Cardiovascular disease (CVD) remains the leading cause of death worldwide, resulting in significant deaths and disability. Alarming statistics for 2021 reveal that CVD claims 20.5 million lives, accounting for around a third of global deaths.
Alarming environmental and lifestyle factors are making young people in India more susceptible to heart disease. Increased air pollution, coupled with the rapidly increasing number of people with diabetes, is causing serious concern. Mental health also plays an important role, as chronic anxiety and depression can indirectly contribute to cardiovascular problems.
These risk factors can result in moderate risk factors such as increased blood pressure, increased blood sugar levels, increased blood lipids, and being overweight or obese. These intermediate risk factors can be identified through measurement in primary care settings and serve as important indicators of increased risk of heart attack, stroke, heart failure, and other complications.
Early detection and management of these risk factors is essential to prevent cardiovascular disease and reduce its devastating consequences.
We are pleased to welcome Purushottam Lal, a renowned interventional cardiologist and recipient of the Padma Vibhushan Award, Padma Bhushan Award and Dr. BC Roy Award from the President of India for his outstanding contribution to the development of interventional cardiology in India. I spoke to Dr. He currently serves as Chairman of Metro Hospital Group.
Heart disease prevalence and risk factors
Dr. Purushottam Lal: The main risk factors include an unhealthy diet rich in trans fats and sugars, lack of exercise, smoking, excessive alcohol consumption, and conditions such as high blood pressure and diabetes. Stress is an often overlooked but significant cause, especially in high pressure environments such as urban centres. Heart disease is becoming more prevalent in India due to factors such as rising pollution levels, genetic predisposition and lack of early detection mechanisms. One of the most important factors that people often ignore is a strong family history of premature coronary artery disease.
Common cardiovascular diseases and symptoms
Dr. Purshotam Lal: The three most common cardiovascular diseases are coronary artery disease (CAD), heart failure, and arrhythmia.
Coronary artery disease (CAD):
CAD is the leading cause of death worldwide, killing approximately 9 million people annually and accounting for 32% of global deaths, according to the World Health Organization (WHO).
In India, CAD causes more than 1.7 million deaths annually, making it the most prevalent cardiovascular disease in the country.
Common CAD symptoms include chest pain (angina), shortness of breath, and fatigue. It is often diagnosed by stress tests, angiography, or blood tests.
Treatment includes lifestyle changes, medications, or surgical interventions such as stents or bypass surgery.
heart failure:
Heart failure affects approximately 64 million people. In India, the number is estimated at 8-10 million, with 35% of cardiovascular-related hospitalizations being due to heart failure.
Symptoms include a persistent cough, leg swelling, and shortness of breath. Diagnosis usually includes an echocardiogram or MRI.
Treatment for heart failure focuses on lifestyle changes, medications to control blood pressure, and sometimes implantation of devices such as pacemakers.
arrhythmia:
Arrhythmia causes palpitations, dizziness, or fainting. It is generally diagnosed by electrocardiogram or Holter monitoring and can be treated with medications, electrical cardioversion, or ablation.
heart disease in young people
Dr. Purushottam Lal: In recent years, heart disease has skyrocketed among young adults due to a combination of lifestyle and environmental factors. High levels of stress, often caused by unhealthy diets, sedentary lifestyles, and work pressure, have become commonplace. Smoking, including the use of e-cigarettes, and excessive alcohol consumption are fueling this trend.
Rising air pollution, increasing prevalence of diabetes, and lack of awareness about preventive healthcare are major concerns for India’s youth. Mental health issues such as chronic anxiety and depression have also been indirectly linked to increased rates of heart disease.
Genetics and heart disease: precautions for people at risk
Dr. Purshotam Lal: Genetics has a huge impact on an individual’s risk of heart disease. People with a family history of cardiovascular disease, particularly those associated with high cholesterol, high blood pressure, or early-onset heart disease, are at increased risk. However, genetics do not determine your fate. Lifestyle choices play an important role in determining your results.
It is important for people with a family history to start taking precautions early. You can reduce your genetic risk by having regular health checkups, monitoring your blood pressure and cholesterol, maintaining a healthy diet, exercising regularly, and avoiding smoking. Genetic screening may also be beneficial in identifying specific markers that indicate higher susceptibility.
The impact of technology on heart health management
Dr. Purshotam Lal: Modern technology has revolutionized the management and prevention of heart disease over the past few years. Wearable devices such as smartwatches can monitor heart rate, detect abnormalities such as atrial fibrillation, and track physical activity. This continuous monitoring helps in early detection, even in asymptomatic people.
Telemedicine has also emerged as an innovative means of providing real-time consultations without geographic barriers. This is particularly impactful in rural India where access to specialized cardiologists is limited. Remote monitoring and virtual diagnosis ensure that patients with chronic heart disease connect with their health care providers and improve adherence to treatment and lifestyle recommendations.
Heart disease in women: unique risks and underdiagnosis
Dr. Purushottam Lal: Rather than the obvious chest pain typical of men, women often experience more subtle symptoms of heart disease, such as fatigue, nausea, shortness of breath, and pain in the neck, jaw, and back. Hormonal differences, especially after menopause, further increase the risk of heart disease.
Heart disease in women is underdiagnosed for several reasons. Historically, medical research has focused on men, and women’s symptoms are thought to be due to less serious conditions, such as anxiety or indigestion. Therefore, increasing awareness of these differences among both health care providers and women themselves is important for early diagnosis and better outcomes.
congenital heart disease in children
Dr. Purshotam Lal: Congenital heart disease (CHD) is the most common congenital disease worldwide. Common types include atrial septal defect (ASD), ventricular septal defect (VSD), and tetralogy of Fallot. Early detection can be achieved through prenatal screening using fetal echocardiography, which can identify most heart defects during pregnancy. After giving birth, symptoms such as rapid breathing, poor feeding, and pale skin may be warning signs.
Early detection is critical because many congenital heart defects can be corrected or managed through medical or surgical intervention if detected early, improving a child’s quality of life.
Impact of the COVID-19 pandemic on heart health
Dr. Purushottam Lal: COVID-19 has had a major impact on heart health, especially for people with pre-existing conditions. The virus has been linked to complications such as myocarditis (inflammation of the heart muscle), blood clots, and arrhythmias. Post-coronavirus syndrome, or “prolonged COVID-19 infection,” can cause persistent cardiovascular problems such as chest pain, fatigue, and heart palpitations, even in people who have had no previous symptoms of heart disease. .
People affected by COVID-19, especially those with heart disease, should continue to closely monitor their heart health. Regular check-ups, echocardiography, and maintaining a healthy lifestyle can help reduce long-term effects.
Artificial intelligence in cardiovascular care
Dr. Purshotam Lal: Artificial intelligence (AI) and machine learning are transforming cardiovascular care by enhancing diagnosis, predicting patient outcomes, and personalizing treatment plans. AI algorithms can quickly analyze large datasets from imaging techniques such as echocardiograms and MRIs, allowing heart problems to be detected earlier and more accurately.
India is increasingly using AI-powered tools to screen for conditions such as heart failure early in underserved populations. Machine learning models can also predict the likelihood of a heart attack based on patterns in a patient’s medical history, enabling proactive rather than reactive care. For example, Indian startup Tricog Health uses an AI-based solution to remotely diagnose heart attacks. The combination of AI and human expertise provides ECG interpretation in real-time. This has proven critical for early diagnosis in rural India where access to specialists is limited. Tricog is often credited with reducing heart attack diagnosis time to less than 10 minutes.