Indians have a high prevalence of ischaemic heart disease. What is more alarming is that it presents or manifests a decade earlier in Indians compared to our Western counterparts. Main reason for this is high clustering of risk factors like diabetes, hypertension, smoking or other forms of tobacco use, high levels of bad cholesterol or low levels of good cholesterol, physical inactivity, obesity, high carbohydrate/high fat diet and high levels of stress in Indians. Many times the first presentation of ischaemic heart disease is acute myocardial infarction and sudden cardiac death. In upto 7 percent of cases the first myocardial infarction is fatal. Many of these patients die before reaching the hospital because of cardiac arrhythmias.
The key to prevention and early detection of ischaemic heart disease lies in early identification of risk factors and their aggressive management and also early detection of the disease before it presents as a heart attack. Risk factors are present for many years before leading to the development of significant ischaemic heart disease. If risk factors are identified and aggressively controlled at early stages many cases of ischaemic heart disease can be prevented or their onset delayed.
