The Good, The Bad, The Ugly

The young male heart is under attack. It's not just that Indian men lead the global list in under-40 heart attacks. In India 78 per cent of men between 30 and 34 run the risk of a heart attack. And their hearts are ageing faster than their real age. There are lot of young men with very advanced heart disease that you would typically find in elderly patients.

The 30s is when the body reaches its aerobic prime, endurance peaks and one can still laugh at botoxed faces. But what should be the best of times is becoming the worst of times for men. To begin with, men are hard-wired to suffer heart disease more than women. In 2010, UK scientists uncovered special Y chromosome genes, inherited from fathers that make men prone to heart attacks. Men also lack the hormonal protection of oestrogen that younger women get. But young masculine hearts in India seem to be particularly susceptible. Compared to 5.6 per cent heart attacks under 40 in the West, India records 12 per cent. “Indian hearts are different”

The cholesterol-related problems are among the common lifestyle-related complaints Indians have. It also showed more men had these complaints than women. It is well-established that cholesterol leads to heart disease.  However, there is still confusion about what are the normal cholesterol levels and the various types of cholesterol.

Indians have the highest rates of coronary artery disease (CAD), even though nearly half of them are vegetarians. By 2015, it is estimated that India will have 62 million patients with CAD. Of these, 23 million will be less than 40 years old. In the past 30 years, the average age of a first heart attack increased by more than 10 years in the US, but decreased by more than 10 years in India. Indians are generally five to 10 years younger than people from other countries by the time they get their first heart attack.

A study released in April by the World Congress of Cardiology in Dubai revealed that Indians are increasing their risk for heart diseases with poor physical activity, a high-fat diet and by steadily shunning fruits and vegetables. It also showed that Indians are born with thinner arteries and are at genetic risk for cardiac diseases. Called the Indian Heart Watch, the study spanned across 11 cities and covered 6,000 men and women. Around 79% of men and 83% of women who participated in the study were found to be physically inactive, while 51% men and 48% women had high-fat diets. 

“A person must take an average of 10,000 steps every day, but we range between 1,500 and 2,000. Our genetic predisposition being higher than the rest, lifestyle plays an important role in maintaining our cholesterol levels. Another important factor is people’s casual attitude to medication.

 “We are genetically three times more vulnerable to heart attacks compared to rest of the world. That escalates with smoking and poor lifestyle. "We are also the diabetes capital of the world. That makes matters worse."

INDIA - Diabetes Capital Of The World

         The World Health Organisation (WHO) estimates that nearly 200 million people all over the world suffer from diabetes and this number is likely to be doubled by 2030. Even as nations prepare to mark World Diabetes Day on November 14, WHO says about 80% of the diabetes deaths occur in middle-income countries.

          In India, there are nearly 50 million diabetics, according to the statistics of the International Diabetes Federation. As the incidence of diabetes is on the rise, doctors say, there is a proportionate rise in the complications that are associated with diabetes. They point out that it is a very crucial stage and awareness on the part of people and administration about diabetes is very essential, adding that people should be made aware and educated about their health and fitness level to reduce the number of patients in India.

          Expert says when diabetes is not well controlled there is damage to the organs and the immune system is impaired. Foot problems occur in people with diabetes and can get serious very fast. Recent statistics show that approximately a quarter of all people with diabetes worldwide at some point during their lifetime will develop sores or breaks (ulcers) in the skin of their feet. Those with long standing diabetes are at the risk of developing diabetic neuropathy and complications of diabetic foot. Round-the-year foot care can ensure that the chances complications are minimized.

          Out of an estimated 62.4 million diabetics in India, 4 to 21 percent women suffer from gestational diabetes mellitus (GDM) — also called glucose intolerance or carbohydrate intolerance. It is a temporary form of diabetes in which the body does not produce adequate amounts of insulin to deal with sugar during pregnancy.

         The prevalence of IGT is thought to be around 8.7 per cent in urban areas and 7.9 per cent in rural areas, although this estimate may be too high. It is thought that around 35 per cent of IGT sufferers go on to develop type 2 diabetes, so India is genuinely facing a healthcare crisis.

         In India, the type of diabetes differs considerably from that in the Western world. Type 1 is considerably more rare, and only about 1/3 of type II diabetics are overweight or obese. Diabetes is also beginning to appear much earlier in life in India, meaning that chronic long-term complications are becoming more common. The implications for the Indian healthcare system are enormous.