The Hindu Business Line : Heart of the matter

Clearly, the party is over at 35 for the average Indian executive. Recent studies in the US and the UK have shown that Indians are particularly susceptible to coronary heart diseases (CHD). What is alarming is that not only is there a higher incidence of the disease among Indians, but also that the disease itself is getting increasingly vicious. According to Dr Vivek Jawali, Chief Cardiovascular Surgeon, Wockhardt Heart Institute, Bangalore, "I find that more Indians in the age group 40-50 are undergoing either angioplasty or a bypass." It is well known that the average age for the white Caucasian suffering from heart disorders is 65 years, while the Indian is unfortunately ahead of other races by almost a decade.

What is it that makes Indians susceptible to the disease at a much younger age? According to Dr Jawali, the natural history of the people of this country is unfavourable toward them. "In other words, it's bad genes that we carry with us." Add to this factors such as high incidence of diabetes among Indians, the occurrence of hyper triglyceridaemia (a high level of triglycerides) which is very special to Indians, middle-age obesity, sudden change in lifestyle, urbanisation, change in dietary habits, society at crossroads and the resultant insecurity, stress at work, lack of exercise and high pollution levels.

Dr V. Subhash Chandra, Head of Manipal Heart Foundation, Bangalore, says it's clear that CHD is not the disease of the middle-aged anymore. With the genetic factors remaining the same, and the environmental factors getting increasingly more damaging, it's only natural that the heart falls prey to the `attack,' he feels.

Dr Jawali, who has operated on at least 500 patients in the age group of 40-45, says that surprisingly, 25 per cent of these were doctors. "And mind you, it's not just the private-sector executive who's vulnerable to the ailment."

He has come across several government servants who have a heart disorder. "The harassment and stress levels are equally high there," he says. Dr Chandra, on the other hand, has seen several blue-collared workers suffering from heart attacks. "It's a wrong notion that it strikes only white-collar workers."

It's true that several younger patients tend to have just one artery angioplasty, but as Dr Chandra points out, "If you have an angioplasty at 45, you have another 30 years to watch out for other complications, while a 70-year-old man with the same disorder may have just about five years left to develop complications." The repercussions, both physical and psychological, are less intense in the latter case.

However, the awareness among Indians has increased, tremendously. "This could be because the facilities have increased, diagnosis is early and technology has facilitated all this."

Dr Jawali gives a checklist for young Indian executives:

If you have a family history of the disease, then 35 is when you start putting the brakes.

Get your lipid profile checked regularly.

Get a stress test done every two years.

Get on to a low-calorie, low-sugar and a low-fat diet.

Quit smoking. About this, Dr Jawali explains that it's an all-or-none factor that works. "When you quit smoking, it should be a complete and clean cut. There's no point in feeling comforted that you are smoking only a couple of cigarettes a day. One or 20 makes no difference," he warns.

Then there's the hypertension factor that's to be noted. Several years ago, a blood pressure reading of 130/80 was considered normal. Then it was set at 120/80. The latest WHO report has set the standard at 110/80.

Dr Jawali rues that the average Indian is very callous about the `workout' aspect. "A brisk morning walk of 45 minutes keeps your blood pressure normal for at least 7-8 hours. And a similar exercise in the evening is even better," he recommends.

Talking of women executives, Dr Jawali says women, having a natural hormonal protection, are normally cushioned against the disease. "But remember this protection can only shield them from domestic stress and probably other predisposing factors. But add professional stress and all the other external elements, and the incidence of the disease among women is also increasing."

He says there used to be a time when five per cent of all cases were women. "Now this has increased to three out of 10 cases. This is something to watch out for."

Picture by Shaju John

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