In­dia home to nearly 40% of world’s heart fail­ure pa­tients

Clin­ics, Reg­istry Would Help Check New Epi­demic Brought On By Life­style Choices

The Times of India (New Delhi edition) - - Times Nation - TIMES NEWS NET­WORK Sheezan Nezami & Archi Rani

In­dia is home to 40% of the world’s 2.6 crore pa­tients with heart fail­ure, yet there is poor aware­ness about the con­di­tion and its treatment. Ma­ha­rash­tra pub­lic health min­is­ter Ek­nath Shinde de­liv­ered this pithy mes­sage while kick­start­ing the Times of In­dia’s ini­tia­tive on heart fail­ure last week. Called the Beat Heart Fail­ure, the ini­tia­tive is part­nered by pharma ma­jor No­var­tis and aims to ed­u­cate the masses about heart fail­ure and en­cour­age them to un­der­take a ba­sic symp­tom check.

The meet­ing—first in a se­ries of dis­cus­sions to be held in var­i­ous ci­ties—was at­tended by se­lect bu­reau­crats and aca­demi­cians in Mum­bai who dis­cussed ways to tackle this rel­a­tively new epi­demic in In­dia. Set­ting up heart fail­ure reg­istry and start­ing heart fail­ure clin­ics in med­i­cal schools and pri­vate hospi­tals emerged as main solutions.

Dub­bing the Beat Heart Fail­ure cam­paign as an “es­sen­tial” and “noble’’ cause, Shinde said, “Heart fail­ure is a chal­lenge ahead of us as, more so be­cause In­di­ans are prone to life­style dis­eases, like hy­per­ten­sion and di­a­betes, that are risk fac­tors for heart fail­ure.”

He quoted a 2017 study that showed that only about 50% of In­dia’s heart fail­ure pa­tients take medicines. “We need to work out a way ahead to en­sure that more pa­tients are di­ag­nosed early and started on treatment,” he added.

KEM Hospi­tal’s car­di­ol­ogy depart­ment head Dr Pra­fulla Kerkar said the prob­lem of heart fail­ure seems worse here be­cause the con­di­tion

man­i­fests a decade ear­lier among In­di­ans. A prob­lem vis-à-vis heart fail­ure is that no one is di­rectly di­ag­nosed as a heart fail­ure pa­tient be­cause it usu­ally de­vel­ops as a re­sult of some other chronic con­di­tion. “If a pa­tient has di­a­betes or car­dio­vas­cu­lar disease and has a low ejec­tion frac­tion (heart’s pump­ing ca­pac­ity), the pa­tient has a high risk of heart fail­ure and should un­dergo fur­ther tests,” he added.

Dr Suresh Menon of No­var­tis said heart fail­ure had a pe­cu­liar pat­tern. “Most dis­eases start with an acute at­tack be­fore the con­di­tion be­comes chronic, but it is the op­po­site with heart fail­ure,” he said.

di­ag­nos­tic (Above) Dr Amol Wankhede (from left), Dr Sad­hana Tayade, Dr Pra­fulla Kerkar, Dr San­jay Mukher­jee and Dr Suresh Menon at the Beat Heart Fail­ure dis­cus­sion; (left) Ma­ha­rash­tra pub­lic health min­is­ter Ek­nath Shinde kick­starts the Times of In­dia’s ini­tia­tive on heart fail­ure

Pa­tients first show up with chronic heart fail­ure which be­comes acute and needs hos­pi­tal­iza­tion, he added.

After un­der­stand­ing the de­tails of In­dia’s heart fail­ure epi­demic that the ex­perts rec­om­mended set­ting up of a heart fail­ure reg­istry in Ma­ha­rash­tra. At present, only Ker­ala has a heart fail­ure reg­istry funded by the In­dian Coun­cil for Med­i­cal Re­search.

Dr Amol Wankhede, a World Health Or­gan­i­sa­tion ad­vi­sor with the Ma­ha­rash­tra gov­ern­ment, felt heart fail­ure could emerge as an epi­demic if mea­sures aren’t taken soon. “If not di­ag­nosed early, pa­tients will re­quire re­peated ICU ad­mis­sions,” he said, adding that the need of the hour is set­ting up guide­lines that even pri­mary health cen­tres could follow. The idea is early iden­ti­fi­ca­tion so that pa­tients can be rushed for fur­ther treatment to ter­tiary-care hospi­tals in ur­ban ar­eas.

Dr Sad­hana Tayade, from the state di­rec­tor gen­eral of health ser­vices, iden­ti­fied the lack of trained man­power as one of the im­ped­i­ments in early di­ag­no­sis. “There is a scarcity of heart

ex­perts at the district lev­els. There is only one MD-trained physi­cians for heart for 14 district hospi­tals,” she said. How­ever, she added that gov­ern­ment’s screen­ing for non-com­mu­ni­ca­ble disease could help iden­tify pa­tients. “We are also em­pan­elling pri­vate hospi­tals and car­di­ol­o­gists in the pri­vate sec­tor to help,” she said.

State med­i­cal ed­u­ca­tion sec­re­tary Dr San­jay Mukher­jee said Ma­ha­rash­tra has un­der­taken many ini­tia­tives to im­prove heart care. “We are in­creas­ing the number of seats for su­per spe­cial­ists this year on­wards so that we have bet­ter in­fra­struc­ture for heart care,” he said. The Ma­ha­rash­tra gov­ern­ment has tied up with NGO Golden Hour Foun­da­tion to train in­terns on the im­por­tance of golden hour in heart treatment.

Dr Mukher­jee added that stud­ies should be con­ducted to check if ar­ti­fi­cial in­tel­li­gence could help in iden­ti­fy­ing the vul­ner­a­ble pop­u­la­tion in this re­gard.

Shinde said that ef­forts should be made to spread aware­ness about heart fail­ure right across so­ci­ety, espe­cially school­child­ren. “Even chil­dren should have the knowl­edge that they need to adopt a healthy life­style to avoid chronic con­di­tions like hy­per­ten­sion and di­a­betes,” he added. Patna: Lo­cals clashed on Thurs­day with the po­lice on Exhibition Road, a com­mer­cial hub in Bi­har’s cap­i­tal, over the hefty fines be­ing im­posed on mo­torists un­der the amended Mo­tor Ve­hi­cles Act for vi­o­lat­ing traf­fic rules.

Com­muters threw stones at po­lice ve­hi­cles and also sur­rounded a VIP car in which a guard was sit­ting with­out wear­ing a seat­belt. Peo­ple also at­tacked two po­lice ve­hi­cles and tried to pull the driver out of one of the them.

The chaos from 11.30 am to 2.30 pm be­gan when a Bor­ing Road resident, Renu Jaiswal, was is­sued a chal­lan for not wear­ing a seat­belt in the front seat of her car.

Renu al­leged that a sub-in­spec­tor, Bra­jesh Ku­mar Singh, used foul lan­guage against her.

Bra­jesh Singh, how­ever, de­nied the al­le­ga­tions and ac­cused Renu of abus­ing him.

Gandhi Maidan po­lice sta­tion SHO Su­nil Ku­mar Singh said 11 peo­ple were de­tained for cre­at­ing a ruckus.

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