Cardiovascular disease (CVD) is a general term used to explain conditions affecting the heart and blood vessels. This is the leading disease that causes the highest mortality in the world. The year 2016 witnessed 31% of deaths because of CVD across the globe.
What is Cardiovascular Disease?
Cardiovascular disease (CVD) is a general term used to explain conditions affecting the heart and blood vessels. This is the leading disease that causes the highest mortality in the world. The year 2016 witnessed 31% of deaths because of CVD across the globe.
Cardiovascular disease (CVD) is a general term used to explain conditions affecting the heart and blood vessels. This is the leading disease that causes the highest mortality in the world. The year 2016 witnessed 31% of deaths because of CVD across the globe. With the start of the 21st century, cardiovascular diseases (CVDs) have emerged as the number one cause of death and disability in India. It includes both rural and urban sectors of India. compared with the Europeans, Indians develop cardiovascular disease at least two decades earlier. For example, in European populations only 25% of CVD deaths occur before attaining 70 years, whereas in India, the percentage of death before 70 years is astonishingly 55%. In addition, case fatality attributable to CVD in low-income countries, including India, appears to be much higher than in middle- and high-income countries. Even though most of the Indians are vegetarians and non-smokers, the number of people suffering from heart diseases and diabetes are very high. India solely is burdened with approximately 30% of cardiovascular-related deaths and would serve as a home to more than 55% of the patients with heart ailments worldwide within the next 15 years. Another astonishing fact is that the cholesterol level among people in India is low, but still the death rates are higher than any other country. Let us look at the French and Indian paradox in the given table for understanding unusual types of heart disease pattern in our country.
French and Indian paradox
‘French paradox ‘is a catchphrase that was coined in the 1980s. It explains about the lowest incidence of cardiovascular diseases in France irrespective of their diet that is rich in saturated fats and high cholesterol from animal fats. This made the researchers look at the correlation between high fat and heart diseases in a new light.
On the contrary, the Indian paradox is, the high incidence of heart diseases inspite of a strict vegetarian diet and very low-fat consumption.
These paradoxes prove that all fats are not bad and that the imbalance between the good fat and bad fat is the triggering factor for heart diseases.
The Causes of heart diseases
Heart diseases are largely prevented by reducing risk factors.
The risk factors contributing to coronary heart disease falls into 2 categories,
TRADITIONAL RISK FACTORS
NON-TRADITIONAL OR EMERGING RISK FACTORS
TRADITIONAL RISK FACTORS:
There are 4 major traditional risk factors that are acknowledged by cardiac experts. Generally, over 80 % of cardiac and stroke related deaths are attributed to these traditional risk factors.
Tobacco
It is estimated that, currently, 30 crore Indians aged ≥15 years are addicted to tobacco. The deaths related to tobacco consumption in our country is truly enormous. Every year Tobacco kills 1 million Indians (more than one-third of adults in India (35%) who use tobacco). Among the 1 million tobacco related death, 6 lakhs are accounted by heart attack and stroke
Uncontrolled diabetes
How Diabetes connected to heart disease? More than 75 % diabetic people die of cardiovascular-related illnesses such as coronary heart disease, stroke, heart failure, and peripheral arterial disease. For women with diabetes, the risks of developing cardiovascular disease are four to eight times more compared with women who do not have diabetes. For men with diabetes, the risk is three to four times greater.
Hypertension
High blood pressure is the most significant modifiable risk factor for cardiovascular disease. It is considered as the most dangerous risk factor than cigarette smoking, dyslipidemia, and diabetes. Hypertension accounts for approximately 60 percent of all strokes and 50 percent of all heart disease events globally.
Family history
A positive family history is one of the important risk factors leading to cardiovascular issues. If one of the parents experienced cardiovascular disease at a young age (before 55 or 65), the risk of developing heart disease is 60 to 75 percent higher for the children. According to a study published in the year 2014 in a reputed journal, having a sibling with CVD raises that risk by 40 percent.
Modifying and controlling these traditional risk factors reduce the incidence of heart attack and stroke by 50 %. The best example is the model adopted by the USA, where the systematic modification of risk factors has reduced the incidence of cardiac diseases significantly.
EMERGING RISK FACTORS
Traditional risk factors like family history, hypertension, diabetes and smoking cannot explain the entire incidence of coronary heart events .Therefore several other significant risk factors have been identified and studied in an effort to improve risk assessment for coronary heart diseases .
Following are few of the important emerging risk factors:
C-reactive protein (CRP) (13):
High levels of serum C-Reactive Protein are considered as a strong predictor of risk of heart diseases, stroke, cardiovascular mortality. They are usually termed as high sensitivity CRP (hs CRP).
Hyperhomocysteinemia (14):
Vitamin B12 and folic acids participate in the metabolism of homocysteine (Hcy). Leaving aside the genetic determinants of hyperhomocysteinemia (HHC), the deficiencies of these vitamins can also result in Hyperhomocysteinemia (HHC). Just 1 month of Vitamin B12 supplementation usually helpful to lower elevated blood levels of homocysteine.
- Carotid intima-media thickness (15):
Thickening of the artery wall is a hallmark feature of atherosclerosis; therefore, Intima media thickness (IMT) measurements can be substantially useful in the prediction of development of cardiovascular disease, and thereby helpful to detect CVD events in advance stage.
Elevated plasma fibrinogen (16)
Emerging research supports a strong connection between high-blood fibrinogen levels and cardiovascular disease. Five of the recent research studies reported, high incidence of heart attack events in persons with elevated blood fibrinogen levels Study also found that elevated fibrinogen is connected with a 35% rise in coronary heart disease in men and a 50% increase in women. Fibrinogen should be added to the list of major cardiovascular risk factors.
Low HDL (Good cholesterol):
Low levels of high-density lipoprotein cholesterol (HDL-C) have long been associated with increased risk for cardiovascular disease. studies have shown that low HDL Cholesterol is connected to an elevated risk of developing cardiovascular disease.1 This is particularly true if higher plasma triglycerides accompany low Plasma Hdl concentration, research suggests that high HDL levels significantly lower risk of premature heart disease and stroke.
Impaired OMEGA 3 TO OMEGA 6 RATIO:
Another important factor is the ratio of Omega 3 and Omega 6 fatty acids in our body. The Ideal ratio of omega 3 to omega 6 is 1:2, but unfortunately the western food habits altered this ratio into 25.1(too much omega 6 and extremely low omega 3), if the ratio is exceeded or mismatched, it causes INFLAMMATION And induce damage in blood vessels and heart. Our body cannot produce these fatty acids; therefore, these lipids are called essential fatty acids. The ideal balance can be achieved by eliminating excess omega 6 from diet and supplementing missing omega 3.
Menus for heart-healthy eating:
Cut the carbs ,sugar, omega 6 rich refined oils and salt
Protocols to be followed to reverse the condition
- Controlling the risk factors.
- Lifestyle modifications.
- Undergoing a raw diet for three months proves beneficial to reverse the condition.
- Consumption of more vegetables and fruits.
- Maintaining the Omega 3 and Omega 6 ratio (ideal being 1:2)
- Supplements such as Omega 3, vitamin B12 and garlic.
- Probiotics and prebiotics supplements.
- Regular exercise.
Countering the epidemic requires the development of strategies such as the formulation and effective implementation of evidence-based policy, reinforcement of health systems, and emphasis on prevention, early detection, and treatment with the use of both conventional and innovative techniques. Several ongoing community-based studies are testing these strategies.
1)Cardiovascular diseases – World Health Organization
https://www.who.int/health-topics/cardiovascular-diseases/#tab=tab_1
2) Heart disease, stroke among top killers in India – The Hindu
3)Cardiovascular Diseases in India Compared With the United States
http://www.onlinejacc.org/content/72/1/79
4)Asian Indian Paradox
https://cadiresearch.org/topic/asian-indian-heart-disease/asian-indians-global/asian-indian-paradox
5)Contaminated Vegetarianism
https://cadiresearch.org/topic/diet-indian/contaminated-vegetarianism
6)Association of central obesity and insulin resistance with high prevalence of diabetes and cardiovascular disease in an elderly population with low fat intake and lower than normal prevalence of obesity: the Indian paradox
https://insights.ovid.com/cardi/199809090/00019501-199809090-00002
7) The French paradox: lessons for other countries
https://heart.bmj.com/content/90/1/107.short
8) Traditional and Nontraditional Risk Factors Predict Coronary Heart Disease in Chronic Kidney Disease: Results from the Atherosclerosis Risk in Communities Study
https://jasn.asnjournals.org/content/16/2/529
9)Tobacco and Cardiovascular Disease: A Summary of Evidence
https://www.ncbi.nlm.nih.gov/books/NBK525170/
10)Cardiovascular Disease and Diabetes
https://www.heart.org/en/health-topics/diabetes/why-diabetes-matters/cardiovascular-disease–diabetes
11) High Blood Pressure and All-Cause and Cardiovascular Disease Mortalities in Community-Dwelling Older Adults
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5059018/
12) Heart disease: All in the family history
https://www.health.harvard.edu/heart-health/heart-disease-all-in-the-family-history
13) C-Reactive Protein as a Cardiovascular Risk Factor
https://www.ahajournals.org/doi/full/10.1161/01.cir.100.1.96
14) Role of homocysteine in the development of cardiovascular disease
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4326479/
15) Carotid Intima‐Media Thickness and Prediction of Cardiovascular Disease
https://www.ahajournals.org/doi/full/10.1161/JAHA.116.005313
16) Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis
https://researchonline.lshtm.ac.uk/id/eprint/12821/
17) Lower HDL-cholesterol, a known marker of cardiovascular risk, was associated with depression in type 1 diabetes: a cross sectional study
https://lipidworld.biomedcentral.com/articles/10.1186/s12944-019-1009-4
18) Serum Omega-6/Omega-3 Ratio and Risk Markers for Cardiovascular Disease in an Industrial Population of Delhi
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On 11th March 2020 SARS-CoV-2 was declared a pandemic, a virus predominantly affecting the respiratory system. Within months there were also reports of neurological disturbances such as lack of smell and taste, dizziness and headaches. As the virus continued to spread from Wuhan through to neighboring countries and continents there was an increasing prevalence and severity of these neurological and psychiatric cases.
