116. Prevention of Heart Attack


Prevention of Heart Attack has indisputable public health importance. Given the prevalence, preventing even a small proportion of events would save thousands of lives, avoid inestimable suffering, and save billons of health care rupees. In addition, measures that prevent Heart Attack may also mitigate other manifestations of atherosclerosis (hardening of arteries), such as stroke and peripheral artery disease and may have an impact on hypertension, diabetes, cognitive function, cancer, depression and other chronic conditions.

Because cardiovascular disease (CVD) mainly Heart Attack has become the number one killer worldwide, widespread deployment of affordable preventive strategies should have high priority in developed and developing countries. When CVD first emerged as the dominant chronic disease in high-income countries, it was thought of as a natural consequence of aging. But CVD appears in most cases to be predominantly a human-made disease, heavily influenced by the choices we make. The past 50 years have witnessed great progress in identifying a large number of lifestyle, as well as biochemical and genetic, factors associated with CVD and in disseminating this information to the public.

Heart Attack generally results from the convergence of a number of factors. Most people with CVD have small, concurrent adverse changes in multiple risk factors rather than extreme deviations in any single risk factor. Left unchecked, atherosclerosis will proceed along a continuum. Predisposing factors such as genes interact with behavioural factors, such as the type of diet an individual follows, whether he or she drinks alcohol, and the amount of exercise he or she gets on a regular basis.

This combination of predisposing factors and behaviours can lead to metabolic abnormalities, such as high cholesterol, hypertension, obesity and diabetes, which may eventually result in quiescent disease. Eventually, this quiescent disease may become overt in the form of a stroke, heart attack or other cardiovascular events. Clues to this underlying quiescent disease can be obtained by using various diagnostic tests.