Coronary artery disease (CAD) is affecting individuals in India more than any other country. The disease pattern in Indian patient is different, involving long segments of relatively small arteries making the procedure of revascularisation like stenting, bypass surgery less effective with high incidence of reoccurrence. More and more people, particularly from rural areas, are coming to hospitals with massive heart attacks. Majority of such patients are young smokers and generally it’s too late to do much for these patients. 30 per cent of such patients die within one hour of getting a massive attack and the one who survive remain rather disabled because of poorly functioning pumping chamber in the prime of their life. It seems like that in such a case unless serious steps are taken to prevent this disease, it will be very difficult to handle it by 2020. Unfortunately, there are wide regional variation with coronary artery disease mortality and burden in India. Apart from well known gender-based differences, there are variations in mortality in different states, urban and rural regions and among different socio-economic groups within the states. Although no nationwide study of risk factors exists, review suggests that there are significant state-level and rural-urban differences in major cardiovascular risk factors of smoking, obesity, central obesity, hypertension, hypercholesterolemia and diabetes. However, there is a need to perform nationwide studies for determining cardiovascular risk factors, using uniform protocols to assess regional differences. There is also a strong need to determine causes of the causes and look into other risk factors besides conventional risk factors like smoking, obesity, central obesity, hypertension, hypercholesterolemia, diabetes etc.
Besides initiatives taken by the government, a public-private partnership (PPP) between government and private hospitals should play a role in awareness strategies. Also, TV channels can spare some time towards health and promote measures to prevent coronary artery diseases.
– Dr Purshotam Lal, Director- Interventional Cardiology and Chairman, Metro Group of Hospitals