Text of the Speech for Heart Foundation
Ladies and Gentleman,
I consider myself very fortunate to have been blessed with the opportunity of addressing this learned gathering on a very monumental and historic occasion. With profound sense of respect and gratitude I would like to recall that on 18th October, 1988 Heart Foundation of India came into being with Padma Vibhushan Dr. B. K. Goyal as its founder President and eminent Cardiologist Dr. Lekha Pathak as its First Secretary General.
The core aim with which the said notable organization came to be created was to promote education by way of having conferences and CME’s and simultaneously undertake the task as a non-governmental organization to render health to poor and needy patients, increase the awareness of heart attack and its prevention amongst the people at large. It was also within the ambit of its aim to target the lifestyle disorders including diabetes and hypertension and to undertake conduct of routine health check-ups on the said count.
With great pride, I deem it necessary to place on record that the Foundation has rendered yeomen services to the mankind and people of this country in a very humble and selfless manner. This has definitely resulted in creation of ‘benchmarks’ on the sands of time which stand out as ‘milestones’ and are inerasable in character.
Yet another initiative that came to be undertaken by the learned duo has been creation of Indian College of Interventional Cardiology, which in the annals of the history turns out to be the first Intervention Society in the country under the aegis of Heart Foundation of India.
It is worthwhile to take note of the fact that the Heart Foundation of India and Indian College of Interventional Cardiology has organized four World ‘Congresses’ and also the ‘Annual’ meets. The first World Congress on Interventional Cardiology was a historical event by virtue of the fact that it attracted more than 3000 delegates and well over 135 internationally acclaimed faculties. They created an impact of its own in wide and varied dimensions which is fondly remembered and befittingly recalled.
The task that has been undertaken and is being continued by the foundation and the society jointly and severally needs to be viewed in the context of certain material facts, which are mind boggling in nature and baffling in character.
India has seen a rapid transition in its disease burden over the past couple of decades. The load of communicable and non-communicable diseases is projected to get reversed by 2020 from its distribution as was observed in 1995. It is undergoing an epidemiological transition and is on a threshold of an ‘epidemic’ of cardiovascular disease. Demographic projections suggest a major increase in cardiovascular disease mortality as life expectancy increases and the age structure of the growing population changes.
It is a matter of record that in an overall sense cardiovascular diseases accounted for around ¼ th of all deaths in India in 2008 and are expected to be the fastest growing chronic illnesses between 2005 and 2015 respectively, growing at an alarming rate of 9.2% each year. A greater worrying fact is that the incidences of cardiovascular diseases have gone up significantly for people between the ages 25 and 69 to nearly 24.8% which means losing more productive people to these diseases.
Prevalence of coronary heart diseases is between 7 to 13% in urban and 2 to 7% in rural India. A conservative estimate indicates that there could be 30 million chronic heart disease patients in India of which 14 million are in urban and 16 million in rural areas. If the current rate continues then by the year 2020 the burden of atherothrombotic cardiovascular diseases in India will surpass all other regions of the world.
Equally baffling is the prevalence of hypertension in India to the extent of 25% in urban and 10% in rural inhabitants. This is matched by a corresponding prevalence of dyslipidemia which is about 37.5% among the adult age group of 15 to 64 years of age.
This significant growth of heart diseases is palpably dependent on a number of interlinked factors including ageing, changing life styles, food habits and other rapidly evolving socio-economic determinants across developing world. Significant among them are improved access to health care, higher income levels, globalization, and urbanization drive increases cardiovascular disease risk factors.
The prevailing situation therefore mandates a ‘cardiac care cycle’ in place combating the challenges of ‘low availability, accessibility and affordability’. As such, we need a better surveillance and reporting system to be put into place which is robust in nature and is efficiently efficacious. This alone will add to the preparedness of the health system and thereby add to the quality of care.
It is therefore, necessary that all the stakeholders including the policy makers need to acknowledge and address the various ‘socio-economic determinants’ that are strongly linked with the cardiovascular disease risk factors and to the related morbidity and mortality. The rising cardiovascular disease burden and the damaging consequences it has on individuals, families and populations require prompt and urgent attention. Innovative strategies are needed to halt the progression of the cardiovascular disease epidemic in resource poor settings in India. To address the socio-economic differentials in the burden of diseases and health care needs of Indians, more resources need to be directed towards applying the existing knowledge based to tackle the cardiovascular disease epidemic in policy, programs, capacity building and research arena.
The issue is huge and gigantic and needs an ‘all pronged integrated holistic approach’ to tackle the same. The dispensation of role and responsibility on this very vital count by the Heart Foundation of India is ‘exemplary and emulative’ as well. I record my gratitude and salutation for this monumental human intervention of consequence and relevance alike.
It is indeed a ‘light house’ to guide all the ‘torch bearers’, who intend to carry the mantle of responsibility on their shoulders for propagation of a larger good with a ‘helping and healing hand’ to the suffering millions waiting for their turn ‘helplessly’ as well as ‘endlessly’.
I also want to touch upon the ongoing diabetic epidemic. People with Diabetes have increased risk of heart disease and stroke. It is imperative that timely action plans are evolved for dealing with the problem in the context of its magnitude, so that it does not gain proportions that would turn out to be difficult to tackle in times to come.
The WHO theme this year is depression (let’s talk). Depression affects around 300 million people worldwide and this number is projected to increase. This needs to be addressed on priority.
Today, more than ever, the need for preventive systems of medicine is being widely realized. Sophisticated diagnostic tools, prescriptive drugs that come in complicated combinations, and a high-level of specialization are making medical care expensive. Illnesses are on the rise. This is where Yoga comes in. Meditation is an integral part of Yoga. The mind is the root of most physical problems is brought out and guidelines for healthy living are given. Shri Narendra Bhai Modi, the Hon'ble Prime Minister of India has also emphasized the need for connecting more and more people not only in India but all over the world – with Yoga and its adoption for the complete health of the mankind. United Nations from 2015 has also adopted 21st June of every year as the International Yoga Day. The focus must change from ‘sickness’ to ‘wellness’ and on common country specific life style protocols. The same needs to be advocated strongly.
We should also debate on increasing the tobacco, sugar and alcohol tax; introducing CPR training in schools; reduction of salt, sugar and hydrogenate oil consumption in the community.
Finally, I want to touch the new risk factor for heart disease and that is PM 2.5 link with atherosclerosis (a marker of air pollution) and noise pollution linked to hypertension. We need to start tackling them in our clinical practice.
I wish you interesting presentations and fruitful discussions for International Congress on “Heart, Hypertension, Diabetes and Intervention” on various faces and facets of it to be availed for the larger good for men and mankind.
Dr Ketan Desai
World Medical Association