Heart failure is a growing public health problem and considered the most common cause of hospitalization for patients aged 65 and over of both sexes. However, the trend can be seen where the lifetime risk of developing heart failure in people over 40 is increasing. The increasing prevalence of heart failure is most likely secondary to an aging population, increased risk factors, better outcomes for acute coronary syndrome survivors, and reduced mortality through better management chronic diseases. Despite advances in the treatment of heart failure, the prognosis for the disease worsens over time, leading to frequent hospitalizations and premature death. Therefore, it is important to identify risk factors for heart failure as soon as they are preventable.
“According to an Indian research study, nearly twenty-five percent of heart failure patients are under the age of forty-five and sixty-seven percent of diagnosed heart failure patients are under the age of fifty-five. -vis a case of heart failure under the age of forty-five in western countries”, Dr RK Jaswal, Interventional Cardiology, Fortis Hospital, Mohali
Effective treatment of comorbidities and reduction of risk factors can reduce the risk of developing heart failure. But, in India, there is not much awareness about the course of the disease, its symptoms, management and treatment. This is why the Times of India has taken the initiative and launched Beat heart failure in partnership with Novartis, with the goal of raising awareness about heart failure among everyday people and educating people about its available management and treatment options to help reduce the death rate from the disease. To achieve this objective, multiple exchanges have been carried out with expert doctors from the main hospitals in the country to share their knowledge of the disease and share best practices.
Mr. Anil Vinayak, Chief Operating Officer of Fortis Healthcare Group, said: “In order to identify, manage and treat heart failure, which affects just over 1% of the Indian population, Mass awareness like this is crucial. Cardiology and Cardiovascular Sciences is a center of excellence at Fortis Healthcare, and expert physicians at our facilities across the country provide treatment and care that meets international standards. As knowledge partners of the Beat Heart Failure campaign, they have tackled many minute aspects of heart failure – from medical management to surgical procedures, with a focus on empowering people with information easy to understand.”
Continuing the collaborative approach, the following doctors from Fortis Hospital, Mohali joined to enlighten us-
- Dr RK Jaswal: Interventional Cardiologist
- Dr. Rajat Sharma: cardiac electrophysiologist
- Dr. Karun Behal: Interventional Cardiologist
Our heart is the most vital and tolerant organ in the body, Dr. Jaswal noted. It beats constantly to supply blood to all parts of the body. Heart failure occurs when the heart cannot pump blood according to the body’s needs. It is a slowly progressive disease that develops over time for several reasons. Eventually, heart failure sets in if the factors harmful to the heart are not medically corrected. People better be on their toes to get an initial evaluation from a cardiologist when they see symptoms like mild shortness of breath.
India is possibly among the countries with a large share of heart failure incidence. Adding a note of caution, Dr Sharma said India is the second most populous country. A large proportion of our fellow citizens already suffer from comorbidities such as hypertension and diabetes. On top of that, we Indians are genetically more prone to coronary heart disease. The origin of heart failure in India due to cardiomyopathy and other heart muscle conditions is similar to that of Caucasians.
Dr. Karun added that coronary artery disease is the leading cause of heart failure. Coronary artery disease refers to the blockage of the artery that supplies blood to the heart muscle. When the blood supply slowly decreases or becomes blocked, the heart muscle weakens, leading to heart failure. We are seeing a clustering of the causes of heart failure such as hypertension, obesity, diabetes, smoking, junk food and a sedentary lifestyle among patients. Socio-psychological stress levels also increased. These are potential risk factors that can precipitate blockage of coronary heart disease and ultimately heart failure. An important strategy may be to focus on minimizing risk factors for reducing cases of heart failure.
It is also very important to focus on lifestyle. Compared to the rest of the world, India is experiencing a huge increase in the prevalence of heart disease among young people due to genetic factors and unhealthy lifestyle. Dr Jaswal said Indians are paying the price of growing wealth with the growth of heart disease.
“Prevention is better than cure,” said Dr. Karun. Heart failure can be better managed if diagnosed early. Doctors have pointed out that the symptoms of heart failure can be very subtle. If a person has not developed heart failure but has risk factors or has developed clinical signs and symptoms of heart failure, this is stage one of heart failure. If medications are introduced in time and lifestyle changes are made, the quality and longevity of life can be improved. Strict adherence to medication is essential.
Not all patients with risk factors develop heart failure. One of the major initiatives may be the identification of the population at risk of developing heart failure. The population at risk would include people with a family history of hypertension, coronary heart disease and other risk factors. However, an aggressive prevention strategy in a community would focus on identifying through rigorous screening the at-risk population to prevent them from falling into the abyss of heart failure, Dr. Sharma said. Caring for people already identified as having heart disease would require a different established approach.
Mandatory executive health checks for all above the age group of thirty, regardless of risk factors, are important to prevent heart failure from spreading among young people. This type of clinical assessment and screening would be a big boost in identifying risk factors and correcting them. The community would be better prepared and warned to deal with any emerging contingencies of heart failure, Dr Jaswal said.
He added that not all heart failure patients will die. Prior to 1985, no treatment was available. Observational studies have shown that people have been killed within six months, but now 97% of people have survived and lived a good quality of life. Patients admitted to cardiac care units have a rule of three. This means that one-third of patients will die, one-third will need to be re-hospitalized later and one-third will be fine, Dr Jaswal explained.
Counseling young people and training them to adopt a healthy lifestyle are important pillars in reducing the threat of heart disease, Dr. Sharma noted. He added that a poor lifestyle is ultimately a deathbed for any heart disease. A healthy and appropriate lifestyle is essential even after diagnosis to reduce the progression of the disease.
If unknown symptoms develop, it is necessary to consult a specialist. Self-diagnosis and prescription are extremely dangerous. Being under the guidance of a cardiologist is extremely essential, Dr. Karun said. Regular monitoring and follow-up results in a dramatic improvement in symptoms.
Heart failure clinics have been established to improve the prognosis of patients with heart failure. They consist of a team consisting of a cardiologist, a dietitian and a counsellor.
Indians like to live in denial and will not make the lifestyle changes needed to live a healthy life. A quarter of what you eat keeps you alive, and the rest keeps your doctor alive. It is necessary to keep the diet under strict regulation. Carbohydrates which include sugar and sweets are the biggest enemy and should be stopped immediately. The amount of salt consumed daily by the Indians is almost fifteen grams, three times the normal. Daily salt intake should be five grams. Fluid intake should be limited. Quitting smoking alcohol is essential.
The doctors ended with a message that heart failure is manageable at every stage. Patient compliance is important for taking medications on time, having regular follow-ups, and instilling a healthier lifestyle.
Remember that heart failure is not about stopping. It’s about starting life in a new way. To learn more about managing heart failure, visit https: https://www.toibeatheartfailure.com/patientguide.php
“The views and opinions expressed in the article by the panelists/experts are based on their independent professional judgment and are being disseminated in the public interest. These views should not be considered a substitute for the professional advice of a licensed physician. The purpose of this article is not to promote any medical procedures or medications and/or to recommend a certain physician. For any specific medical condition, please consult your licensed physician. BCCL, its affiliates and publications of his group assume no responsibility for the accuracy or consequences of adhering to their expert opinions.