F.P. Report
PESHAWAR: The secret to living well and longer is eat half, walk double, laugh triple, and love without measure. Both genetic and lifestyle factors contribute to individual-level risk of coronary artery disease.
The extent to which increased genetic risk can be offset by a healthy lifestyle is well-known. We need to make the move from secondary to primary and primordial prevention. Focus on overall wellness while accounting for social context and Social determinants of health (SDOH) will pay large dividends for various NCDs. Age, Sex, Hypertension, smoking and Diabetes are the main causes of heart diseases and an ideal Cardio Vascular Health (CVH) can mitigate 50% of the increased risk associated with non-ideal genetic makeup. Multi-sartorial approaches and approaches across the life span are needed in Pakistan.
These remarks were stated by cardiologist experts Dr. Saleem S. Virani, Dr. Khurram Nasir and Dr. Naeem Tahirkheli from United States of America (USA) during 51st Cardio-Con organized by Pakistan Cardiac Society held at Khyber Medical University (KMU), Peshawar. The vice chancellor KMU Prof. Dr. Zia ul Haq, ex vice chancellor Prof. Dr. Muhammad Hafizullah, Prof. Dr. Sheryar A. Shaikh, Prof. Dr. Sohail Aziz, Prof. Dr. Kiramat Ali Shah and Prof. Dr. Sahibzada A. Waheed were also talked to the conference.
The experts said that across four studies involving 55,685 participants, genetic and lifestyle factors were independently associated with susceptibility to coronary artery disease. Among participants at high genetic risk, a favorable lifestyle was associated with a nearly 50% lower relative risk of coronary artery disease than was an unfavorable lifestyle.
Indo-Pakistani populations have one of the highest risks of coronary artery disease (CAD) in the world. Apart from smoking, women had more CAD risk factors (diabetes, hypertension, obesity, dyslipidemia) than men. Definite CAD (history and Q waves on ECG) was more prevalent in men than in women (6.1% vs 4.0%).
The findings indicate that one in five middle-aged adults in urban Pakistan may have underlying CAD. Women are at greater risk than men.
A US based study revealed that South Asians had higher prevalence of T2D 23 % compared with other ethnicities (6% in Caucasians, 13% Chinese Americans, 17% Hispanics, 18% in Blacks). South Asians have increased visceral fat in the abdomen liver and around the heart. Approximately 6% of pregnancies in the US are complicated by gestational diabetes mellitus (GDM), estimated prevalence of GDM in South Asia is up to 17%. GDM results in long term increase in CV risk for both mother and offspring.
South Asians have a distinct bio profile related to measures of insulin resistance, biomarkers and lipid markers. Diabetes and Coronary heart disease (CHD) is more frequent and more premature in South Asians. Premature hypertension also appears to be more prevalent in South Asians.
There is an ongoing need for further disaggregation of ASCVD risk among various subgroups of South Asian individuals. Most of the ASCVD in South Asians can be explained by traditional risk factors.
