The Telegraph
Since 1st March, 1999
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No puffing, no gorging, not 40'But it still can happen to you
- Heart disease casts net wider & earlier

Calcutta, Sept. 24: Aniket Ganguly has never touched a cigarette in his life, has normal blood pressure and is not obese. Yet just before his 43rd birthday last week, he was diagnosed to be suffering from coronary heart disease.

“How is that possible' I don’t have any of the risk factors associated with heart ailments,” a stunned Ganguly who leads a fairly disciplined life asked his doctor.

But city-based cardiologists are seeing more and more cases like this. According to a modest estimate, 30-35 per cent of all heart patients in the city do not have any of the known risk factors, including diabetes and high bad cholesterol levels.

“In most cases, we suspect a sedentary lifestyle and family history are contributing to the late diagnosis of heart problems, but we are looking at causes beyond the realm of the known risk factors,” says Kunal Sarkar, chief cardiac surgeon at the Rabindranath Tagore International Institute of Cardiac Sciences.

“Now factors like vascular inflammation triggered by a possible bacterial attack or even an unknown strain of viral infection are emerging as probable causes. We have just begun to study these.”

But there are also people who are at risk because of the usual reasons ' a history of the ailment in the family, for instance ' but are not aware of it. About a third of the population falls in this category, doctors said on the eve of World Health Day.

“The trends are definitely changing now. We have been seeing a lot of patients who have been involved in drug abuse, causing one segment of the heart to go into a spasm, making the other segment develop a fracture line.

“Another big factor being regularly encountered by us has been stress, probably now emerging as the single-largest reason behind heart attacks,” says Sujoy Shad, cardio-thoracic surgeon with Apollo Gleneagles Hospital.

Cardiologists say most patients do not have an inkling of the disease until a very late age, by when it has progressed significantly.

“A person feels he is fit only to learn later that all this while he had a heart ailment, quite similar to what happens with so many cancer patients,” says cardiologist Tarun Praharaj of the B.M. Birla Heart Research Centre.

His colleague Shuvo Dutta agrees. “There was a time when a man was considered to be perfectly fit until the age of 45-50. Even now, people hardly think of a thorough cardiac check-up before they turn 45. But now our focus is on early detection, and the correct age for starting regular check-ups would be the early thirties.”

A three-year study on the health of over 6,000 city policemen supports this.

“We chose the fittest and youngest possible team of policemen and then decided to go for a detailed cardiac check-up over a three-year period,” said Sarkar. The Tagore institute conducted the study, which has just been concluded.

It found that almost 85 per cent of the policemen tested were under the “false belief” that they were physically fit.

“Most of them had two to three of the known risk factors, including high cholesterol, diabetes, smoking history and family history. But they were in the dark that each of them was a potential cardiac patient. All were suggested therapies,” Sarkar added.

Rise in obesity, declared an epidemic by the World Health Organisation, is another big threat. Excess weight has a direct link to high cholesterol and diabetes, cardiologists warn.

A recent study which appeared in the New England Journal of Medicine revealed that with every increase of 1 in the body mass index, the risk of heart failure rose by 5 per cent for men and 7 per cent for women.

“It is not just that people are not aware of the adverse effects, it is also a case of the mindset that ‘this can never happen to me’,” says Upendra Kaul, cardiologist with Fortis Hospital in Delhi.

With over 50 million people suffering from cardiovascular diseases in the country ' coronary artery disease accounts for the maximum cases, followed by valvular heart disease and congenital heart disease ' doctors are looking at newer techniques for identification and treatment.

One of these is a CT scanner which enables a cardiologist to create a bigger image of the heart.

“The scanner, which will land in the city soon, will help us understand the intricacies of the heart’s anatomy, including the calcium deposition on the heart walls, much better,” says Shad.

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