Health

Hope for Indians at Risk for Heart Attacks and Strokes

The researchers on heart disease are about to announce a revolutionary thinking on the cause of heart disease. This is very significant especially for Indians, in whom a higher incidence of heart attack and sudden death at relatively young age has been noted.

Until now cholesterol has been blamed for heart disease. Aided by high blood pressure, diabetes and obesity, cholesterol is deposited in the arteries as plaques. When these plaques burst like pimples, small particles are broken off and are carried downstream causing blockage of important branches of arteries. This leads to heart attack or strokes resulting in death or severe disability.

A study conducted by Indian American cardiologists few years ago concluded that Indians have smaller coronary arteries compared to Caucasians. This facilitated blockage of the arteries even with relatively minor particles and resulted in heart attacks. It was also surprising to see that many Indians affected did not have high cholesterol that is blamed for plaque formation. New evidence now available may explain why this is so. Read on.

The new theory is that the plaques become loose because of low-grade inflammation. Even chronic mild gum infection can trigger this inflammation of arteries. The plaques become softer, and can get detached and result in catastrophe. Plaques are seen as a process of aging. However, they are much more in people with high blood pressure, high cholesterol and obesity. What makes the plaques get loose is the inflammation.

Now there is a blood test that can predict if someone is at a higher risk to get heart attack or stroke. It is called C Reactive Protein (CRP), which can be measured with a simple blood test, not unlike the cholesterol test. People with high level of CRP should be treated with ‘statin’ group of drugs, even if their cholesterol is normal. Statin drugs are now in common use for treating high cholesterol. They are also seen to stabilize and heal the inflammation of the arteries. CRP is already used to investigate patients now in selected cases. The issue as to who are the patients that need the test as a monitoring device is still not settled. The guidelines for interpretation and treatment will be issued soon.

Meanwhile controlling blood pressure, regulating diabetes, reducing weight, stopping smoking and drinking alcohol in moderation are recommended (yes, alcohol in moderation has a protective effect on the blood vessels!). Earlier these measures are instituted the lesser the chances of heart attack and stroke.  

04-Aug-2002

More by :  Dr. Neria H. Hebbar

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