Why regular check-ups hold the key to beating heart failure

NEW DELHI: If you have coronary artery disease (CAD), which causes narrowing or blocking of the heart’s main blood vessels, it’s possible that the condition may progress into heart failure. To slow the progression or diagnose it in time for the right intervention, it’s important to get regular check-ups done, Dr Naresh Trehan, chairman and managing director of Medanta Medicity, Gurgaon, told TOI.
According to a study published in the Indian Heart Journal recently, the hospital’s heart failure clinic saw 6,111 patients between January 2014 and June 2017.
Of this, the disease history of 5,590 patients was studied to find that 78% had a history of coronary artery disease.
Dr Trehan said the prevalence of CAD has risen sharply in India over the last three decades and it is driving the rise in the prevalence of heart failure. “The second most common cause of heart failure is diabetes. If both CAD and diabetes patients are screened regularly for heart failure, it is possible to halt the progression of the disease and reduce the mortality rates,” the cardiac surgeon said.
Heart failure patients in India are 10 years younger than their western counterparts. However, the Medanta study shows the all-cause mortality is 18% one year after the first visit, which is much higher than that reported in Asian Heart Failure or Heart Failure Association of the European Society of Cardiology.
“The higher mortality could be because of a significantly high prevalence of CAD in our subjects. Unlike heart failure resulting from cardiomyopathy, hypertension or diabetes, left ventricular systolic dysfunction due to an earlier myocardial infarction and underlying CAD is often irreversible and could be responsible for a higher mortality rate,” the study, led by Dr Vijay K Chopra, says. It says heart failure is a major public health problem, accounting for considerable morbidity and mortality worldwide.
According to Dr Sundeep Mishra, professor of cardiology at AIIMS, two main reasons for increased incidence of heart failure in India are increasing longevity and successful treatment of other heart conditions, for example CAD. “The awareness about heart failure is very low in our country. Most people do not know the different between a heart attack and heart failure. They think it’s the same thing. That’s why we need to have more heart clinics so that patients suffering from the disease can received treatment as per the guidelines. Also, the caregivers need to be explained about the precautions needed in caring for heart failure patients,” he said. Dr Mishra said new medicines are available to manage the condition well, for example beta-blockers and ace-inhibitors. “Even in severe cases, there is the option of putting the patient of Left Ventricular Assistive Device (LVAD) or conduct a heart transplant,” he added.
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References

1. ^{^} heart failure (timesofindia.indiatimes.com)
2. ^{^} Cardiology (timesofindia.indiatimes.com)

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