Doctor explains: The alarming surge in cardiovascular diseases and how to combat them

Cardiovascular diseases (CVDs) remain the leading cause of death worldwide, accounting for 32 per cent of global fatalities. According to statistics from the World Health Organisation, CVDs claimed 17.9 million lives in 2019 with heart attacks and of these deaths, 85% were died due to heart attack and stroke. A staggering 75% of CVDs accounted for 38% of the 17 million premature deaths (under age 70) due to non-communicable diseases in the same year, according to the WHO.

We spoke with Dr. Sukriti Bhalla, Senior Consultant- Cardiology at Aakash Healthcare (New Delhi) to discuss the detection, awareness, prevention and management of disease to help prevent heart attacks.

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Cardiovascular diseases remain the leading cause of death globally. What are the most common heart conditions, and what are the major risk factors contributing to their prevalence?

Dr. Sukriti Bhalla: Yes, heart disease is the leading cause of death worldwide at the moment. The most common form of heart disease is coronary artery disease, which affects the arteries supplying blood to the heart. Any blockage in these arteries can lead to heart attacks, whether minor or major. There are modifiable and non-modifiable risk factors. Modifiable factors include weight, obesity, and hypertension. While hypertension can be genetic, we can control it. We can also reduce smoking, alcohol intake, and exposure to toxins. These are some of the risk factors that can help reduce the burden of coronary artery disease.

What are the most common types of cardiovascular diseases, and what symptoms, diagnoses, and treatments are available?

Dr. Sukriti Bhalla: The most common heart diseases can be divided into coronary artery disease, structural heart disease, and some genetic or familial heart conditions present at birth. Coronary artery disease presents with symptoms like palpitations, sweating, shortness of breath, and tiredness. Structural heart disease, which could involve a valve issue or a hole in the heart, presents different symptoms such as chest heaviness, palpitations, and breathlessness. There are other types like hypertensive heart disease and pregnancy-induced heart disease, and while the categories differ, many symptoms, such as dyspnea, palpitations, and excessive tiredness, overlap.

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With rising cases of heart disease among the younger population, what are the key risk factors contributing to this trend?

Dr. Sukriti Bhalla: The younger population needs to pay attention to what they eat. Excessive consumption of palm oil, fried food, and unhealthy food habits increase risks. Maintaining a healthy weight, regular exercise, avoiding smoking, reducing alcohol intake, and avoiding harmful substances are crucial. Gym-goers should be cautious about using metabolic steroids, as they can harm the heart. Even some types of protein supplements can lead to dilated cardiomyopathy. Young people need to understand these risks and have regular cardiology check-ups.

What role do genetics play in heart disease, and should individuals with a family history of heart issues take specific preventive measures?

Dr. Sukriti Bhalla: Genetics is essential. If you have a family history of heart disease—say your father had a heart attack at 50—there is a chance you could have one at 40. Genetic factors like high cholesterol, lipoprotein(a), and homocysteine levels can increase risk. Therefore, individuals with such histories should undergo earlier and more frequent health checkups and keep metabolic diseases like hypertension and diabetes under control.

How has technology, such as medical health devices and telemedicine, impacted heart disease management and prevention?

Dr. Sukriti Bhalla: Technology has played a significant role. Many young people now use digital watches and phones that track their steps and heart rate. Some devices even offer electrocardiogram (ECG) monitoring. This can help identify potential issues early. However, while the internet offers a lot of information, it’s important to confirm symptoms and consult a cardiologist rather than self-diagnosing.

Heart disease symptoms in women often differ from those in men. What should women specifically be aware of when it comes to heart problems? Why is heart disease sometimes underdiagnosed in women?

Dr. Sukriti Bhalla: Women often underplay their symptoms, and for a long time, we benefited from the protective effect of estrogen. However, with the increasing use of hormonal therapies, as well as smoking and alcohol consumption, women are now at a higher risk of developing heart disease at an earlier age. Pregnant women, for instance, may experience shortness of breath not only due to low hemoglobin but also due to pregnancy-induced cardiomyopathy, which is reversible if treated in time.

What are the most common congenital heart conditions seen in children, and how can they be detected early?

Dr. Sukriti Bhalla: Congenital heart diseases include atrial septal defects, ventricular septal defects, tetralogy of Fallot, and transposition of great arteries, among others. These can now be detected early through fetal echocardiograms before birth. If there is a family history of heart disease, genetic testing and early echocardiograms can help in identifying these conditions before the child is born.

What has been the impact of COVID-19 on heart health, particularly for individuals with pre-existing heart conditions? Are there long-term cardiovascular effects for people who have recovered from COVID-19, and what precautions should they take?

Dr. Sukriti Bhalla: COVID-19 put many people in a thrombogenic state, leading to coagulopathy, which in turn caused thrombotic events and cardiovascular complications. While we observed many cardiovascular issues during the pandemic, including cases of myocarditis (MIS) in younger patients, we still don’t have enough data to definitively state how much COVID-19 contributes to long-term heart disease. People who had COVID or were vaccinated should monitor any changes in their health, such as rising cholesterol levels, the onset of diabetes, or chest pain, and seek early diagnosis and treatment.

How is artificial intelligence (AI) and machine learning being used to improve cardiovascular care?

Dr. Sukriti Bhalla: AI has been helpful in many areas, including assisting with early diagnosis and patient education. However, there’s a lot of misinformation as well, so people need to consult with a doctor before jumping to conclusions based on what they read online. AI should be used judiciously in collaboration with healthcare professionals.