EDITOR-IN-CHIEF
Krishnakumar Kunnath, the singer popularly known as ‘KK’, age 53. Filmmaker Raj Kaushal, 49. Travel industry pioneer Ankur Bhatia, 48. Kannada actor-producer Puneeth Rajkumar, 46. Actor Sidharth Shukla, 40. Pankhuri Shrivastava, founder of rental startup Grabhouse, 32. Saurashtra cricketer Avi Barot, 29….
In that list of celebrities who died suddenly due to an unforeseen cardiac event in the recent past, all were quite young or on the right side of middle age. People dying of a heart attack is not news but the fact that they died with no obvious symptoms, like chest pain, and no visible vulnerabilities, is the new development. A recent study titled ‘Indian Hearts Lacking Care’, conducted by wellness company India Health Link in collaboration with social advocacy group HEAL Foundation, found that 53 per cent of Indians in the 26-40 age group are at high risk of cardiovascular disease due to two pathologies—obesity and hypertension. The Sri Jayadeva Institute of Cardiovascular Sciences in Bengaluru has found a 22 per cent increase in admissions for premature heart attacks since 2017. According to the WHO, South Asians are 40 per cent more likely to have heart complications than people in the West, mainly because of the lifestyle and dietary habits of urban India. The three ingredients that accentuate the risk of heart disease, if consumed in excess, are: salt, saturated fats and sugar. The advent of fast and processed food in India, with its overload of all three elements, has definitely increased the incidence of heart disease in India. The WHO recommends no more than 16-22 gm of saturated fats and 6 gm of salt in a day. As for free sugars, it says daily intake must be less than 10 per cent of our total energy intake. “A further reduction to below 5 per cent, or roughly 25 grams (6 teaspoons) per day, would provide additional health benefits,” it counsels us. But we flout all this routinely, unthinkingly. Consider this: a Mcspicy paneer burger has 17.12 gm of saturated fat, equivalent to your daily limit, and a single serving of McDonald’s ghee rice with Mcspicy chicken has about 2.3 gm of salt, almost half your daily allowance. Even a Burger King masala veg whopper has 11.8 gm of sugar—a third of your daily allowance! Not to mention 13.5 gm of saturated fat and 1.7 gm sodium.
The irony about the rising incidence of heart disease is, things don’t have to be that way. The plain fact is that heart disease is not some sudden, unforeseeable, unknowable act of malevolent destiny. There isn’t a lot of reason to get paralysed by fear about it these days. Perhaps no organ in the human body has been researched as much as the heart. The medical science surrounding it has been evolving at the rate of a human heartbeat. The diagnostic tools are laser-sharp and micro-precise these days. The C-reactive protein, although a non-specific marker of inflammation, has a predictive capacity way higher than LDL cholesterol levels. Concepts and methods from physics, like distant light scattering, have flowed into CRP testing to make it ultrasensitive. So even if the protein itself was discovered in 1930, we are at a revolutionary cusp in terms of being able to know more and more about our hearts. There are other protein markers too—like troponin and brain natriuretic peptide, used at various stages of detection and treatment. The thallium myocardial perfusion scan helps evaluate blood flow in the heart, as do radioactive tracers; computed tomography can scan calcium deposits on arterial plaque; and magnetic resonance imaging creates pictures of your heart from many angles. The latest way to look at the heart is through the eye. AI-assisted scans of the slender vasculature behind our retinas are enabling doctors to predict the risk of heart attacks with a high degree of accuracy and have started being used as the primary diagnostic mode in parts of the West. The therapeutic and minimally invasive surgical interventions too are getting fairly sci-fi and very sound—replacement valves, implanted defibrillators connected to smartphones, vastly improved stents, assist devices and robotic sleeves, not to speak of outright transplants or the more experimental field of stem cell therapy.
Ahealthy lifestyle is the key to keeping your heart in good condition. However, by the looks of it, it seems Indians are going the other way. Swiggy and Zomato delivered 12 million samosas in urban India last year—also two biryanis per second—as Senior Associate Editor Sonali Acharjee writes in our cover story this week. “Doctors have been noticing a rise in silent heart attacks in the last few years simply because patients remain unaware that they are at risk. With major advances in cardiac medicine that can predict heart attacks with 99 per cent accuracy and treat them with 1-2 per cent long-term risk, the recent rise in deaths by heart attack is a completely avoidable health disaster for the country,” she says.
For many, it’s only the fear of the unknown that’s keeping it unknown. Not knowing what’s going on in your body won’t stop it from going on—knowing it will. Pretending that all is well will not abolish disease, a regular trip to the doctor and the testing lab—however unpleasant it may sound—actually will. Most diagnostic and treatment procedures nowadays show a high success rate. Wilful ignorance is injurious to health.