New Risk Scale for Indian Hearts

CHENNAI: India will soon have its own thresholds for risk factors like diabetes, hypertension and lipid profiles that can lead to cardiac diseases. This follows a finding that Indians are likely to get cardiac disorders even if the risk factors were lower than those defined by Western countries. The Indian Council of Medical Research and Apollo Hospitals will soon bring out India-specific guidelines on levels of blood sugar, blood pressure and cholesterol that would require medical intervention or lifestyle modification, said Apollo Hospitals chairman Dr Prathap C Reddy, ahead of the Cardiology Society of India's 60th annual conference. The ICMR recently brought out Indian guidelines for obesity. "At present, we follow the Western guidelines to say that a person with fasting sugar above 126 mg/dl is diabetic. It is a cause for concern if the cholesterol level is above 150. We are looking at bringing in our own values,'' he said. The study was undertaken after Apollo Hospital's analysis of CT scans showed that at least 5% of people in the region developed heart diseases even without having any of the five defined risk factors cholesterol, hypertension, diabetes, family history of heart disease and smoking. Worse, a majority of these patients developed diabetes or hypertension a decade later. The study, presented to the European Atherosclerosis Society, was carried out by the department of radiology at the Apollo Heart Centre. "We used the data of more than 4,000 people, who underwent CT scans at our centre. Though 10% of them had no risk factors, nearly half of them had cardiac diseases. Unlike the common trend where people acquire heart disease after developing risk factors, here the heart disease acts as precursor to diabetes and hypertension,'' consultant radiologist Dr Rochita V Ramanan told visiting members of the American College of Cardiology. "We also found that nearly 80% of people who have abdominal obesity have heart diseases. The key indication to these diseases is that it is preventable if we see the warning signs early,'' Dr Ramanan said. India, according to WHO, would be the world capital of cardiac disease by 2015. Indian cardiac patients are already at least 10 years younger than counterparts in the West. It's not because Indians are genetically predisposed, but because the risk factors that lead to cardiac diseases among Indians are underestimated, said Dr Jagat Narula, professor of medicine, chief of cardiology, University of California.