Data analysis of 4000 consecutive patients having Coronary Artery Disease, who visited the Cardiology department of Indira Gandhi Medical College (IGMC) Shimla in 2018, indicated that the number of patients from rural areas of Himachal Pradesh was higher than those from urban areas.
As many as 92% of patients were from rural areas, although the population of rural areas of Himachal is 70 % ( as per the 2011 census).
The analysis showed that 60 % of the total 4000 patients had high Blood Pressure and 40% had Diabetes. High BP and Diabetes were more common in urban patients than those from rural areas.
The objective of this data collection and analysis was to understand the demographic profile, urban-rural distribution and their reasons for a heart attack to plan informed interventions to decrease the burden of heart attack in Himachal Pradesh, said Dr PC Negi, a noted cardiologist and Professor at IGMC, Shimla.
Although there are six government medical colleges in Himachal Pradesh, yet majority of heart patients from the state come to IGMC, the oldest medical College and hospital, which has the best facility.
The data showed that about 50% of patients had pre-diabetes, which was equally prevalent in patients from urban and rural areas. Seventy per cent of the patients, both from urban and rural areas, had high cholesterol, 70% were overweight and/or obese.
This too was equally prevalent in urban and rural patients.
As many as 35% of patients were leading sedentary lives and 25% were consuming tobacco.
The number of patients consuming tobacco, however, was similar in urban and rural populations.
The analysis brought to light that although the patients were prescribed medicines as per the recommendation of professional scientific bodies, several patients with controlled BP, sugar, and high cholesterol were seen in only less than 30%.
Dr Negi said the likely reasons for suboptimal control of risk factors could be due to persistent consumption of unhealthy diet, leading sedentary life, prevalent obesity, and poor adherence to prescribed treatment.
"Uncontrolled BP, sugar, high cholesterol, continuing consumption of tobacco, failure to achieve optimum body weight, physical inactivity are important drivers of recurrence of heart attack, heart failure, disabilities and premature deaths," he said.
The high burden of Coronary Artery Disease ( that may lead to heart attack) in general and in rural populations in particular in HP is a cause of concern.
"We now know why people get heart attacks and how we can prevent it. But the biggest challenge is its implementation of preventive measures at the population level. There is an urgent need to strengthen primary health care systems in the state in terms of adequate trained manpower, diagnostics, ensuring availability of drugs, IT-enabled monitoring tools for early detection of people at risk of heart attack and their risk management to reduce the risk of heart attack and premature deaths could be decreased, " said Dr Negi.
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