By Purabi Shridhar

Dil dhak dhak kare...," Your heart might actually be beating out a message for help! Studies show that Indians are more prone, both by genetic disposition and dietary habits, to fall prey to the problems of the heart. As if in confirmation, more and more Indians are becoming victims of cardiovascular diseases (CVD) and worse, the average age of the victims is getting younger.

"India is worse off because heart disease here is not just angina. It begins young, sometimes in the mother's womb itself. There's something wrong with our genes," says Dr Rakesh Varma, Head of Department, Cardiology, Safdarjang Hospital, Delhi, and regional secretary of the Cardiology Society of India (CSI).

Statistics Speak
At a conservative estimate, CVD or heart attacks, caused 2.4 million deaths in India in 1990. By 2015, the World Health Organisation (WHO) estimates heart attack will be the single greatest 'killer' in India. In metros, 10 per cent of population is above 35 years and has heart problems.

There are at least 50 million people in India suffering from heart problems. This number will double in the next six years, as heart problems are expected to rise by 103 per cent in men and 90 per cent in women.

At this rate, by 2020, India will have the largest CVD burden in the world and that CVD would account for one-third of all deaths. Unfortunately, many of these will be young victims.

So what makes Indians so susceptible to CVD? Why are younger people falling prey? It appears that Indians begin with two major handicaps - shorter longevity as compared to Western countries, and genetic disposition. According to Dr Varma, the lifespan of an Indian today is 65 to70 years as compared to 80 years in developed countries, "So suppose someone has to get an attack at three-fourths of his lifespan, he or she will get it between 40 and 45 years here as compared to 65 years abroad.

"Second, there is a problem with our genes. Indians are susceptible to rheumatic heart. In the US or in Europe, the first manifestation of rheumatic heart is seen at 50 years, here we have full blown cases as early as at 10 years," explains Dr Varma.

Also, India's transition into a developed society is impacting health. The net result - wrong food habits and lifestyle changes.

The scenario is depressing all right but not exactly worth losing heart over! As Dr Varma says, "Figures are rising all right, but projections are not always correct. Sometimes, other factors come into play... like who would have thought Delhi would go the CNG way!"

Act Now
Keep your heart hale and hearty:
Cut out smoking and alcohol: Smoking,says eminent cardiologist Dr S Padmavati, is a major risk factor for heart attack as it increases the LDL or bad cholesterol and reduces the HDL or good cholesterol. The probability of premature death amongst men in the 40 to 54 year age group is 300 per cent more among smokers. Estimates also say that 142 million men and 72 million women above 15 years are tobacco consumers.
Alcohol has a similar negative effect. It is a source of empty calories that can be turned into fat and increase the level of blood triglycerides, which are harmful for the heart.

Watch Your Diet
The bad news is that the Indian diet, even the vegetarian one, is faulty. Using coconut, palm or hydrogenated oils like 'vanaspati' are a strict no-no. Use vegetable oils sparingly. The Indian diet is also heavy on carbohydrates. "Our food is rich and our lifestyle sedentary, which means double jeopardy," warns

Dr Varma. Obesity is a sure shot killer. Even a one per cent increase in the prevalence of obesity in countries like India and China leads to 20 million additional cases of obesity. And even in a developed continent like Europe, it is estimated that at least one-third deaths from CVD are caused by unhealthy diets.

Eighty to 95 per cent of increase of diabetes can be attributed to obesity. For the right diet, reduce intake of salt, and increase intake of fruits and vegetables. Say 'No' to the 'whites' - salt, sugar and refined cereals.

Grapes, mangoes, bananas and chikoos, egg yolks, organ meats and rich milk and dairy products are strictly no-nos. Check your sugar level: India is home to 32.7 million diabetics, the highest in the world. Also, Indians are prone to diabetes at an earlier age, 10 years earlier than people in the West. People with diabetes are two to four times likely to develop CVD.

Control Stress
Aggressive, competitive and over-ambitious personalities need to be on guard. Stress is a major cause of increased heart disease. Five key variables have been identified as possible psycho-social risk factors for coronary heart disease are acute and chronic stress, hostility, depression, social support and socio-economic status. If you are prone to stress, learn to ease out tension.