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Business News/ News / Business Of Life/  A matter of the heart
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A matter of the heart

A lifestyle disease that is hard to pronounce but one that is putting more and more young people at risk. On World Heart Day, a look at dyslipidemia

Dyslipidemia increases the risk of heart disease. Photo: iStockphotoPremium
Dyslipidemia increases the risk of heart disease. Photo: iStockphoto

OTHERS :

Last month, a 26-year-old information technology (IT) professional came to a hospital’s outpatient department with complaints of acute chest pain and excessive sweating. His electrocardiogram showed myocardial infarction (commonly known as a heart attack) and blood tests showed high triglycerides and low-density lipoprotein (LDL), or bad, cholesterol, and low high-density lipoprotein (HDL), or good, cholesterol.

He had dyslipidemia, a disorder of the lipoprotein metabolism, which could mean overproduction or deficiency of lipoprotein (cholesterol and triglycerides). Commonly, it manifests as elevation of total cholesterol, LDL cholesterol and triglyceride concentration levels, and a decrease in HDL cholesterol concentrations in the blood. High cholesterol, if not controlled, will eventually lead to heart trouble of some kind.

Further tests showed that the left main coronary artery was blocked and an angioplasty was required.

The IT professional was a heavy smoker and had been consuming two packs a day over the last six-seven years. “For him, the cause of his heart attack was smoking and dyslipidemia, and the irony is that this person hadn’t even heard about dyslipidemia before this attack," says Viveka Kumar, director of the cath lab and senior consultant (interventional cardiology and electrophysiology) at the Max Super Speciality Hospital, Saket, New Delhi.

Experts are not surprised. “The prevalence of dyslipidemia, a lifestyle disorder caused by the imbalance in lipids, is high in India and is increasing with each passing day. This disorder is directly proportionate to the growing incidence of heart attacks in people as early as in their 30s and 40s," says Santosh Kumar Agarwal, senior interventional cardiologist at the Kailash Hospital and Heart Institute in Noida, adjacent to Delhi. The problem is that an abnormal lipid profile mostly goes unnoticed in a young person since there are no obvious symptoms.

At a press conference during the second International Summit on Lipids held in New Delhi last month, Raman Puri, founder and vice-chairman of the Lipid Association of India and senior interventional cardiologist at Apollo Hospital, made public the results of a study by his team from 2012-14. In a study group of 2,502 children aged 14-18, 23% had above-normal cholesterol levels. They found high triglyceride levels in 45.6% of the children, low HDL cholesterol in 44.4%, and high basal metabolic index, a direct risk indicator for lifestyle disorders like diabetes and heart disease, in a substantial number of the study group (2.3% were overweight and 3.8%, obese). The results were published in the March issue of the Journal Of The American College Of Cardiology.

“These results are really serious, as high LDL cholesterol, high triglyceride and low HDL cholesterol, all indicators of dyslipidemia, increase the risk of heart disease in future," says Dr Puri over mail. “Plus, as one gets older, if abnormal lipid parameters get associated with other risk factors like smoking, abdominal obesity, tobacco chewing, diabetes, metabolic syndrome, the incidence of heart disease goes up substantially."

To quite an extent, the rise of heart disease in the country is due to the poor lifestyle choices of today’s generation. “It all boils down to unhealthy dietary habits, sedentary lifestyle, lack of exercise," says Tilak Suvarna, senior interventional cardiologist and head of the department of cardiology at the Asian Heart Institute, Mumbai.

A poor diet, comprising high levels of trans fat, salt, sugar and cholesterol, little sleep, smoking, alcohol consumption and little physical exercise, are all catalysts. “Our stress levels are higher than ever before and we tend to resort to anger and violence to solve the smallest issues. All this has resulted in a premature incidence of heart disease and associated disorders," says Dr Agarwal.

Dr Kumar says: “Dyslipidemia in the young is usually diagnosed during routine investigation. In my clinical practice, I see around 20-30 young patients with dyslipidemia in a week. Sometimes, they may come with vague symptoms like generalized weakness, leg pain, nausea, vomiting, abdominal pain.

The only way of diagnosing dyslipidemia is through regular blood check-ups. “I recommend tests every five years to everyone above the age of 20. A family history is also a good indicator to check if a person is prone to dyslipidemia" says Dr Agarwal.

Be careful

Although it is asymptomatic, long-standing elevation of serum lipid levels can lead to atherosclerosis, or thickening of the artery walls. “Over a couple of decades, chronically elevated serum cholesterol can contribute to the formation of plaque in arteries, which leads to the narrowing or complete blockage of arteries, and, subsequently, to heart attacks and strokes. Besides, dyslipidemia also increases the risk of peripheral vascular disease, stroke and metabolic syndrome in the long run," says Dr Agarwal.

Dr Kumar lists dietary ways to keep a check: “Total fat intake should only be 25-35% of total daily calories. Avoid trans fat and refined carbs. Also, have a high-fibre, low-sodium diet and include lots of fruits and green vegetables." Dr Agarwal recommends an exercise routine that includes at least 30 minutes of moderate-intensity physical activity daily.

According to Dr Suvarna, the first step in treatment is to assess the individual’s risk of heart disease in future—this is assessed on the basis of algorithms and risk scores.

“If the predicted risk is high, then cholesterol-lowering drugs called statins and lifestyle changes are advised, irrespective of risk," he says. “This is not a disorder to be taken lightly—early diagnosis is imperative."

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Published: 28 Sep 2015, 08:13 PM IST
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