Indian scenario of Cardiovascular disease
Although the prevalence of CVD in India was reported to be comparable to that in united states in 1969s when the US had the second highest CVD mortality in the world, with big geographic difference between different parts of India were present.
Ancient Indian physician Charak and Sushruta Some 2800 years earlier identified the Cardiac disorders as disorders effecting the people of upper socio economic classes who were Obese, Lethargic, Consuming large quantities of fatty food and sweet drinks etc. But there have been limited studies on CVD in India, at Present India is also in a high risk group for the development of CVD. Some subsets such as immigrants urban and upper socio-economic classes have an unusually high incidence of the disease and mortality. Indians frequently get the disease at a comparatively younger age in the absence of the accepted risk factors.
The prevalence of CVD varies between 4-6 % in rural Indian to 10-12 % in Urban North West India. How ever in urban south Indians the prevalence is about 16%. The absolute risk of CVD differs from culture to Culture which empahsises the role of various factors responsible for CVD.
Since CVD are Multifactorial in origin therefore the increased
susceptibility of the disease usually associated with increased prevalence of these factors in India -
susceptibility of the disease usually associated with increased prevalence of these factors in India -
- High Prevalence of Obesity Particularly Central Obesity with high Hip-Waist
Ratio.
Ratio.
- High Prevalence of Non Insulin Dependent Diabetes Mellitus, Impaired Glucose Tolerance Or Increased Concentration of fasting plasma Insulin .
Indians have shown 2.0-3.0 high prevalence of NIDDM
- Presence of Dyslipaedimia -High Plasma Triglyceride, Low HDL & High
Cholesterol Level.
Cholesterol Level.
- Prevalence of Small Dense LDL particles.
- Hyperinsulinaemia, Elevated Proinsulin And Insulin Ratio.
- Increased Consumption of Lipoproteins
Simultaneously the type of conventional diet pattern appears to have significant role in promoting the present epidemic of the disease amongst them. The typical Indian diet is cereal based with increased consumption of total fat and its subtypes may have the pathogenic role in the development of the disease. The basic defect in the Indian diet is the virtual deficiency of highly unsaturated n-3 fats. The traditional Indian cooking were replaced by n-6 enriched oils. This leads to impairment of destruction of alpha lipoenic acid and blocks the only available source for obtaining the highly unsaturated n-3 essential fats. So the diets derived from refined cereals and high fat diet with an physiological concentration of n-6 fat elevated n-6/n-3 ratio is a major coronary risk factor in the epidemiology of Indians.
In rural India the prevalence of CVD is also increasing, the reasons are the food habits, Medium Physical activity, Low body weight, Hypercholesteremia etc. Most of the Indian rural population belongs to the poor socio-economic group and the habit of chewing tobacco and smoking are very common which is the major risk factor if CVD. The unknown CVD cases are also common in rural India .
There are no reports of decline of CVD in India Where as there is marked reduction in the incidence of disease in several western countries.
So we must have to focus on the fact that CVD needs to be prevented and physicians should make every effort to modify reversible risk factors. Primary care physicians are in ideal position to play major role in Preventing the progression of CVD in India by Providing some basic Guidelines to the patients prone to the disease.
Ayurveda the holistic Science of India has lot to offer to Medical Science in prevention of such type of disorders by its unique concepts of Life-style, Diet, Seasonal regimens and line of treatment which are completely suitable and acceptable by Indians. Only the motivation is required to refresh the knowledge of this oldest Indian science, Which not only deals with the diseases but deals with the Body, Mind & Disease simultaneously and that can reverse the major risk factors of such type of Progressing diseases in India.
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