Let us beat the blues of the heart

Dr Richa Sharma, CNS Correspondent, India
The number of sudden demises of visibly healthy individuals, with no relevant medical history, due to cardiac arrests or heart failures has reportedly escalated in recent times. Cardio vascular diseases, or CVDs as they are more commonly called, seem to have penetrated all layers of society affecting one and all. They are no longer associated with just the supposedly rich, urban, and/or older class of citizens.

A number of risk factors, namely age, gender, tobacco use, physical inactivity, unhealthy diet, obesity, hypertension, hyper lipidemia and diabetes (1),  have been enumerated in reports responsible for the high incidence of CVDs. However, one of the major risk factors that remains highly neglected in almost all the targeted interventions is stress- stress at work place, or at school/college or even in social relationships and the likes. India is witnessing a demographic transition (population ageing), an epidemiologic transition (shift from communicable to non communicable diseases) and a nutritional transition (high caloric consumption and low physical activity), and all these have subsequently resulted in a substantial increase in the non communicable disease (NCDs) related deaths. This reflects in the ever increasing mortality figures from India (almost 53% of total deaths) and 44% of disability adjusted life years (DALYs).

The projections further predict an increase to 67% of total deaths by 2030 with CVD being a major contributor to this burden accounting for 52% of NCD associated deaths and 29% of total deaths. Moreover, India is also witnessing a rapidly evolving and developing technological front and consequently stress has inevitably tiptoed in and created a niche for itself in our lives.

The government of India launched the National Programme for Prevention and Control of Diabetes, Cardiovascular Disease and Stroke in 2008 in the wake of growing realization about the humongous impact of NCDs over the health of population. The programme document enlists strategies to address stress. However, the implementation of these strategies remains largely undermined. In today’s competitive environment, most people do not have enough time for themselves or for their families. Technologically driven lifestyles, goal oriented demands, job related competition and deadlines to meet, etc. have made the people adept at adapting to ever changing times. Simultaneously, all this has disrupted the fine balance between work and a peaceful life. A vast majority of the cardiac patients are in the age group of 15-59 years-- the most productive years of life. Stress is also responsible for the lifestyle people are opting for now-- it directly or indirectly leads to unhealthy diet choices, smoking, alcohol consumption and low level of physical activity.

 As mentioned by Dr Jose L Castro, the New Chair of NCD Alliance and Executive Director of International Union Against Tuberculosis and Lung Disease (The Union), in a webinar hosted by Citizen News Service, it is imperative for the governments to integrate and highlight NCDs as a priority in national programmes and be accountable for the commitments they have made. He also highlighted the crucial role played by civil society organizations to consistently advocate in support of NCD prevention. This is very important to ensure constant support to NCD programmes and to make the policy makers realize the growing importance of paying adequate attention to these ‘silent killers’.

 However, given the current situation, merely the government and/or civil society organizations should not be expected to address the stresses of everyday life faced by individuals. They can be used as a vehicle to channelize proper behavioral change programmes by spreading health education, promoting a healthy lifestyle and creating more awareness about making proper choices. But the onus of maintaining the lifestyle choices lies on individuals. It should be inculcated in every individual to make informed choices that are essential for ensuring a better, healthy and hearty lifestyle.

Additionally, at organization levels, educational institutions and workplaces should ensure a relatively stress-free environment, within the realms of possibility and also ensure effective functioning of committees to tackle various issues. As Dr. Castro mentioned in the webinar, low and middle income countries are faced with the double burden of NCDs and their ill preparedness to handle this burden. They have paltry developmental assistance for dealing with NCDs. So it becomes all the more important for the individual and the community to be accountable for their personal actions and choices.

Dr Richa Sharma, Citizen News Service - CNS
October 3, 2015