Coronary heart diseases chd

CAD AND ITS RISK FACTORS

1. 1 BRIG DR HEMANT KUMAR PROF & HOD ,AJIMS& RC MANGALORE

2. WOMEN DISREGARD HEART PROBLEMS

3. MEN TOO DISREGARD THEIR HEART PROBLEMS

4. CHD(IHD) is a chronic condition of closely related syndromes resulting from myocardial ischemia -an imbalance between the supply or perfusion and demand of the heart for oxygenated blood

5. DEFINITION OF CHD Impairment of heart function due to inadequate blood flow to the heart compared to its needs , caused by obstructive change in the coronary circulation to the heart”. 25- 30% deaths in most industrialized countries

6. WHAT IS A CHRONIC DISEASE

7. 2 The committee on chronic illnesses in USA has defined chronic disease as comprising of impairments or deviations from normal , which have one or more of following characteristics Permanent Leave residual Deformity Caused by Non reversible pathological changes Require special training for rehabilitation May require long periods (>3 months) of observation/ supervision and care

8. CVDs are the number 1 cause of death globally: more people die annually from CVDs than from any other cause. An estimated 17.9 million people died from CVDs in 2016 , representing 31% of all global deaths. Of these deaths, 85% are due to heart attack and stroke .

9. Over 75% of CVD deaths take place in low- and middle-income countries . Out of the 17 million premature deaths (under the age of 70) due to NCDs in 2015 , 82% are in low- and middle-income countries , and 37% are caused by CVDs .

10. Most cardiovascular diseases can be prevented by addressing behavioural risk factors . Such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol using population-wide strategies.

11. INDIA ???

12. With the turn of the century, CVDs have become the leading cause of mortality in India . In comparison with the people of European ancestry, CVD affects Indians at least a decade earlier and in their most productive midlife years

13. 16 In Western populations only 23% of CVD deaths occur before the age of 70 years ; in India, this number is 52%. In addition, case fatality attributable to CVD in India , is much higher than in middle- and high-income countries.

14. The WHO has estimated that, with the current burden of CVD, India would lose $237 billion from productivity and spending on health care over a 10-year period

15. 18 International variations CHD is now considered as our “Modern Epidemic”. Not an unavoidable consequence of aging. Epidemics of CHD began at different times in different countries . Developed countries were the first to be affected

16. At present, CHD is decreasing in many developed countries , but is increasing in developing and transitional countries, partly as a result of increased longevity, urbanization and lifestyle changes Highest mortality is found in European countries followed by SEAR countries.

17. Gaps In Natural History

18. 21 There are many gaps in our Knowledge about the the natural history of CVD . These gaps cause difficulties in aetiological investigation and research. Theses are- 1. Absence of a know n agent : 2. Multifactorial causation: 3. Long latent period 4. Indefinite onset

19. 22 The major conditions of CVD are : Ischemic heart disease Hypertension Cerebrovascular disease (stroke) Congenital heart disease Rheumatic heart disease

20. 23 CHD can manifest itself in any of the following ways Angina Pectoris Myocardial Infarction \ Heart Attack Irregularities of the Heart Cardiac failure Sudden Death

21. CHD RISK FACTORES 24

22. 28 Age specific Prevalence Rates AGE GROUP Urban (PR/1000) Rural(PR/1000) M F M F 20-24 8 6 17 10 25-29 19 26 13 15 30-34 17 22 12 10 35-39 43 48 18 15 40-44 47 65 17 23 45-49 83 105 20 38 50-54 93 112 30 50 55-59 162 152 26 50 60+ 174 175 70 67

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24. 31 PRIMORDIAL PREVENTION Focused on decreasing risk factor load in the population by increasing awareness and access through education and health promotion

25. PRIMARY PREVENTION Examples of primary prevention include  smoking and alcohol cessation , preserving good nutritional status, physical fitness , reg u lar chec k o f blo o d p r e s sure and c ertain bl o od parameters, e.g., cholesterol, blood lipids, glucose)

26. 33 Secondary: Screening and treatment of symptomatic patients, set up personal risk profile Tertiary : Cardiovascular rehabilitation , prevention of recurrence of CVD (new heart attack: 5-7 times higher risk among CVD patients)

27. 34 has re c om m en d e d the The W H O e x pert co m mittee following strategy : I. Population strategy Prevention in whole populations Primordial prevention in whole population High risk strategy Secondary prevention

28. WHEN IS WORLD HEART DAY ??

29. TAKE HOME MESSAGES

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