving socio-economic determinants like access to healthcare. The surge in heart diseases affects not just the urban and economically well-off but also the under-privileged. The Indian rural population and urban poor especially are facing a “double burden”: the incidence of acute diseases in general (heart attacks in particular) is showing a spurt, while there is also a rapid growth in the incidence of chronic diseases.
There has been a steady annual rise of 25-30 per cent per year in the number of coronary interventions over the past several years. A more worrying fact is that the incidence of heart attacks has gone up by 24.8% for young people between ages 25 and 60 which means loss of more productive people to these diseases. Regrettably, coronary heart disease often remains “silent” until symptoms become overt and life-threatening and this is the major bugbear as we stand at present.
The best way to prevent heart attacks is to keep your risk facts under control, a) Don’t smoke or expose yourself to second-hand smoke. b) Maintain a healthy blood pressure. c) Monitor your cholesterol (blood lipids). d) Limit your calories e) Make exercise a daily habit. f) Reduce stress. g) Stay informed: science changes constantly.
In the above context, readers will be happy to know that many studies are suggesting there’s one more simple way to prevent heart attacks is to include “omega-3 polyunsaturated fatty acids” as part of a diet. While many thought this was a fad a few years ago, we think differently today. What are Omega-3s fatty acids? They are essential fatty acids that the body needs for certain functions, including blood clotting, digestion, muscle activity, and cell division and growth. The only way the body can get omega-3 is through the foods we eat. Fatty fish – such as salmon, trout, tuna, sardines, and anchovies – is a key source of omega-3s, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Other sources include leafy vegetables, walnuts, and some vegetable oils, which normally contain the omega-3 alphalinolenic acid (ALA).
Recently, a study published in JAMA (Journal of the American Medical Association) by the Division of Cardiovascular Medicine at Stanford University School of Medicine in California looked at how omega-3s derived from seafood and plant-based foods influence favourably the risk of death from heart attacks (myocardial infarction). The team analyzed data of 19 studies that included 45,637 individuals from across 16 countries, including the US, the United Kingdom, Italy, Norway, and Australia.
It found that participants who had higher concentrations of seafood- and plant-based omega-3s in their blood were around 10 percent less likely to suffer heart attacks, compared with participants who had lower omega-3 concentrations. These findings held true even after accounting for a number of possible confounding factors, such as participants’ age, sex, race/ethnicity, the presence of diabetes, and use of aspirin or cholesterol-lowering drugs. Overall, the authors say their results indicate that consuming foods rich in omega-3 lowers brings down the risk of heart attacks.
This study comes at a time when there was uncertainty about cardiovascular effects of omega-3s and not all trials of fish oil supplementation had shown benefits. But the present study is undoubtedly an important one, involving a large chunk of population from various countries and is moreover published in an important medical Journal. It definitely lends solid support to the hypothesis that fish and omega-3 consumption favourably reduces the incidence of heart attacks.
Eating fish, we all know, is associated with many cultures of the world primarily in coastal areas. It’s so common that taking few names would be injustice to others. But think of Goans. Aren’t they fish-lovers like no one else? A Goan adores his “fish” – even when prices ride over their heads – just as they love their “feni” and “xit-coddi.” So, as I take this opportunity to convey good tidings to my fellow-Goenkars, can I rest happy that I am giving them one more reason to be happy? Cheers!
(Dr Francisco Colaço is a
seniormost consulting
physician, pioneer of Echocardiography in Goa.)
