Dr. Naresh Trehan of Escorts Hospital puts forth three shocking bare facts regarding heart-ailments. Firstly, the incidence of coronary heart disease is rising rather alarmingly in India. Secondly, it is striking comparatively younger persons in the most productive years when they are the most productive and useful to their families and the nation. More prone to it are those people (in their 30’s and 40’s) who are very much result and target oriented and are always working under the conditions of acute stress. And finally, wrong eating-habits are the root cause of this fatal ailment constituting as much as 91 cases per hundred. Foods, such as junk food having low nutritive value and those with high fatty acid, consumption of which slowly leads to deposition of cholesterol in the arteries attached to heart, are a sort of slow poison for the people above the age of thirty.

Cardiologists the world over are engaged in discovering now methods of treating heart diseases. Some of these methods entail innovations in extensive care of heart patients in units equipped with sophisticated electronic gadgets, new and effective drugs, refined and improved techniques of balloon angioplasty and coronary artery bypass graft save a number of lives with these procedures, improve the quality of life in some and even prolong life to some extent in a subset of patients. It must be realized that these facilities can be provided only to a limited number of privileged people in the major cities of the country. Even if one has a few dozens of multicrore centres and hospitals doing open heart surgery, it will never solve the problem of the teeming millions. Medical science cannot provide them with a vaccine and immunize them against a heart attack. They can, at best, provide one with more hospitals so that one has a chance of survival after one has a heart attack. Yet, the hospitals are too inadequate in number and have facilities tagged with heavy prices. And even then they do not guaranty the non-recurrence of the attack. So where does one go from this dead-end showing a ‘no way out’ signboard? Is there any solution to this grave problem? Well, the solution is available says Dr. Bimal Chahajer, former assistant professor at AIIMS and the Director of SAAOL (Science and Art of Living). He brings a ray of hope of ressurection to those who have undergone the trauma of heart attack by quoting a well known phrase – Prevention is better than Cure. Despite advancements made in the field of medicine and surgery, prevention is the best measure to control the disease. He further adds that however today there may be tens of surgical cures such as balloon angioplasty, bypass graft surgery, cold laser therapy etc. available world wide to treat heart-ailments, yet they are not the ultimate cures of heart disease because they just combat the present acute phase of illness by surgical interventions and bring the patient back to normal with a temporary relief (besides carrying risks along with them). Moreover, the most important disadvantage of these surgeries is early recurrence of blockages. The statistics show that about 50% of patients come back with a reblock with in the 6 months. Therefore what is required for the better chances of survival leading to a long and healthy life is maintenance of the heart’s health. As coronary blockages develop due to the risk factors majority of which is related to wrong living, the treatment should be rectification of the lifestyle.

What we generally call a heart attack, doctors call it Coronary Heart Disease (CHD) or Coronary Artery Disease (CAD) or Ischaemic Heart Disease (IHD). It is also called the plague of the nineties. Once believed to be a disease of rich and the affluent in the developed countries, it is striking Indians rather steeply. Survey in Delhi’s urban areas has brought a disturbing aspect of CHD. It is more prevalent among the younger population between their 30’s and 40’s. Two new cases of CHD are being detected each hour in Delhi. If Delhi alone represents urban India, then 100 new cases of heart disease increase every hour, that means roughly 2500 cases per day. The initial report by Bhartiya Trust who did house to house survey in Delhi tells that 32 out of every 100 are suffering from CHD. That was way back in 1988. This picture is every gloomier now. A recent survey estimates 52.5 millions of heart patients in India by the year 2001 if the present trends of CHD are not arrested. Another noteworthy fact is that it’s the men only who bear the brunt of heart attacks more. Ninety percent of heart attacks occur in males. The females are quite resistant to get heart attacks but after the age of 50 years, they face the similar frequency as in males. The reason why females get less heart-attacks is not very clear but it is thought that certain females harmones like oestrogen and less smoking may be protecting them.

Dr. T.S. Mahant of Batra Hospital & Dr. Naresh Trehan of Escorts Hospital throw light on the major causes leading to blockage in the arteries attached to heart. The risk factors for CHD may be classified further into physical, behavioural and medical factors.

Physical factors:
(i) lack of physical activity & exercise
(ii) obesity or over weight.

Behavior factors :
(i) high stress, anxiety
(ii) smoking, drinking, tobacco chewing
(iii) food habits, milk products, non vegetarian food rich in fatty acids and calories.

medical factors :
(i) high blood pressure
(ii) high serum cholesterol and triglycerides
(iii) low HDL cholesterol
(iv) highblood sugar.

All the factors above are almost equally responsible for CHD. They further add that prevention and healing of disease does not rest in the hands of a selected few, but in the hands of every human being. The physicians can only augment the healing process. Therefore, a patient or any human being above the age of thirty by changing his style of living and following some simple, yet crucial measures can prevent a heart attack almost completely. Here again, Dr. Chajjer opines that the best and the ultimate cure of the heart ailments is the reversal of the same. The reversal of majority of risk factors can also reverse the coronary artery deposits thereby healing the heart ailments completely. Till 10-15 years back the cardiologists were of the opinion that heart disease was a permanent disease and would progressively worsen. A series of research studies has proved this concept wrong in the last decade and also has shown that a reversal is possible if serum cholesterol can be lowered along with Stress Management, Yoga, Dietary and Modification. Animal experiments with lipid lowering drugs have also substantiated the reversal theory. In fat deposition spots, the superficial layer of the blocks are more amenable to reversal as they are newly deposited. Here, he refers to Dr. Dean Ornish of America who pioneered the reversal procedure of heart ailments by formulating a plan of life style changes which had 4 major disciplines, all aiming at an integrated attack on heart disease and its reversal.

(i) Stress management which would comprise of Yoga, Meditation, Imagery and Breathing exercises all together for the duration of not more than an hour a day.
(ii) Light Aerobic exercise which would usually be the quite convenient half an hours week.
(iii) He would ask his patients to stop smoking.
(iv) And to adhere to a strictly Vegetarian Diet extremely low in fat content.

Dr. Dean Ornish’s approach to combating heart disease and its reversal produced remarkable results.
But Dr. K.K. Aggarwal director of Heart care foundation of India prescribes another remarkable cure which combines both, the surgical treatment and the reversal procedure with Yoga & Meditation. According to him this combination surely produces better results with a speedy recovery. Leaning on just any of these two may not help. He firmly believes in the connection between the mind and the body. While giving prescription to his patients h tells them to take a mental and spiritual bath too. He says that the patient himself has to be his own doctor of course with the advice of his physician.