Heart Diseases Burden and Risk Management

Prof Rishi SethiMDDMFACCFESCFSCAIFAPSICMAMS

Department of CardiologyKing Georgersquos Medical University

LucknowIndia

Inspired by-

Global Burden of Cardiovascular Disease

Global Mortality from Coronary Artery Disease

Relative Mortality Rates

Economic Burden of Cardiovascular Diseases

bull Four non-communicable disorders (NCD) together contribute to ndash 59 of global mortality (317 million deaths) and ndash 43 of the global burden of disease in

bull The Cardiovascular diseases alone accounts for 34 of all deaths in women and 28 in men

bull The World Health Report estimates that in 85 of the CV burden arose from the low and middle income countries

The World Health Report Making a Difference Geneva World Health Organization 1999

Cardiovascular diseases

Risk factorsamp

prevention

Raised blood pressure (13 per cent of global deaths is attributed)

Tobacco use (9 per cent) Raised blood glucose (6 per cent) Physical inactivity (6 per cent) and Overweight and obesity (5 per cent)

Global Atlas on Cardiovascular Disease Prevention and Control Mendis S Puska P Norrving B editors World Health Organization (in collaboration with the World Heart Federation and World Stroke Organization) Geneva 2011

In Terms of Attributable Deaths

Prominent Risk Factors for CV Diseases

bull Smokingbull Hypertensionbull Dyslipidemia bull Metabolic Syndromebull Mental Stress

Modifiable risk factors

Hypertension (high blood pressure)

ndash Globally nearly one billion people have hypertension

ndash The ldquosilent killer because it often has no warning signs or symptoms

ndash People with hypertension are more likely to develop complications of diabetes

World Health Organization Regional Office for Southeast Asia Hypertension fact sheet

bull Encourage an optimal blood pressure of less then 12080 mm Hg through lifestyle approaches

bull Pharmacologic therapy is indicated when blood pressure is gt 14090 mm Hg

Tobacco usebull Cause nearly 10 per cent of all CVDbull Higher risk in female smokers young men and heavy

smokersbull Currently about 1 billion smokers in the world todaybull Within two years of quitting the risk of coronary heart

disease is substantially reduced and within 15 years the risk of CVD returns to that of a non-smoker

Teo KK Ounpuu S Hawken S et al INTERHEART Study Investigators Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study a case-control study Lancet 2006368(9536)647ndash658

HOW SMOKING HARMS THECARDIOVASCULAR SYSTEM

bull Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed

bull This can narrow the blood vessels and can lead to many cardiovascular conditions

bull Atherosclerosisbull Coronary Heart Disease bull Strokebull Peripheral Arterial Disease (PAD) bull Abdominal Aortic Aneurysm

Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome

Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK

Indian heart Journal 01200860(3)205-9

AbstractOBJECTIVE Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high

sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS)

METHODS Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay Patients were stratified by levels of hs-CRP into

low (lt1 mgL) intermediate (1-3 mgL) or high (gt3 mgL) groups and in tertiles of 0-039 mgL 04-11 mgL and gt11 mgL respectively Classification of patient into upper (214) middle (4537 percent) and lower (333) SES was based on Kuppuswami Index which includes education income and profession Presence or absence of traditional risk factors for CAD diabetes hypertension dyslipidemia and smoking was recorded in each patient

RESULTS Mean levels of hs-CRP in lower middle and upper SES were 23 +- 21 mgL 08 +- 17 mgL and 12 +- 15 mgL respectively hs-CRP

levels were significantly higher in low SES compared with both upper SES (p = 0033) and middle SES (p = 0001) Prevalence of more than one traditional CAD risk factors was seen in 135 375 and 6767 percent in patient of lower middle and upper SES It was observed that multiple risk factors had a linear correlation with increasing SES Of the four traditional risk factors of CAD smoking was the only factor which was significantly higher in lower SES (73) as compared to middle (5167 percent) and upper (394) SES We found that 623 208 and 265 patients of low middle and upper SES had hs-CRP values in the highest tertile Median value of the Framingham risk score in low middle and upper SES as 11 14 and 18 respectively We observed that at each category of Framingham risk low SES had higher hs-CRP

CONCLUSION We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser

traditional risk factors and lower Framingham risk These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors

Inspired by-

Global Burden of Cardiovascular Disease

Global Mortality from Coronary Artery Disease

Relative Mortality Rates

Economic Burden of Cardiovascular Diseases

bull Four non-communicable disorders (NCD) together contribute to ndash 59 of global mortality (317 million deaths) and ndash 43 of the global burden of disease in

bull The Cardiovascular diseases alone accounts for 34 of all deaths in women and 28 in men

bull The World Health Report estimates that in 85 of the CV burden arose from the low and middle income countries

The World Health Report Making a Difference Geneva World Health Organization 1999

Cardiovascular diseases

Risk factorsamp

prevention

Raised blood pressure (13 per cent of global deaths is attributed)

Tobacco use (9 per cent) Raised blood glucose (6 per cent) Physical inactivity (6 per cent) and Overweight and obesity (5 per cent)

Global Atlas on Cardiovascular Disease Prevention and Control Mendis S Puska P Norrving B editors World Health Organization (in collaboration with the World Heart Federation and World Stroke Organization) Geneva 2011

In Terms of Attributable Deaths

Prominent Risk Factors for CV Diseases

bull Smokingbull Hypertensionbull Dyslipidemia bull Metabolic Syndromebull Mental Stress

Modifiable risk factors

Hypertension (high blood pressure)

ndash Globally nearly one billion people have hypertension

ndash The ldquosilent killer because it often has no warning signs or symptoms

ndash People with hypertension are more likely to develop complications of diabetes

World Health Organization Regional Office for Southeast Asia Hypertension fact sheet

bull Encourage an optimal blood pressure of less then 12080 mm Hg through lifestyle approaches

bull Pharmacologic therapy is indicated when blood pressure is gt 14090 mm Hg

Tobacco usebull Cause nearly 10 per cent of all CVDbull Higher risk in female smokers young men and heavy

smokersbull Currently about 1 billion smokers in the world todaybull Within two years of quitting the risk of coronary heart

disease is substantially reduced and within 15 years the risk of CVD returns to that of a non-smoker

Teo KK Ounpuu S Hawken S et al INTERHEART Study Investigators Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study a case-control study Lancet 2006368(9536)647ndash658

HOW SMOKING HARMS THECARDIOVASCULAR SYSTEM

bull Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed

bull This can narrow the blood vessels and can lead to many cardiovascular conditions

bull Atherosclerosisbull Coronary Heart Disease bull Strokebull Peripheral Arterial Disease (PAD) bull Abdominal Aortic Aneurysm

Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome

Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK

Indian heart Journal 01200860(3)205-9

AbstractOBJECTIVE Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high

sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS)

METHODS Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay Patients were stratified by levels of hs-CRP into

low (lt1 mgL) intermediate (1-3 mgL) or high (gt3 mgL) groups and in tertiles of 0-039 mgL 04-11 mgL and gt11 mgL respectively Classification of patient into upper (214) middle (4537 percent) and lower (333) SES was based on Kuppuswami Index which includes education income and profession Presence or absence of traditional risk factors for CAD diabetes hypertension dyslipidemia and smoking was recorded in each patient

RESULTS Mean levels of hs-CRP in lower middle and upper SES were 23 +- 21 mgL 08 +- 17 mgL and 12 +- 15 mgL respectively hs-CRP

levels were significantly higher in low SES compared with both upper SES (p = 0033) and middle SES (p = 0001) Prevalence of more than one traditional CAD risk factors was seen in 135 375 and 6767 percent in patient of lower middle and upper SES It was observed that multiple risk factors had a linear correlation with increasing SES Of the four traditional risk factors of CAD smoking was the only factor which was significantly higher in lower SES (73) as compared to middle (5167 percent) and upper (394) SES We found that 623 208 and 265 patients of low middle and upper SES had hs-CRP values in the highest tertile Median value of the Framingham risk score in low middle and upper SES as 11 14 and 18 respectively We observed that at each category of Framingham risk low SES had higher hs-CRP

CONCLUSION We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser

traditional risk factors and lower Framingham risk These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors

Global Burden of Cardiovascular Disease

Global Mortality from Coronary Artery Disease

Relative Mortality Rates

Economic Burden of Cardiovascular Diseases

bull Four non-communicable disorders (NCD) together contribute to ndash 59 of global mortality (317 million deaths) and ndash 43 of the global burden of disease in

bull The Cardiovascular diseases alone accounts for 34 of all deaths in women and 28 in men

bull The World Health Report estimates that in 85 of the CV burden arose from the low and middle income countries

The World Health Report Making a Difference Geneva World Health Organization 1999

Cardiovascular diseases

Risk factorsamp

prevention

Raised blood pressure (13 per cent of global deaths is attributed)

Tobacco use (9 per cent) Raised blood glucose (6 per cent) Physical inactivity (6 per cent) and Overweight and obesity (5 per cent)

Global Atlas on Cardiovascular Disease Prevention and Control Mendis S Puska P Norrving B editors World Health Organization (in collaboration with the World Heart Federation and World Stroke Organization) Geneva 2011

In Terms of Attributable Deaths

Prominent Risk Factors for CV Diseases

bull Smokingbull Hypertensionbull Dyslipidemia bull Metabolic Syndromebull Mental Stress

Modifiable risk factors

Hypertension (high blood pressure)

ndash Globally nearly one billion people have hypertension

ndash The ldquosilent killer because it often has no warning signs or symptoms

ndash People with hypertension are more likely to develop complications of diabetes

World Health Organization Regional Office for Southeast Asia Hypertension fact sheet

bull Encourage an optimal blood pressure of less then 12080 mm Hg through lifestyle approaches

bull Pharmacologic therapy is indicated when blood pressure is gt 14090 mm Hg

Tobacco usebull Cause nearly 10 per cent of all CVDbull Higher risk in female smokers young men and heavy

smokersbull Currently about 1 billion smokers in the world todaybull Within two years of quitting the risk of coronary heart

disease is substantially reduced and within 15 years the risk of CVD returns to that of a non-smoker

Teo KK Ounpuu S Hawken S et al INTERHEART Study Investigators Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study a case-control study Lancet 2006368(9536)647ndash658

HOW SMOKING HARMS THECARDIOVASCULAR SYSTEM

bull Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed

bull This can narrow the blood vessels and can lead to many cardiovascular conditions

bull Atherosclerosisbull Coronary Heart Disease bull Strokebull Peripheral Arterial Disease (PAD) bull Abdominal Aortic Aneurysm

Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome

Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK

Indian heart Journal 01200860(3)205-9

AbstractOBJECTIVE Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high

sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS)

METHODS Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay Patients were stratified by levels of hs-CRP into

low (lt1 mgL) intermediate (1-3 mgL) or high (gt3 mgL) groups and in tertiles of 0-039 mgL 04-11 mgL and gt11 mgL respectively Classification of patient into upper (214) middle (4537 percent) and lower (333) SES was based on Kuppuswami Index which includes education income and profession Presence or absence of traditional risk factors for CAD diabetes hypertension dyslipidemia and smoking was recorded in each patient

RESULTS Mean levels of hs-CRP in lower middle and upper SES were 23 +- 21 mgL 08 +- 17 mgL and 12 +- 15 mgL respectively hs-CRP

levels were significantly higher in low SES compared with both upper SES (p = 0033) and middle SES (p = 0001) Prevalence of more than one traditional CAD risk factors was seen in 135 375 and 6767 percent in patient of lower middle and upper SES It was observed that multiple risk factors had a linear correlation with increasing SES Of the four traditional risk factors of CAD smoking was the only factor which was significantly higher in lower SES (73) as compared to middle (5167 percent) and upper (394) SES We found that 623 208 and 265 patients of low middle and upper SES had hs-CRP values in the highest tertile Median value of the Framingham risk score in low middle and upper SES as 11 14 and 18 respectively We observed that at each category of Framingham risk low SES had higher hs-CRP

CONCLUSION We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser

traditional risk factors and lower Framingham risk These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors

Global Mortality from Coronary Artery Disease

Relative Mortality Rates

Economic Burden of Cardiovascular Diseases

bull Four non-communicable disorders (NCD) together contribute to ndash 59 of global mortality (317 million deaths) and ndash 43 of the global burden of disease in

bull The Cardiovascular diseases alone accounts for 34 of all deaths in women and 28 in men

bull The World Health Report estimates that in 85 of the CV burden arose from the low and middle income countries

The World Health Report Making a Difference Geneva World Health Organization 1999

Cardiovascular diseases

Risk factorsamp

prevention

Raised blood pressure (13 per cent of global deaths is attributed)

Tobacco use (9 per cent) Raised blood glucose (6 per cent) Physical inactivity (6 per cent) and Overweight and obesity (5 per cent)

Global Atlas on Cardiovascular Disease Prevention and Control Mendis S Puska P Norrving B editors World Health Organization (in collaboration with the World Heart Federation and World Stroke Organization) Geneva 2011

In Terms of Attributable Deaths

Prominent Risk Factors for CV Diseases

bull Smokingbull Hypertensionbull Dyslipidemia bull Metabolic Syndromebull Mental Stress

Modifiable risk factors

Hypertension (high blood pressure)

ndash Globally nearly one billion people have hypertension

ndash The ldquosilent killer because it often has no warning signs or symptoms

ndash People with hypertension are more likely to develop complications of diabetes

World Health Organization Regional Office for Southeast Asia Hypertension fact sheet

bull Encourage an optimal blood pressure of less then 12080 mm Hg through lifestyle approaches

bull Pharmacologic therapy is indicated when blood pressure is gt 14090 mm Hg

Tobacco usebull Cause nearly 10 per cent of all CVDbull Higher risk in female smokers young men and heavy

smokersbull Currently about 1 billion smokers in the world todaybull Within two years of quitting the risk of coronary heart

disease is substantially reduced and within 15 years the risk of CVD returns to that of a non-smoker

Teo KK Ounpuu S Hawken S et al INTERHEART Study Investigators Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study a case-control study Lancet 2006368(9536)647ndash658

HOW SMOKING HARMS THECARDIOVASCULAR SYSTEM

bull Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed

bull This can narrow the blood vessels and can lead to many cardiovascular conditions

bull Atherosclerosisbull Coronary Heart Disease bull Strokebull Peripheral Arterial Disease (PAD) bull Abdominal Aortic Aneurysm

Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome

Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK

Indian heart Journal 01200860(3)205-9

AbstractOBJECTIVE Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high

sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS)

METHODS Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay Patients were stratified by levels of hs-CRP into

low (lt1 mgL) intermediate (1-3 mgL) or high (gt3 mgL) groups and in tertiles of 0-039 mgL 04-11 mgL and gt11 mgL respectively Classification of patient into upper (214) middle (4537 percent) and lower (333) SES was based on Kuppuswami Index which includes education income and profession Presence or absence of traditional risk factors for CAD diabetes hypertension dyslipidemia and smoking was recorded in each patient

RESULTS Mean levels of hs-CRP in lower middle and upper SES were 23 +- 21 mgL 08 +- 17 mgL and 12 +- 15 mgL respectively hs-CRP

levels were significantly higher in low SES compared with both upper SES (p = 0033) and middle SES (p = 0001) Prevalence of more than one traditional CAD risk factors was seen in 135 375 and 6767 percent in patient of lower middle and upper SES It was observed that multiple risk factors had a linear correlation with increasing SES Of the four traditional risk factors of CAD smoking was the only factor which was significantly higher in lower SES (73) as compared to middle (5167 percent) and upper (394) SES We found that 623 208 and 265 patients of low middle and upper SES had hs-CRP values in the highest tertile Median value of the Framingham risk score in low middle and upper SES as 11 14 and 18 respectively We observed that at each category of Framingham risk low SES had higher hs-CRP

CONCLUSION We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser

traditional risk factors and lower Framingham risk These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors

Relative Mortality Rates

Economic Burden of Cardiovascular Diseases

bull Four non-communicable disorders (NCD) together contribute to ndash 59 of global mortality (317 million deaths) and ndash 43 of the global burden of disease in

bull The Cardiovascular diseases alone accounts for 34 of all deaths in women and 28 in men

bull The World Health Report estimates that in 85 of the CV burden arose from the low and middle income countries

The World Health Report Making a Difference Geneva World Health Organization 1999

Cardiovascular diseases

Risk factorsamp

prevention

Raised blood pressure (13 per cent of global deaths is attributed)

Tobacco use (9 per cent) Raised blood glucose (6 per cent) Physical inactivity (6 per cent) and Overweight and obesity (5 per cent)

Global Atlas on Cardiovascular Disease Prevention and Control Mendis S Puska P Norrving B editors World Health Organization (in collaboration with the World Heart Federation and World Stroke Organization) Geneva 2011

In Terms of Attributable Deaths

Prominent Risk Factors for CV Diseases

bull Smokingbull Hypertensionbull Dyslipidemia bull Metabolic Syndromebull Mental Stress

Modifiable risk factors

Hypertension (high blood pressure)

ndash Globally nearly one billion people have hypertension

ndash The ldquosilent killer because it often has no warning signs or symptoms

ndash People with hypertension are more likely to develop complications of diabetes

World Health Organization Regional Office for Southeast Asia Hypertension fact sheet

bull Encourage an optimal blood pressure of less then 12080 mm Hg through lifestyle approaches

bull Pharmacologic therapy is indicated when blood pressure is gt 14090 mm Hg

Tobacco usebull Cause nearly 10 per cent of all CVDbull Higher risk in female smokers young men and heavy

smokersbull Currently about 1 billion smokers in the world todaybull Within two years of quitting the risk of coronary heart

disease is substantially reduced and within 15 years the risk of CVD returns to that of a non-smoker

Teo KK Ounpuu S Hawken S et al INTERHEART Study Investigators Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study a case-control study Lancet 2006368(9536)647ndash658

HOW SMOKING HARMS THECARDIOVASCULAR SYSTEM

bull Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed

bull This can narrow the blood vessels and can lead to many cardiovascular conditions

bull Atherosclerosisbull Coronary Heart Disease bull Strokebull Peripheral Arterial Disease (PAD) bull Abdominal Aortic Aneurysm

Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome

Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK

Indian heart Journal 01200860(3)205-9

AbstractOBJECTIVE Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high

sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS)

METHODS Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay Patients were stratified by levels of hs-CRP into

low (lt1 mgL) intermediate (1-3 mgL) or high (gt3 mgL) groups and in tertiles of 0-039 mgL 04-11 mgL and gt11 mgL respectively Classification of patient into upper (214) middle (4537 percent) and lower (333) SES was based on Kuppuswami Index which includes education income and profession Presence or absence of traditional risk factors for CAD diabetes hypertension dyslipidemia and smoking was recorded in each patient

RESULTS Mean levels of hs-CRP in lower middle and upper SES were 23 +- 21 mgL 08 +- 17 mgL and 12 +- 15 mgL respectively hs-CRP

levels were significantly higher in low SES compared with both upper SES (p = 0033) and middle SES (p = 0001) Prevalence of more than one traditional CAD risk factors was seen in 135 375 and 6767 percent in patient of lower middle and upper SES It was observed that multiple risk factors had a linear correlation with increasing SES Of the four traditional risk factors of CAD smoking was the only factor which was significantly higher in lower SES (73) as compared to middle (5167 percent) and upper (394) SES We found that 623 208 and 265 patients of low middle and upper SES had hs-CRP values in the highest tertile Median value of the Framingham risk score in low middle and upper SES as 11 14 and 18 respectively We observed that at each category of Framingham risk low SES had higher hs-CRP

CONCLUSION We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser

traditional risk factors and lower Framingham risk These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors

Economic Burden of Cardiovascular Diseases

bull Four non-communicable disorders (NCD) together contribute to ndash 59 of global mortality (317 million deaths) and ndash 43 of the global burden of disease in

bull The Cardiovascular diseases alone accounts for 34 of all deaths in women and 28 in men

bull The World Health Report estimates that in 85 of the CV burden arose from the low and middle income countries

The World Health Report Making a Difference Geneva World Health Organization 1999

Cardiovascular diseases

Risk factorsamp

prevention

Raised blood pressure (13 per cent of global deaths is attributed)

Tobacco use (9 per cent) Raised blood glucose (6 per cent) Physical inactivity (6 per cent) and Overweight and obesity (5 per cent)

Global Atlas on Cardiovascular Disease Prevention and Control Mendis S Puska P Norrving B editors World Health Organization (in collaboration with the World Heart Federation and World Stroke Organization) Geneva 2011

In Terms of Attributable Deaths

Prominent Risk Factors for CV Diseases

bull Smokingbull Hypertensionbull Dyslipidemia bull Metabolic Syndromebull Mental Stress

Modifiable risk factors

Hypertension (high blood pressure)

ndash Globally nearly one billion people have hypertension

ndash The ldquosilent killer because it often has no warning signs or symptoms

ndash People with hypertension are more likely to develop complications of diabetes

World Health Organization Regional Office for Southeast Asia Hypertension fact sheet

bull Encourage an optimal blood pressure of less then 12080 mm Hg through lifestyle approaches

bull Pharmacologic therapy is indicated when blood pressure is gt 14090 mm Hg

Tobacco usebull Cause nearly 10 per cent of all CVDbull Higher risk in female smokers young men and heavy

smokersbull Currently about 1 billion smokers in the world todaybull Within two years of quitting the risk of coronary heart

disease is substantially reduced and within 15 years the risk of CVD returns to that of a non-smoker

Teo KK Ounpuu S Hawken S et al INTERHEART Study Investigators Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study a case-control study Lancet 2006368(9536)647ndash658

HOW SMOKING HARMS THECARDIOVASCULAR SYSTEM

bull Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed

bull This can narrow the blood vessels and can lead to many cardiovascular conditions

bull Atherosclerosisbull Coronary Heart Disease bull Strokebull Peripheral Arterial Disease (PAD) bull Abdominal Aortic Aneurysm

Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome

Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK

Indian heart Journal 01200860(3)205-9

AbstractOBJECTIVE Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high

sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS)

METHODS Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay Patients were stratified by levels of hs-CRP into

low (lt1 mgL) intermediate (1-3 mgL) or high (gt3 mgL) groups and in tertiles of 0-039 mgL 04-11 mgL and gt11 mgL respectively Classification of patient into upper (214) middle (4537 percent) and lower (333) SES was based on Kuppuswami Index which includes education income and profession Presence or absence of traditional risk factors for CAD diabetes hypertension dyslipidemia and smoking was recorded in each patient

RESULTS Mean levels of hs-CRP in lower middle and upper SES were 23 +- 21 mgL 08 +- 17 mgL and 12 +- 15 mgL respectively hs-CRP

levels were significantly higher in low SES compared with both upper SES (p = 0033) and middle SES (p = 0001) Prevalence of more than one traditional CAD risk factors was seen in 135 375 and 6767 percent in patient of lower middle and upper SES It was observed that multiple risk factors had a linear correlation with increasing SES Of the four traditional risk factors of CAD smoking was the only factor which was significantly higher in lower SES (73) as compared to middle (5167 percent) and upper (394) SES We found that 623 208 and 265 patients of low middle and upper SES had hs-CRP values in the highest tertile Median value of the Framingham risk score in low middle and upper SES as 11 14 and 18 respectively We observed that at each category of Framingham risk low SES had higher hs-CRP

CONCLUSION We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser

traditional risk factors and lower Framingham risk These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors

bull Four non-communicable disorders (NCD) together contribute to ndash 59 of global mortality (317 million deaths) and ndash 43 of the global burden of disease in

bull The Cardiovascular diseases alone accounts for 34 of all deaths in women and 28 in men

bull The World Health Report estimates that in 85 of the CV burden arose from the low and middle income countries

The World Health Report Making a Difference Geneva World Health Organization 1999

Cardiovascular diseases

Risk factorsamp

prevention

Raised blood pressure (13 per cent of global deaths is attributed)

Tobacco use (9 per cent) Raised blood glucose (6 per cent) Physical inactivity (6 per cent) and Overweight and obesity (5 per cent)

Global Atlas on Cardiovascular Disease Prevention and Control Mendis S Puska P Norrving B editors World Health Organization (in collaboration with the World Heart Federation and World Stroke Organization) Geneva 2011

In Terms of Attributable Deaths

Prominent Risk Factors for CV Diseases

bull Smokingbull Hypertensionbull Dyslipidemia bull Metabolic Syndromebull Mental Stress

Modifiable risk factors

Hypertension (high blood pressure)

ndash Globally nearly one billion people have hypertension

ndash The ldquosilent killer because it often has no warning signs or symptoms

ndash People with hypertension are more likely to develop complications of diabetes

World Health Organization Regional Office for Southeast Asia Hypertension fact sheet

bull Encourage an optimal blood pressure of less then 12080 mm Hg through lifestyle approaches

bull Pharmacologic therapy is indicated when blood pressure is gt 14090 mm Hg

Tobacco usebull Cause nearly 10 per cent of all CVDbull Higher risk in female smokers young men and heavy

smokersbull Currently about 1 billion smokers in the world todaybull Within two years of quitting the risk of coronary heart

disease is substantially reduced and within 15 years the risk of CVD returns to that of a non-smoker

Teo KK Ounpuu S Hawken S et al INTERHEART Study Investigators Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study a case-control study Lancet 2006368(9536)647ndash658

HOW SMOKING HARMS THECARDIOVASCULAR SYSTEM

bull Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed

bull This can narrow the blood vessels and can lead to many cardiovascular conditions

bull Atherosclerosisbull Coronary Heart Disease bull Strokebull Peripheral Arterial Disease (PAD) bull Abdominal Aortic Aneurysm

Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome

Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK

Indian heart Journal 01200860(3)205-9

AbstractOBJECTIVE Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high

sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS)

METHODS Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay Patients were stratified by levels of hs-CRP into

low (lt1 mgL) intermediate (1-3 mgL) or high (gt3 mgL) groups and in tertiles of 0-039 mgL 04-11 mgL and gt11 mgL respectively Classification of patient into upper (214) middle (4537 percent) and lower (333) SES was based on Kuppuswami Index which includes education income and profession Presence or absence of traditional risk factors for CAD diabetes hypertension dyslipidemia and smoking was recorded in each patient

RESULTS Mean levels of hs-CRP in lower middle and upper SES were 23 +- 21 mgL 08 +- 17 mgL and 12 +- 15 mgL respectively hs-CRP

levels were significantly higher in low SES compared with both upper SES (p = 0033) and middle SES (p = 0001) Prevalence of more than one traditional CAD risk factors was seen in 135 375 and 6767 percent in patient of lower middle and upper SES It was observed that multiple risk factors had a linear correlation with increasing SES Of the four traditional risk factors of CAD smoking was the only factor which was significantly higher in lower SES (73) as compared to middle (5167 percent) and upper (394) SES We found that 623 208 and 265 patients of low middle and upper SES had hs-CRP values in the highest tertile Median value of the Framingham risk score in low middle and upper SES as 11 14 and 18 respectively We observed that at each category of Framingham risk low SES had higher hs-CRP

CONCLUSION We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser

traditional risk factors and lower Framingham risk These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors

Cardiovascular diseases

Risk factorsamp

prevention

Raised blood pressure (13 per cent of global deaths is attributed)

Tobacco use (9 per cent) Raised blood glucose (6 per cent) Physical inactivity (6 per cent) and Overweight and obesity (5 per cent)

Global Atlas on Cardiovascular Disease Prevention and Control Mendis S Puska P Norrving B editors World Health Organization (in collaboration with the World Heart Federation and World Stroke Organization) Geneva 2011

In Terms of Attributable Deaths

Prominent Risk Factors for CV Diseases

bull Smokingbull Hypertensionbull Dyslipidemia bull Metabolic Syndromebull Mental Stress

Modifiable risk factors

Hypertension (high blood pressure)

ndash Globally nearly one billion people have hypertension

ndash The ldquosilent killer because it often has no warning signs or symptoms

ndash People with hypertension are more likely to develop complications of diabetes

World Health Organization Regional Office for Southeast Asia Hypertension fact sheet

bull Encourage an optimal blood pressure of less then 12080 mm Hg through lifestyle approaches

bull Pharmacologic therapy is indicated when blood pressure is gt 14090 mm Hg

Tobacco usebull Cause nearly 10 per cent of all CVDbull Higher risk in female smokers young men and heavy

smokersbull Currently about 1 billion smokers in the world todaybull Within two years of quitting the risk of coronary heart

disease is substantially reduced and within 15 years the risk of CVD returns to that of a non-smoker

Teo KK Ounpuu S Hawken S et al INTERHEART Study Investigators Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study a case-control study Lancet 2006368(9536)647ndash658

HOW SMOKING HARMS THECARDIOVASCULAR SYSTEM

bull Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed

bull This can narrow the blood vessels and can lead to many cardiovascular conditions

bull Atherosclerosisbull Coronary Heart Disease bull Strokebull Peripheral Arterial Disease (PAD) bull Abdominal Aortic Aneurysm

Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome

Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK

Indian heart Journal 01200860(3)205-9

AbstractOBJECTIVE Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high

sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS)

METHODS Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay Patients were stratified by levels of hs-CRP into

low (lt1 mgL) intermediate (1-3 mgL) or high (gt3 mgL) groups and in tertiles of 0-039 mgL 04-11 mgL and gt11 mgL respectively Classification of patient into upper (214) middle (4537 percent) and lower (333) SES was based on Kuppuswami Index which includes education income and profession Presence or absence of traditional risk factors for CAD diabetes hypertension dyslipidemia and smoking was recorded in each patient

RESULTS Mean levels of hs-CRP in lower middle and upper SES were 23 +- 21 mgL 08 +- 17 mgL and 12 +- 15 mgL respectively hs-CRP

levels were significantly higher in low SES compared with both upper SES (p = 0033) and middle SES (p = 0001) Prevalence of more than one traditional CAD risk factors was seen in 135 375 and 6767 percent in patient of lower middle and upper SES It was observed that multiple risk factors had a linear correlation with increasing SES Of the four traditional risk factors of CAD smoking was the only factor which was significantly higher in lower SES (73) as compared to middle (5167 percent) and upper (394) SES We found that 623 208 and 265 patients of low middle and upper SES had hs-CRP values in the highest tertile Median value of the Framingham risk score in low middle and upper SES as 11 14 and 18 respectively We observed that at each category of Framingham risk low SES had higher hs-CRP

CONCLUSION We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser

traditional risk factors and lower Framingham risk These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors

Raised blood pressure (13 per cent of global deaths is attributed)

Tobacco use (9 per cent) Raised blood glucose (6 per cent) Physical inactivity (6 per cent) and Overweight and obesity (5 per cent)

Global Atlas on Cardiovascular Disease Prevention and Control Mendis S Puska P Norrving B editors World Health Organization (in collaboration with the World Heart Federation and World Stroke Organization) Geneva 2011

In Terms of Attributable Deaths

Prominent Risk Factors for CV Diseases

bull Smokingbull Hypertensionbull Dyslipidemia bull Metabolic Syndromebull Mental Stress

Modifiable risk factors

Hypertension (high blood pressure)

ndash Globally nearly one billion people have hypertension

ndash The ldquosilent killer because it often has no warning signs or symptoms

ndash People with hypertension are more likely to develop complications of diabetes

World Health Organization Regional Office for Southeast Asia Hypertension fact sheet

bull Encourage an optimal blood pressure of less then 12080 mm Hg through lifestyle approaches

bull Pharmacologic therapy is indicated when blood pressure is gt 14090 mm Hg

Tobacco usebull Cause nearly 10 per cent of all CVDbull Higher risk in female smokers young men and heavy

smokersbull Currently about 1 billion smokers in the world todaybull Within two years of quitting the risk of coronary heart

disease is substantially reduced and within 15 years the risk of CVD returns to that of a non-smoker

Teo KK Ounpuu S Hawken S et al INTERHEART Study Investigators Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study a case-control study Lancet 2006368(9536)647ndash658

HOW SMOKING HARMS THECARDIOVASCULAR SYSTEM

bull Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed

bull This can narrow the blood vessels and can lead to many cardiovascular conditions

bull Atherosclerosisbull Coronary Heart Disease bull Strokebull Peripheral Arterial Disease (PAD) bull Abdominal Aortic Aneurysm

Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome

Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK

Indian heart Journal 01200860(3)205-9

AbstractOBJECTIVE Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high

sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS)

METHODS Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay Patients were stratified by levels of hs-CRP into

low (lt1 mgL) intermediate (1-3 mgL) or high (gt3 mgL) groups and in tertiles of 0-039 mgL 04-11 mgL and gt11 mgL respectively Classification of patient into upper (214) middle (4537 percent) and lower (333) SES was based on Kuppuswami Index which includes education income and profession Presence or absence of traditional risk factors for CAD diabetes hypertension dyslipidemia and smoking was recorded in each patient

RESULTS Mean levels of hs-CRP in lower middle and upper SES were 23 +- 21 mgL 08 +- 17 mgL and 12 +- 15 mgL respectively hs-CRP

levels were significantly higher in low SES compared with both upper SES (p = 0033) and middle SES (p = 0001) Prevalence of more than one traditional CAD risk factors was seen in 135 375 and 6767 percent in patient of lower middle and upper SES It was observed that multiple risk factors had a linear correlation with increasing SES Of the four traditional risk factors of CAD smoking was the only factor which was significantly higher in lower SES (73) as compared to middle (5167 percent) and upper (394) SES We found that 623 208 and 265 patients of low middle and upper SES had hs-CRP values in the highest tertile Median value of the Framingham risk score in low middle and upper SES as 11 14 and 18 respectively We observed that at each category of Framingham risk low SES had higher hs-CRP

CONCLUSION We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser

traditional risk factors and lower Framingham risk These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors

Prominent Risk Factors for CV Diseases

bull Smokingbull Hypertensionbull Dyslipidemia bull Metabolic Syndromebull Mental Stress

Modifiable risk factors

Hypertension (high blood pressure)

ndash Globally nearly one billion people have hypertension

ndash The ldquosilent killer because it often has no warning signs or symptoms

ndash People with hypertension are more likely to develop complications of diabetes

World Health Organization Regional Office for Southeast Asia Hypertension fact sheet

bull Encourage an optimal blood pressure of less then 12080 mm Hg through lifestyle approaches

bull Pharmacologic therapy is indicated when blood pressure is gt 14090 mm Hg

Tobacco usebull Cause nearly 10 per cent of all CVDbull Higher risk in female smokers young men and heavy

smokersbull Currently about 1 billion smokers in the world todaybull Within two years of quitting the risk of coronary heart

disease is substantially reduced and within 15 years the risk of CVD returns to that of a non-smoker

Teo KK Ounpuu S Hawken S et al INTERHEART Study Investigators Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study a case-control study Lancet 2006368(9536)647ndash658

HOW SMOKING HARMS THECARDIOVASCULAR SYSTEM

bull Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed

bull This can narrow the blood vessels and can lead to many cardiovascular conditions

bull Atherosclerosisbull Coronary Heart Disease bull Strokebull Peripheral Arterial Disease (PAD) bull Abdominal Aortic Aneurysm

Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome

Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK

Indian heart Journal 01200860(3)205-9

AbstractOBJECTIVE Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high

sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS)

METHODS Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay Patients were stratified by levels of hs-CRP into

low (lt1 mgL) intermediate (1-3 mgL) or high (gt3 mgL) groups and in tertiles of 0-039 mgL 04-11 mgL and gt11 mgL respectively Classification of patient into upper (214) middle (4537 percent) and lower (333) SES was based on Kuppuswami Index which includes education income and profession Presence or absence of traditional risk factors for CAD diabetes hypertension dyslipidemia and smoking was recorded in each patient

RESULTS Mean levels of hs-CRP in lower middle and upper SES were 23 +- 21 mgL 08 +- 17 mgL and 12 +- 15 mgL respectively hs-CRP

levels were significantly higher in low SES compared with both upper SES (p = 0033) and middle SES (p = 0001) Prevalence of more than one traditional CAD risk factors was seen in 135 375 and 6767 percent in patient of lower middle and upper SES It was observed that multiple risk factors had a linear correlation with increasing SES Of the four traditional risk factors of CAD smoking was the only factor which was significantly higher in lower SES (73) as compared to middle (5167 percent) and upper (394) SES We found that 623 208 and 265 patients of low middle and upper SES had hs-CRP values in the highest tertile Median value of the Framingham risk score in low middle and upper SES as 11 14 and 18 respectively We observed that at each category of Framingham risk low SES had higher hs-CRP

CONCLUSION We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser

traditional risk factors and lower Framingham risk These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors

Modifiable risk factors

Hypertension (high blood pressure)

ndash Globally nearly one billion people have hypertension

ndash The ldquosilent killer because it often has no warning signs or symptoms

ndash People with hypertension are more likely to develop complications of diabetes

World Health Organization Regional Office for Southeast Asia Hypertension fact sheet

bull Encourage an optimal blood pressure of less then 12080 mm Hg through lifestyle approaches

bull Pharmacologic therapy is indicated when blood pressure is gt 14090 mm Hg

Tobacco usebull Cause nearly 10 per cent of all CVDbull Higher risk in female smokers young men and heavy

smokersbull Currently about 1 billion smokers in the world todaybull Within two years of quitting the risk of coronary heart

disease is substantially reduced and within 15 years the risk of CVD returns to that of a non-smoker

Teo KK Ounpuu S Hawken S et al INTERHEART Study Investigators Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study a case-control study Lancet 2006368(9536)647ndash658

HOW SMOKING HARMS THECARDIOVASCULAR SYSTEM

bull Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed

bull This can narrow the blood vessels and can lead to many cardiovascular conditions

bull Atherosclerosisbull Coronary Heart Disease bull Strokebull Peripheral Arterial Disease (PAD) bull Abdominal Aortic Aneurysm

Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome

Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK

Indian heart Journal 01200860(3)205-9

AbstractOBJECTIVE Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high

sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS)

METHODS Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay Patients were stratified by levels of hs-CRP into

low (lt1 mgL) intermediate (1-3 mgL) or high (gt3 mgL) groups and in tertiles of 0-039 mgL 04-11 mgL and gt11 mgL respectively Classification of patient into upper (214) middle (4537 percent) and lower (333) SES was based on Kuppuswami Index which includes education income and profession Presence or absence of traditional risk factors for CAD diabetes hypertension dyslipidemia and smoking was recorded in each patient

RESULTS Mean levels of hs-CRP in lower middle and upper SES were 23 +- 21 mgL 08 +- 17 mgL and 12 +- 15 mgL respectively hs-CRP

levels were significantly higher in low SES compared with both upper SES (p = 0033) and middle SES (p = 0001) Prevalence of more than one traditional CAD risk factors was seen in 135 375 and 6767 percent in patient of lower middle and upper SES It was observed that multiple risk factors had a linear correlation with increasing SES Of the four traditional risk factors of CAD smoking was the only factor which was significantly higher in lower SES (73) as compared to middle (5167 percent) and upper (394) SES We found that 623 208 and 265 patients of low middle and upper SES had hs-CRP values in the highest tertile Median value of the Framingham risk score in low middle and upper SES as 11 14 and 18 respectively We observed that at each category of Framingham risk low SES had higher hs-CRP

CONCLUSION We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser

traditional risk factors and lower Framingham risk These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors

Hypertension (high blood pressure)

ndash Globally nearly one billion people have hypertension

ndash The ldquosilent killer because it often has no warning signs or symptoms

ndash People with hypertension are more likely to develop complications of diabetes

World Health Organization Regional Office for Southeast Asia Hypertension fact sheet

bull Encourage an optimal blood pressure of less then 12080 mm Hg through lifestyle approaches

bull Pharmacologic therapy is indicated when blood pressure is gt 14090 mm Hg

Tobacco usebull Cause nearly 10 per cent of all CVDbull Higher risk in female smokers young men and heavy

smokersbull Currently about 1 billion smokers in the world todaybull Within two years of quitting the risk of coronary heart

disease is substantially reduced and within 15 years the risk of CVD returns to that of a non-smoker

Teo KK Ounpuu S Hawken S et al INTERHEART Study Investigators Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study a case-control study Lancet 2006368(9536)647ndash658

HOW SMOKING HARMS THECARDIOVASCULAR SYSTEM

bull Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed

bull This can narrow the blood vessels and can lead to many cardiovascular conditions

bull Atherosclerosisbull Coronary Heart Disease bull Strokebull Peripheral Arterial Disease (PAD) bull Abdominal Aortic Aneurysm

Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome

Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK

Indian heart Journal 01200860(3)205-9

AbstractOBJECTIVE Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high

sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS)

METHODS Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay Patients were stratified by levels of hs-CRP into

low (lt1 mgL) intermediate (1-3 mgL) or high (gt3 mgL) groups and in tertiles of 0-039 mgL 04-11 mgL and gt11 mgL respectively Classification of patient into upper (214) middle (4537 percent) and lower (333) SES was based on Kuppuswami Index which includes education income and profession Presence or absence of traditional risk factors for CAD diabetes hypertension dyslipidemia and smoking was recorded in each patient

RESULTS Mean levels of hs-CRP in lower middle and upper SES were 23 +- 21 mgL 08 +- 17 mgL and 12 +- 15 mgL respectively hs-CRP

levels were significantly higher in low SES compared with both upper SES (p = 0033) and middle SES (p = 0001) Prevalence of more than one traditional CAD risk factors was seen in 135 375 and 6767 percent in patient of lower middle and upper SES It was observed that multiple risk factors had a linear correlation with increasing SES Of the four traditional risk factors of CAD smoking was the only factor which was significantly higher in lower SES (73) as compared to middle (5167 percent) and upper (394) SES We found that 623 208 and 265 patients of low middle and upper SES had hs-CRP values in the highest tertile Median value of the Framingham risk score in low middle and upper SES as 11 14 and 18 respectively We observed that at each category of Framingham risk low SES had higher hs-CRP

CONCLUSION We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser

traditional risk factors and lower Framingham risk These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors

bull Encourage an optimal blood pressure of less then 12080 mm Hg through lifestyle approaches

bull Pharmacologic therapy is indicated when blood pressure is gt 14090 mm Hg

Tobacco usebull Cause nearly 10 per cent of all CVDbull Higher risk in female smokers young men and heavy

smokersbull Currently about 1 billion smokers in the world todaybull Within two years of quitting the risk of coronary heart

disease is substantially reduced and within 15 years the risk of CVD returns to that of a non-smoker

Teo KK Ounpuu S Hawken S et al INTERHEART Study Investigators Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study a case-control study Lancet 2006368(9536)647ndash658

HOW SMOKING HARMS THECARDIOVASCULAR SYSTEM

bull Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed

bull This can narrow the blood vessels and can lead to many cardiovascular conditions

bull Atherosclerosisbull Coronary Heart Disease bull Strokebull Peripheral Arterial Disease (PAD) bull Abdominal Aortic Aneurysm

Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome

Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK

Indian heart Journal 01200860(3)205-9

AbstractOBJECTIVE Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high

sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS)

METHODS Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay Patients were stratified by levels of hs-CRP into

low (lt1 mgL) intermediate (1-3 mgL) or high (gt3 mgL) groups and in tertiles of 0-039 mgL 04-11 mgL and gt11 mgL respectively Classification of patient into upper (214) middle (4537 percent) and lower (333) SES was based on Kuppuswami Index which includes education income and profession Presence or absence of traditional risk factors for CAD diabetes hypertension dyslipidemia and smoking was recorded in each patient

RESULTS Mean levels of hs-CRP in lower middle and upper SES were 23 +- 21 mgL 08 +- 17 mgL and 12 +- 15 mgL respectively hs-CRP

levels were significantly higher in low SES compared with both upper SES (p = 0033) and middle SES (p = 0001) Prevalence of more than one traditional CAD risk factors was seen in 135 375 and 6767 percent in patient of lower middle and upper SES It was observed that multiple risk factors had a linear correlation with increasing SES Of the four traditional risk factors of CAD smoking was the only factor which was significantly higher in lower SES (73) as compared to middle (5167 percent) and upper (394) SES We found that 623 208 and 265 patients of low middle and upper SES had hs-CRP values in the highest tertile Median value of the Framingham risk score in low middle and upper SES as 11 14 and 18 respectively We observed that at each category of Framingham risk low SES had higher hs-CRP

CONCLUSION We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser

traditional risk factors and lower Framingham risk These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors

Tobacco usebull Cause nearly 10 per cent of all CVDbull Higher risk in female smokers young men and heavy

smokersbull Currently about 1 billion smokers in the world todaybull Within two years of quitting the risk of coronary heart

disease is substantially reduced and within 15 years the risk of CVD returns to that of a non-smoker

Teo KK Ounpuu S Hawken S et al INTERHEART Study Investigators Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study a case-control study Lancet 2006368(9536)647ndash658

HOW SMOKING HARMS THECARDIOVASCULAR SYSTEM

bull Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed

bull This can narrow the blood vessels and can lead to many cardiovascular conditions

bull Atherosclerosisbull Coronary Heart Disease bull Strokebull Peripheral Arterial Disease (PAD) bull Abdominal Aortic Aneurysm

Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome

Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK

Indian heart Journal 01200860(3)205-9

AbstractOBJECTIVE Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high

sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS)

METHODS Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay Patients were stratified by levels of hs-CRP into

low (lt1 mgL) intermediate (1-3 mgL) or high (gt3 mgL) groups and in tertiles of 0-039 mgL 04-11 mgL and gt11 mgL respectively Classification of patient into upper (214) middle (4537 percent) and lower (333) SES was based on Kuppuswami Index which includes education income and profession Presence or absence of traditional risk factors for CAD diabetes hypertension dyslipidemia and smoking was recorded in each patient

RESULTS Mean levels of hs-CRP in lower middle and upper SES were 23 +- 21 mgL 08 +- 17 mgL and 12 +- 15 mgL respectively hs-CRP

levels were significantly higher in low SES compared with both upper SES (p = 0033) and middle SES (p = 0001) Prevalence of more than one traditional CAD risk factors was seen in 135 375 and 6767 percent in patient of lower middle and upper SES It was observed that multiple risk factors had a linear correlation with increasing SES Of the four traditional risk factors of CAD smoking was the only factor which was significantly higher in lower SES (73) as compared to middle (5167 percent) and upper (394) SES We found that 623 208 and 265 patients of low middle and upper SES had hs-CRP values in the highest tertile Median value of the Framingham risk score in low middle and upper SES as 11 14 and 18 respectively We observed that at each category of Framingham risk low SES had higher hs-CRP

CONCLUSION We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser

traditional risk factors and lower Framingham risk These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors

HOW SMOKING HARMS THECARDIOVASCULAR SYSTEM

bull Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed

bull This can narrow the blood vessels and can lead to many cardiovascular conditions

bull Atherosclerosisbull Coronary Heart Disease bull Strokebull Peripheral Arterial Disease (PAD) bull Abdominal Aortic Aneurysm

Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome

Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK

Indian heart Journal 01200860(3)205-9

AbstractOBJECTIVE Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high

sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS)

METHODS Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay Patients were stratified by levels of hs-CRP into

low (lt1 mgL) intermediate (1-3 mgL) or high (gt3 mgL) groups and in tertiles of 0-039 mgL 04-11 mgL and gt11 mgL respectively Classification of patient into upper (214) middle (4537 percent) and lower (333) SES was based on Kuppuswami Index which includes education income and profession Presence or absence of traditional risk factors for CAD diabetes hypertension dyslipidemia and smoking was recorded in each patient

RESULTS Mean levels of hs-CRP in lower middle and upper SES were 23 +- 21 mgL 08 +- 17 mgL and 12 +- 15 mgL respectively hs-CRP

levels were significantly higher in low SES compared with both upper SES (p = 0033) and middle SES (p = 0001) Prevalence of more than one traditional CAD risk factors was seen in 135 375 and 6767 percent in patient of lower middle and upper SES It was observed that multiple risk factors had a linear correlation with increasing SES Of the four traditional risk factors of CAD smoking was the only factor which was significantly higher in lower SES (73) as compared to middle (5167 percent) and upper (394) SES We found that 623 208 and 265 patients of low middle and upper SES had hs-CRP values in the highest tertile Median value of the Framingham risk score in low middle and upper SES as 11 14 and 18 respectively We observed that at each category of Framingham risk low SES had higher hs-CRP

CONCLUSION We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser

traditional risk factors and lower Framingham risk These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors

Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome

Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK

Indian heart Journal 01200860(3)205-9

AbstractOBJECTIVE Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high

sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS)

METHODS Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay Patients were stratified by levels of hs-CRP into

low (lt1 mgL) intermediate (1-3 mgL) or high (gt3 mgL) groups and in tertiles of 0-039 mgL 04-11 mgL and gt11 mgL respectively Classification of patient into upper (214) middle (4537 percent) and lower (333) SES was based on Kuppuswami Index which includes education income and profession Presence or absence of traditional risk factors for CAD diabetes hypertension dyslipidemia and smoking was recorded in each patient

RESULTS Mean levels of hs-CRP in lower middle and upper SES were 23 +- 21 mgL 08 +- 17 mgL and 12 +- 15 mgL respectively hs-CRP

levels were significantly higher in low SES compared with both upper SES (p = 0033) and middle SES (p = 0001) Prevalence of more than one traditional CAD risk factors was seen in 135 375 and 6767 percent in patient of lower middle and upper SES It was observed that multiple risk factors had a linear correlation with increasing SES Of the four traditional risk factors of CAD smoking was the only factor which was significantly higher in lower SES (73) as compared to middle (5167 percent) and upper (394) SES We found that 623 208 and 265 patients of low middle and upper SES had hs-CRP values in the highest tertile Median value of the Framingham risk score in low middle and upper SES as 11 14 and 18 respectively We observed that at each category of Framingham risk low SES had higher hs-CRP

CONCLUSION We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser

traditional risk factors and lower Framingham risk These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors

QUITTING SMOKING CUTS CVD RISKS

bull Even though we donrsquot know exactly which smokers will develop CVD from smoking the best thing all smokers can do for their hearts is to quit

bull Smokers who quit start to improve their heart health and reduce their risk for CVD immediately

bull Within a year the risk of heart attack drops dramatically and even people who have already had a heart attack can cut their risk of having another if they quit smoking

bull Within five years of quitting smokers lower their risk of stroke to about that of a person who has never smoked

bull Counseling nicotine replacement and other pharmacotherapy as indicated in conjunction with a behavioral program or other formal smoking cessation programme

Raised blood glucose (Diabetes)bull CVD accounts for about 60 per cent of all mortality in people

with diabetesbull Diabetics also have a poorer prognosis after cardiovascular

events compared to people without diabetesbull Lack of early detection and care for diabetes results in severe

complications including heart attacks

Global Atlas on Cardiovascular Disease Prevention and Control Mendis S Puska P Norrving B editors World Health Organization (in collaboration with the World Heart Federation and World Stroke Organization) Geneva 2011

bull Primary care access to measurement of blood glucose and cardiovascular risk assessment as well as essential medicines including insulin can improve health outcomes of people with diabetes

bull Target HbA1Clt7 if this can be accomplished without significant hypoglycemia

Physical inactivity

bull Defined as less than five times 30 minutes of moderate activity per week or less than three times 20 minutes of vigorous activity per week or equivalent

bull Approximately 32 million deaths and each year are attributable to insufficient physical activity

bull 20 to 30 per cent increased risk of all cause mortality compared to those who are physically active

bull Higher prevalence in high-income countries

Unhealthy diet

bull High dietary intakes of bull Saturated fat bull Trans-fats and salt and bull Low intake of fruits vegetables and fish are linked to

cardiovascular risk

bull Frequent consumption of high-energy foods such as processed foods that are high in fats and sugars promotes obesity compared to low-energy foods

bull WHO recommends a population salt intake of less than 5

gramspersonday to help the prevention of CVDbull Elimination of trans-fat and replacement of saturated with

polyunsaturated vegetable oils lowers coronary heart disease risk

bull A healthy diet can contribute to a healthy body weight a desirable lipid profile and a desirable blood pressure

Cholesterollipids

bull Globally one third of ischaemic heart disease is attributable to high cholesterol

bull prevalence of raised total cholesterol among adults is around 97 percent

bull Global prevalence of raised total cholesterol among adults was 39 percent

We are Different

Indian Heart J 20025459-66Lancet 2000356279-84

Evidence

bull Asian Indian living in USA ndash 54 men had HDL lt40mg

bull People of Indian origin with TG gt150mgndash Males - 43ndash Females ndash 24

Indian Heart J 199648343-353Indian Heart J 200052407-410

Compared to Western Population

JAPI 200452137-142

TG

JAPI 200452137-142

HDL

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

Clin Endocrinol Meta 201095(4)1793ndash1801

Studies Conducted in our own State -UP

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Overweight and obesity

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

bull In 2012 34 percent of adults over the age of 20 were overweight

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

The World Health Report Making a Difference Geneva World Health Organization

bull To achieve optimal health the median BMI for adult populations should be in the range of 21ndash23 kgm2

bull Weight loss of as little as 10 lbs reduces blood pressure

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

bull Counseling nicotine replacement and other pharmacotherapy as indicated in conjunction with a behavioral program or other formal smoking cessation programme

Raised blood glucose (Diabetes)bull CVD accounts for about 60 per cent of all mortality in people

with diabetesbull Diabetics also have a poorer prognosis after cardiovascular

events compared to people without diabetesbull Lack of early detection and care for diabetes results in severe

complications including heart attacks

Global Atlas on Cardiovascular Disease Prevention and Control Mendis S Puska P Norrving B editors World Health Organization (in collaboration with the World Heart Federation and World Stroke Organization) Geneva 2011

bull Primary care access to measurement of blood glucose and cardiovascular risk assessment as well as essential medicines including insulin can improve health outcomes of people with diabetes

bull Target HbA1Clt7 if this can be accomplished without significant hypoglycemia

Physical inactivity

bull Defined as less than five times 30 minutes of moderate activity per week or less than three times 20 minutes of vigorous activity per week or equivalent

bull Approximately 32 million deaths and each year are attributable to insufficient physical activity

bull 20 to 30 per cent increased risk of all cause mortality compared to those who are physically active

bull Higher prevalence in high-income countries

Unhealthy diet

bull High dietary intakes of bull Saturated fat bull Trans-fats and salt and bull Low intake of fruits vegetables and fish are linked to

cardiovascular risk

bull Frequent consumption of high-energy foods such as processed foods that are high in fats and sugars promotes obesity compared to low-energy foods

bull WHO recommends a population salt intake of less than 5

gramspersonday to help the prevention of CVDbull Elimination of trans-fat and replacement of saturated with

polyunsaturated vegetable oils lowers coronary heart disease risk

bull A healthy diet can contribute to a healthy body weight a desirable lipid profile and a desirable blood pressure

Cholesterollipids

bull Globally one third of ischaemic heart disease is attributable to high cholesterol

bull prevalence of raised total cholesterol among adults is around 97 percent

bull Global prevalence of raised total cholesterol among adults was 39 percent

We are Different

Indian Heart J 20025459-66Lancet 2000356279-84

Evidence

bull Asian Indian living in USA ndash 54 men had HDL lt40mg

bull People of Indian origin with TG gt150mgndash Males - 43ndash Females ndash 24

Indian Heart J 199648343-353Indian Heart J 200052407-410

Compared to Western Population

JAPI 200452137-142

TG

JAPI 200452137-142

HDL

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

Clin Endocrinol Meta 201095(4)1793ndash1801

Studies Conducted in our own State -UP

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Overweight and obesity

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

bull In 2012 34 percent of adults over the age of 20 were overweight

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

The World Health Report Making a Difference Geneva World Health Organization

bull To achieve optimal health the median BMI for adult populations should be in the range of 21ndash23 kgm2

bull Weight loss of as little as 10 lbs reduces blood pressure

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

Raised blood glucose (Diabetes)bull CVD accounts for about 60 per cent of all mortality in people

with diabetesbull Diabetics also have a poorer prognosis after cardiovascular

events compared to people without diabetesbull Lack of early detection and care for diabetes results in severe

complications including heart attacks

Global Atlas on Cardiovascular Disease Prevention and Control Mendis S Puska P Norrving B editors World Health Organization (in collaboration with the World Heart Federation and World Stroke Organization) Geneva 2011

bull Primary care access to measurement of blood glucose and cardiovascular risk assessment as well as essential medicines including insulin can improve health outcomes of people with diabetes

bull Target HbA1Clt7 if this can be accomplished without significant hypoglycemia

Physical inactivity

bull Defined as less than five times 30 minutes of moderate activity per week or less than three times 20 minutes of vigorous activity per week or equivalent

bull Approximately 32 million deaths and each year are attributable to insufficient physical activity

bull 20 to 30 per cent increased risk of all cause mortality compared to those who are physically active

bull Higher prevalence in high-income countries

Unhealthy diet

bull High dietary intakes of bull Saturated fat bull Trans-fats and salt and bull Low intake of fruits vegetables and fish are linked to

cardiovascular risk

bull Frequent consumption of high-energy foods such as processed foods that are high in fats and sugars promotes obesity compared to low-energy foods

bull WHO recommends a population salt intake of less than 5

gramspersonday to help the prevention of CVDbull Elimination of trans-fat and replacement of saturated with

polyunsaturated vegetable oils lowers coronary heart disease risk

bull A healthy diet can contribute to a healthy body weight a desirable lipid profile and a desirable blood pressure

Cholesterollipids

bull Globally one third of ischaemic heart disease is attributable to high cholesterol

bull prevalence of raised total cholesterol among adults is around 97 percent

bull Global prevalence of raised total cholesterol among adults was 39 percent

We are Different

Indian Heart J 20025459-66Lancet 2000356279-84

Evidence

bull Asian Indian living in USA ndash 54 men had HDL lt40mg

bull People of Indian origin with TG gt150mgndash Males - 43ndash Females ndash 24

Indian Heart J 199648343-353Indian Heart J 200052407-410

Compared to Western Population

JAPI 200452137-142

TG

JAPI 200452137-142

HDL

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

Clin Endocrinol Meta 201095(4)1793ndash1801

Studies Conducted in our own State -UP

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Overweight and obesity

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

bull In 2012 34 percent of adults over the age of 20 were overweight

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

The World Health Report Making a Difference Geneva World Health Organization

bull To achieve optimal health the median BMI for adult populations should be in the range of 21ndash23 kgm2

bull Weight loss of as little as 10 lbs reduces blood pressure

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

bull Primary care access to measurement of blood glucose and cardiovascular risk assessment as well as essential medicines including insulin can improve health outcomes of people with diabetes

bull Target HbA1Clt7 if this can be accomplished without significant hypoglycemia

Physical inactivity

bull Defined as less than five times 30 minutes of moderate activity per week or less than three times 20 minutes of vigorous activity per week or equivalent

bull Approximately 32 million deaths and each year are attributable to insufficient physical activity

bull 20 to 30 per cent increased risk of all cause mortality compared to those who are physically active

bull Higher prevalence in high-income countries

Unhealthy diet

bull High dietary intakes of bull Saturated fat bull Trans-fats and salt and bull Low intake of fruits vegetables and fish are linked to

cardiovascular risk

bull Frequent consumption of high-energy foods such as processed foods that are high in fats and sugars promotes obesity compared to low-energy foods

bull WHO recommends a population salt intake of less than 5

gramspersonday to help the prevention of CVDbull Elimination of trans-fat and replacement of saturated with

polyunsaturated vegetable oils lowers coronary heart disease risk

bull A healthy diet can contribute to a healthy body weight a desirable lipid profile and a desirable blood pressure

Cholesterollipids

bull Globally one third of ischaemic heart disease is attributable to high cholesterol

bull prevalence of raised total cholesterol among adults is around 97 percent

bull Global prevalence of raised total cholesterol among adults was 39 percent

We are Different

Indian Heart J 20025459-66Lancet 2000356279-84

Evidence

bull Asian Indian living in USA ndash 54 men had HDL lt40mg

bull People of Indian origin with TG gt150mgndash Males - 43ndash Females ndash 24

Indian Heart J 199648343-353Indian Heart J 200052407-410

Compared to Western Population

JAPI 200452137-142

TG

JAPI 200452137-142

HDL

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

Clin Endocrinol Meta 201095(4)1793ndash1801

Studies Conducted in our own State -UP

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Overweight and obesity

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

bull In 2012 34 percent of adults over the age of 20 were overweight

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

The World Health Report Making a Difference Geneva World Health Organization

bull To achieve optimal health the median BMI for adult populations should be in the range of 21ndash23 kgm2

bull Weight loss of as little as 10 lbs reduces blood pressure

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

Physical inactivity

bull Defined as less than five times 30 minutes of moderate activity per week or less than three times 20 minutes of vigorous activity per week or equivalent

bull Approximately 32 million deaths and each year are attributable to insufficient physical activity

bull 20 to 30 per cent increased risk of all cause mortality compared to those who are physically active

bull Higher prevalence in high-income countries

Unhealthy diet

bull High dietary intakes of bull Saturated fat bull Trans-fats and salt and bull Low intake of fruits vegetables and fish are linked to

cardiovascular risk

bull Frequent consumption of high-energy foods such as processed foods that are high in fats and sugars promotes obesity compared to low-energy foods

bull WHO recommends a population salt intake of less than 5

gramspersonday to help the prevention of CVDbull Elimination of trans-fat and replacement of saturated with

polyunsaturated vegetable oils lowers coronary heart disease risk

bull A healthy diet can contribute to a healthy body weight a desirable lipid profile and a desirable blood pressure

Cholesterollipids

bull Globally one third of ischaemic heart disease is attributable to high cholesterol

bull prevalence of raised total cholesterol among adults is around 97 percent

bull Global prevalence of raised total cholesterol among adults was 39 percent

We are Different

Indian Heart J 20025459-66Lancet 2000356279-84

Evidence

bull Asian Indian living in USA ndash 54 men had HDL lt40mg

bull People of Indian origin with TG gt150mgndash Males - 43ndash Females ndash 24

Indian Heart J 199648343-353Indian Heart J 200052407-410

Compared to Western Population

JAPI 200452137-142

TG

JAPI 200452137-142

HDL

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

Clin Endocrinol Meta 201095(4)1793ndash1801

Studies Conducted in our own State -UP

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Overweight and obesity

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

bull In 2012 34 percent of adults over the age of 20 were overweight

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

The World Health Report Making a Difference Geneva World Health Organization

bull To achieve optimal health the median BMI for adult populations should be in the range of 21ndash23 kgm2

bull Weight loss of as little as 10 lbs reduces blood pressure

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

Unhealthy diet

bull High dietary intakes of bull Saturated fat bull Trans-fats and salt and bull Low intake of fruits vegetables and fish are linked to

cardiovascular risk

bull Frequent consumption of high-energy foods such as processed foods that are high in fats and sugars promotes obesity compared to low-energy foods

bull WHO recommends a population salt intake of less than 5

gramspersonday to help the prevention of CVDbull Elimination of trans-fat and replacement of saturated with

polyunsaturated vegetable oils lowers coronary heart disease risk

bull A healthy diet can contribute to a healthy body weight a desirable lipid profile and a desirable blood pressure

Cholesterollipids

bull Globally one third of ischaemic heart disease is attributable to high cholesterol

bull prevalence of raised total cholesterol among adults is around 97 percent

bull Global prevalence of raised total cholesterol among adults was 39 percent

We are Different

Indian Heart J 20025459-66Lancet 2000356279-84

Evidence

bull Asian Indian living in USA ndash 54 men had HDL lt40mg

bull People of Indian origin with TG gt150mgndash Males - 43ndash Females ndash 24

Indian Heart J 199648343-353Indian Heart J 200052407-410

Compared to Western Population

JAPI 200452137-142

TG

JAPI 200452137-142

HDL

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

Clin Endocrinol Meta 201095(4)1793ndash1801

Studies Conducted in our own State -UP

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Overweight and obesity

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

bull In 2012 34 percent of adults over the age of 20 were overweight

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

The World Health Report Making a Difference Geneva World Health Organization

bull To achieve optimal health the median BMI for adult populations should be in the range of 21ndash23 kgm2

bull Weight loss of as little as 10 lbs reduces blood pressure

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

bull WHO recommends a population salt intake of less than 5

gramspersonday to help the prevention of CVDbull Elimination of trans-fat and replacement of saturated with

polyunsaturated vegetable oils lowers coronary heart disease risk

bull A healthy diet can contribute to a healthy body weight a desirable lipid profile and a desirable blood pressure

Cholesterollipids

bull Globally one third of ischaemic heart disease is attributable to high cholesterol

bull prevalence of raised total cholesterol among adults is around 97 percent

bull Global prevalence of raised total cholesterol among adults was 39 percent

We are Different

Indian Heart J 20025459-66Lancet 2000356279-84

Evidence

bull Asian Indian living in USA ndash 54 men had HDL lt40mg

bull People of Indian origin with TG gt150mgndash Males - 43ndash Females ndash 24

Indian Heart J 199648343-353Indian Heart J 200052407-410

Compared to Western Population

JAPI 200452137-142

TG

JAPI 200452137-142

HDL

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

Clin Endocrinol Meta 201095(4)1793ndash1801

Studies Conducted in our own State -UP

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Overweight and obesity

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

bull In 2012 34 percent of adults over the age of 20 were overweight

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

The World Health Report Making a Difference Geneva World Health Organization

bull To achieve optimal health the median BMI for adult populations should be in the range of 21ndash23 kgm2

bull Weight loss of as little as 10 lbs reduces blood pressure

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

Cholesterollipids

bull Globally one third of ischaemic heart disease is attributable to high cholesterol

bull prevalence of raised total cholesterol among adults is around 97 percent

bull Global prevalence of raised total cholesterol among adults was 39 percent

We are Different

Indian Heart J 20025459-66Lancet 2000356279-84

Evidence

bull Asian Indian living in USA ndash 54 men had HDL lt40mg

bull People of Indian origin with TG gt150mgndash Males - 43ndash Females ndash 24

Indian Heart J 199648343-353Indian Heart J 200052407-410

Compared to Western Population

JAPI 200452137-142

TG

JAPI 200452137-142

HDL

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

Clin Endocrinol Meta 201095(4)1793ndash1801

Studies Conducted in our own State -UP

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Overweight and obesity

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

bull In 2012 34 percent of adults over the age of 20 were overweight

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

The World Health Report Making a Difference Geneva World Health Organization

bull To achieve optimal health the median BMI for adult populations should be in the range of 21ndash23 kgm2

bull Weight loss of as little as 10 lbs reduces blood pressure

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

We are Different

Indian Heart J 20025459-66Lancet 2000356279-84

Evidence

bull Asian Indian living in USA ndash 54 men had HDL lt40mg

bull People of Indian origin with TG gt150mgndash Males - 43ndash Females ndash 24

Indian Heart J 199648343-353Indian Heart J 200052407-410

Compared to Western Population

JAPI 200452137-142

TG

JAPI 200452137-142

HDL

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

Clin Endocrinol Meta 201095(4)1793ndash1801

Studies Conducted in our own State -UP

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Overweight and obesity

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

bull In 2012 34 percent of adults over the age of 20 were overweight

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

The World Health Report Making a Difference Geneva World Health Organization

bull To achieve optimal health the median BMI for adult populations should be in the range of 21ndash23 kgm2

bull Weight loss of as little as 10 lbs reduces blood pressure

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

Evidence

bull Asian Indian living in USA ndash 54 men had HDL lt40mg

bull People of Indian origin with TG gt150mgndash Males - 43ndash Females ndash 24

Indian Heart J 199648343-353Indian Heart J 200052407-410

Compared to Western Population

JAPI 200452137-142

TG

JAPI 200452137-142

HDL

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

Clin Endocrinol Meta 201095(4)1793ndash1801

Studies Conducted in our own State -UP

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Overweight and obesity

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

bull In 2012 34 percent of adults over the age of 20 were overweight

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

The World Health Report Making a Difference Geneva World Health Organization

bull To achieve optimal health the median BMI for adult populations should be in the range of 21ndash23 kgm2

bull Weight loss of as little as 10 lbs reduces blood pressure

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

Compared to Western Population

JAPI 200452137-142

TG

JAPI 200452137-142

HDL

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

Clin Endocrinol Meta 201095(4)1793ndash1801

Studies Conducted in our own State -UP

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Overweight and obesity

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

bull In 2012 34 percent of adults over the age of 20 were overweight

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

The World Health Report Making a Difference Geneva World Health Organization

bull To achieve optimal health the median BMI for adult populations should be in the range of 21ndash23 kgm2

bull Weight loss of as little as 10 lbs reduces blood pressure

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

JAPI 200452137-142

HDL

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

Clin Endocrinol Meta 201095(4)1793ndash1801

Studies Conducted in our own State -UP

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Overweight and obesity

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

bull In 2012 34 percent of adults over the age of 20 were overweight

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

The World Health Report Making a Difference Geneva World Health Organization

bull To achieve optimal health the median BMI for adult populations should be in the range of 21ndash23 kgm2

bull Weight loss of as little as 10 lbs reduces blood pressure

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

bullThe prevalence of low HDL

bullAsian Indians -628 of the nondiabetic and 674 of the diabetic)bullCentral and northern Europeans (203 and 373)bullJapanese (257 and 341)bull Qingdao Chinese (157 and 170)

Clin Endocrinol Meta 201095(4)1793ndash1801

Studies Conducted in our own State -UP

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Overweight and obesity

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

bull In 2012 34 percent of adults over the age of 20 were overweight

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

The World Health Report Making a Difference Geneva World Health Organization

bull To achieve optimal health the median BMI for adult populations should be in the range of 21ndash23 kgm2

bull Weight loss of as little as 10 lbs reduces blood pressure

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

Studies Conducted in our own State -UP

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

UPCSI-LIPID Study Participating Centersbull SGPGIMS Lucknow- Prof Nakul Sinha Dr Aditya Kapoor Dr Satyendra Tewari Dr

Sudeep Kumarbull KGMU Lucknow- Prof RK Saran Prof VS Narainbull LPS Institute of Cardiology Kanpur- Prof RPS Bharadwaj Prof RK Bansalbull MLN Medical College Allahabad- Prof PC Saxenabull BHU Varanasi- Prof PR Guptabull BRD Medical College Gorakhpur- Prof Mukul Mishrabull MLB Medical College Jhansi- Prof Praveen Jainbull Heart Line Hospital Varanasi- Dr PR Sinha

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Young patientrsquos (lt45 years) with CAD

bullTG ndash 17538 mgbullLDL- 11243 mgbullHDL- 4092 mg

Overweight and obesity

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

bull In 2012 34 percent of adults over the age of 20 were overweight

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

The World Health Report Making a Difference Geneva World Health Organization

bull To achieve optimal health the median BMI for adult populations should be in the range of 21ndash23 kgm2

bull Weight loss of as little as 10 lbs reduces blood pressure

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

Overweight and obesity

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

bull In 2012 34 percent of adults over the age of 20 were overweight

bull Worldwide at least 28 million people die each year as a result of being overweight or obese

The World Health Report Making a Difference Geneva World Health Organization

bull To achieve optimal health the median BMI for adult populations should be in the range of 21ndash23 kgm2

bull Weight loss of as little as 10 lbs reduces blood pressure

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

bull To achieve optimal health the median BMI for adult populations should be in the range of 21ndash23 kgm2

bull Weight loss of as little as 10 lbs reduces blood pressure

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

Non-modifiable risk factors

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

Age

bull As a person gets older the heart undergoes subtle physiologic changes even in the absence of disease

bull When a condition like CVD affects the heart these age-related changes may compound the problem or its treatment

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

Gender

bull A man is at greater risk of heart disease than a pre-menopausal woman

bull Once past the menopause a womanrsquos risk is similar to a manrsquos

bull Risk of stroke however is similar for men and women

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

Family history

bull If a first-degree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) the risk increases

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip

Thank Youhellip

• Heart Diseases Burden and Risk Management
• Inspired by-
• Global Burden of Cardiovascular Disease
• Global Mortality from Coronary Artery Disease
• Relative Mortality Rates
• Economic Burden of Cardiovascular Diseases
• PowerPoint Presentation
• Cardiovascular diseases
• Slide 9
• Prominent Risk Factors for CV Diseases
• Slide 11
• Modifiable risk factors
• Hypertension (high blood pressure)
• Slide 14
• Tobacco use
• Slide 16
• HOW SMOKING HARMS THE CARDIOVASCULAR SYSTEM
• Poor mans risk factor correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome Sethi R1 Puri A Makhija A Singhal A Ahuja A Mukerjee S Dwivedi SK Narain VS Saran RK Puri VK Indian heart Journal 01200860(3)205-9
• QUITTING SMOKING CUTS CVD RISKS
• Slide 20
• Raised blood glucose (Diabetes)
• Slide 22
• Physical inactivity
• Unhealthy diet
• Slide 25
• Cholesterollipids
• Slide 27
• We are Different
• Evidence
• Compared to Western Population
• Slide 31
• Slide 32
• Studies Conducted in our own State -UP
• Slide 34
• Overweight and obesity
• Slide 36
• Non-modifiable risk factors
• Age
• Gender
• Family history
• Thank Youhellip