26
Tuesday
May 2020
12:04 AM IST
News Headlines
Need to find a way to outlast Pujara in summer series: Cummins        La Liga can resume week of June 8 - Spanish Prime Minister        Extend loan automatically to all eligible borrowers without fear of 3Cs: FM to banks        Will try to restart international flights before August: Puri        Iran warns US not to interfere with Venezuela oil shipment        Sri Lanka to ease coronavirus restrictions from May 26        Coronavirus cases cross 10,000-mark in Ahmedabad, 24 deaths        Amphan toll rises to 85 in Bengal; protests over electricity, water supply        Prisoners aged above 60 to be released on emergency parole to decongest jail in Delhi        Record jump in COVID-19 cases, 137 more deaths        Bryant items fetch premium prices, Trout card sets record        Baseball players respond to MLB on virus protocols        RBI extends moratorium on loans for another 3 months till Aug        Sensex, Nifty turn choppy; RIL jumps on KKR deal        Quarantine must for domestic air travellers: Kerala govt        At least 57 killed in Pakistan passenger plane crash in Karachi        China introduces new security bill in parliament to tighten controls over Hong Kong        Trump lashes out at scientists whose findings contradict him        COVID-19 death toll climbs to 3,583 in India        Pak troops shell LoC areas in twin sectors of Poonch, Rajouri        
Home   | Main News   | Kerala  | National   | International  | Business   | Sports   | Entertainment   | Columns   | Offbeat   | Health   | About Deepika 
Health News
Why should We Invest in Preventive Cardiology in the Young?
 
When human beings were hunter gatherers, the diseases they contracted were zoonoses – diseases spread through animals. When man turned to agriculture, he settled in the river banks and his clan stayed together. Then the most common diseases were infections. Later, as the industrial revolution was followed by digital revolution, a new set of illnesses came into being – the Life Style Diseases or as generally put, non-communicable diseases. Currently in the world, approximately 50% of death is due to non-communicable diseases (NCD).

They include cardiovascular diseases (CVD), diabetes, accidents, mental, disorders and chronic lung diseases. In India also nearly half of death is due to NCD and CVD is the most common component causing death. Currently it accounts for 35% of all deaths in India and is increasing along with its not so friendly neighbor, China.

The modifiable risk factors for CVD include, high blood pressure, dyslipidemia (abnormality of Cholesterol), diabetes mellitus, over weight and obesity and smoking. The other lesser factors are sedentary habit, mental stress and dietary habits. Primary prevention of CVD in an adult is by controlling the above factors. One can possibly prevent the CVD risk factors by primordial prevention, which is theoretically appealing but less practical.

The final common pathway of CVD is atherosclerosis which is a deposition of fatty and other material in the wall of arteries supplying the heart, brain, kidneys etc. Many studies done in young people who die young – during the wars, accidents etc, have shown that atherosclerosis begins in the adolescence and accelerates in the adult. The adolescents share the same CVD risk factors that of an adult population.Hence, prevention of CVD could start from adolescence.

In our state, these major CVD risk factors are high in prevalence. Nearly 10% of adult population have coronary heart disease, at least 30% of adults have high blood pressure, 10-15% of adults have diabetes and 20-30% of men still smoke. In addition, the average value of cholesterol in the blood of Keralites is higher than the optimal values. Over weight and obesity prevalence is increasing.

Many studies in Kerala have shown that high blood pressure is seen in children at least in 5%, obesity in 5% and insulin resistance to be more in children of Kerala. In the young adults of Kerala, the prevalence of all CVD risk factors are above the national averages. And most importantly, all these CVD risk factors track to adulthood.

These phenomena convey a crucial message. If we could start controlling the CVD risk factors from adolescence onwards, that would lead to reduction in the burden of CVD risk factors in the young. That would translate into reduction of CVD risk factors in the young adult and further cause reduction in CVD in the adult. This is the fundamental basis of preventive cardiology in the young. One has to ‘Catch Them Young’ and make young people “heartsmart”.

In the west, screening children and adolescents for high blood pressure, obesity and dyslipidemia is becoming popular. Some of the screening can be universal - high BP and obesity and some can be selective – for dyslipidemia. We in Kerala can also screen our adolescents for CVD risk factors, probably concentrating on high risk population.

The screening could be achieved either by universal screening or selective situations and offered preventive and remedial measures.

A Preventive Cardiology in The Young Clinic can offer a lot to at risk population of adolescents. At risk population include those children whose parents and/or grandparents having premature CAD, having high lipid values and those children who are hypertensive, smokers or obese.

The concept of a preventive cardiology in the young can be conceptualized as a multi-disciplinary team taking care of adolescent cardiovascular health. We have termed these proposed clinics as Adolescent Cardiovascular Health Clinics as we will stress on maintaining health rather than treating morbidity.These clinics also look at children who had Kawasaki disease in their early childhood, who were born lighter (Birth Weight <2.5 kg) or who have chronic kidney disease.

The three crucial components of care givers in AHCs are Pediatrician, Pediatric Cardiologist, Nutritionist and Pediatric endocrinologist. The clinic can also have additional input and support from physical medicine, obstetricians and nurses.

KIMS is planning to start a AHC program from January 2020 onwards. This is going to be a bi weekly focused clinic to be run by pediatric cardiologist, pediatric endocrinologist and nutritionist. The clinic will the first of its kind in private sector. Beginning from January, adolescents can be directed to the clinic by pediatricians, physicians, cardiologists, public health nurses and even teachers. The aim will be a multidisciplinary approach to modify adolescent CVD risk factors, involving the entire family.

Those who can visit our clinic

1. Overweight and obese adolescents
2. Adolescent with high blood pressure
3. Adolescents whose parent has a premature CVD
4. Adolescent who smokes
5. Adolescents who were either LBW or had Kawasaki disease in childhood.

In addition, our intention will be also to take care of adolescents who have a chronic cardiac illness – either congenital or acquired or post-operative congenital heart disease. They are generally ‘orphaned’ due to their age, both by pediatricians and physicians.

In conclusion, starting of a dedicated Adolescent Cardiac Health clinic is a great investment for the future. An investment which could reduce both individual and societal burden of CVD in our state and country.

Dr. Zulfikar Ahamed
Paediatric Cardiologist,
KIMS Hospital,
Trivandrum


Accountability to Affected Population experience established for Kerala floods recovery, continues to be effective for COVID-19 response in the state
Mental health education– the earlier the better
Scenario of Private Vs Govt schools students Mental Health of Delhi
Please Open Up, Tell Something
Bleeding per rectum – don’t panic, but never ignore!
Gujarat man seeks mercy killing of daughter; moves HC
Green Tea and Weight loss
Urinary Stones - Symptoms, Dietary factors, Preventive measures
Say goodbye to brittle nails
Is thyroid causing hairfall? Don't panic
Tulsi - The magical plant
SuperBottom by a Super Mom for your Super kids
KERALA NEWS
Quarantine must for domestic air travellers: Kerala govt
 Thiruvananthapuram: Domestic flyers arriving in Kerala must undergo strict home quarantine as per th  
12 fresh COVID-19 cases in Kerala, total rises to 642
Central financial package lacks public healthcare initiatives: Kerala CM
29 fresh cases in Kerala; Over 67,000 under observation
INTERNATIONAL NEWS
Iran warns US not to interfere with Venezuela oil shipment
 Tehran: Iran's president on Saturday warned the United States not to interfere with a shipment of oi
Sri Lanka to ease coronavirus restrictions from May 26
At least 57 killed in Pakistan passenger plane crash in Karachi
China introduces new security bill in parliament to tighten controls over Hong Kong
NATIONAL NEWS
Coronavirus cases cross 10,000-mark in Ahmedabad, 24 deaths
 Ahmedabad: Coronavirus cases in Ahmedabad crossed the 10,000-mark and rose to 10,001 after 277 new p
Amphan toll rises to 85 in Bengal; protests over electricity, water supply
Prisoners aged above 60 to be released on emergency parole to decongest jail in Delhi
COVID-19 death toll climbs to 3,583 in India
Untitled Page
Rashtra Deepika LTD
Copyright @ 2020 , Rashtra Deepika Ltd.