It is important to understand the key causes of the disease
Heart attacks comprise the majority of the deaths which are caused due to cardiovascular diseases. As per the estimates of the World Health Organisation (WHO), around 18 million lives are lost every year due to heart related diseases.
This draws our attention towards understanding the key causes behind this fatal disease.
A research study conducted by Indian researchers has found the prominent reasons for heart attacks. "Prevalence of coronary artery disease (CAD) in India is progressively increasing as shown by data that cardiovascular diseases (CVDs) were accountable for 28.1% of total deaths and 14.1% of total disability-adjusted life years (DALYs) in 2016, compared to 15.2% and 6.9%, respectively, in 1990," the study report says.
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The study titled "Metabolic risk factors in first acute coronary syndrome (MERIFACS) Study" is published in the Indian Heart Journal.
What did the study find?
The study found that diabetes, body mass index and waist hip ratio are the key causes of heart related issues.
The study led by senior cardiologist Dr B. Hygriv Rao from KIMS hospital, Hyderabad studied a total of 2153 patients.
"In routine clinical practice focus is generally directed to the assessment and control of major conventional risk factors (CRF) - diabetes, hypertension, elevated low-density cholesterol (LDL-C) and smoking," the researchers have said, and have added that these conventional risk factors alone appear insufficient to explain the higher risk of acute coronary syndrome in India.
The researchers say that low level of high-density lipoprotein cholesterol (HDL-C), increased body-mass index (BMI), waist-hip ratio (WHR), triglycerides, and inadequately controlled diabetes (defined as glycosylated haemoglobin [HbA1c] >7%) also significantly contribute to the risk but does not get due attention in the routine clinical practice.
The reason, they explain is, "For instance HbA1c is less commonly used for screening and diagnosis of diabetes due to the higher out-of-pocket expenses when compared to the fasting and postprandial blood sugar levels."
How was the study conducted?
The body-mass index (BMI) was calculated using the formula: Body weight (kg)/height2 (m2). A value ≥ 25 kg/m2 was considered high as per the international classification.
For waist-hip ratio, the cut-off values were ≥0.9 for men and ≥0.85 for women.
HDL-C ≤ 40 mg% in men and ≤50 mg% in women were considered low. HbA1c ≥ 7 indicated uncontrolled diabetes.
Triglyceride levels more than 150 mg was considered high.
The participants were monitored for over a period of 18 months starting from January 2019.
There were 1648 (76.5%) males and 505 (23.5%) were females.
What are the conventional risk factors for heart attack?
The study had classified the risk factors into two parts: conventional risk factors and specific metabolic risk factors.
The conventional risk factors are: hypertension where the patient was diagnosed with high blood pressure for a blood pressure reading more than 130/85 mm Hg, diabetes mellitus, elevated LDL-C, smoking where smokers were individuals who
smoked/consumed any tobacco in the previous 12 months and included those who had quit within the past year.
There was a high prevalence of these factors, which is about 93%. Hypertension was observed in 41.7% of people, diabetes in 43.7%, smoking in 29.5% and elevated LDL-C in 53.5% of people.
What are the specific metabolic risk factors?
The specific metabolic risk factors included in the study were:
Body mass index, waist hip ratio, HDL-C, Hyper triglyceridemia and HbA1c.
The prevalence of these factors in the patients was 97%, which is clearly higher than the conventional risk factors. "The metabolic risk factors seen were abnormal values of BMI in 1133 (52.6%), Waist-Hip ratio (W:H ratio) in 1641 (76.2%), HbA1c in 787 (36.6%), Triglycerides in 557 (25.9%) and HDL-C in 1182 (54.9%)," the study found.
INTERHEART study
The study quotes INTERHEART global study which was held across 52 countries in 262 centers. This is one of the large case control studies which has established the role of different risk factors in contributing to the occurrence of myocardial infarction and coronary artery disease.
This study linked 9 risk factors with more than 90% risk of myocardial infarction. "Smoking, diabetes, hypertension, abdominal obesity, psycho-social index, and Apo B/Apo A1 ratio contributed to the risk of myocardial infarction while exercise and consumption of fruits and vegetables were protective," the study found.
It is important to be well informed
With so much information available on the internet, finding the right matter is indispensable. The onus is on the individual to find what type of information he or she is feeding himself or herself.
Instead of looking up for information related to symptoms, one should directly take an appointment from the doctor and get all the tests done.
Regular medical checkups, leading an active life, cutting down on prolonged hours of sitting, reducing consumption of alcohol, decreasing the amount of smoking and having a proper and balanced diet can ensure a healthy heart.