The Indian Council of Medical Research (ICMR) will constitute a national committee to suggest a policy framework on the various aspects of preventive medicine. An assurance to this effect was given by Dr N K Ganguly, Director-General, ICMR, in Hyderabad on Sunday. Responding to the suggestion made by Dr P M Bhargava, president, MARCH (Medically Aware& Responsible Citizens of Hyderabad), that ICMR constitute a national committee on preventive medicine, Dr Ganguly welcomed the suggestion and said a committee would be set up as soon as experts from different disciplines of medicine, the pharmaceutical industry, academia and other related fields were identified.
Dr Ganguly was the chief guest at a meeting of MARCH on Preventive Medicine in Cardiovascular Diseases and Diabetes. The meeting, attended by eminent doctors and physicians, pressed the alarm bell that cardiovascular diseases would become the number one killer by the year 2010 and would account for 34 % deaths in India. More than 17 million people die of heart diseases and strokes every year worldwide. Of this at least 50 % deaths could be avoided by taking simple effective measures like reducing major risk factors like high blood pressure, high cholesterol, obesity and taking regular exercises.
According to World Health Report 2002, 75 % heart diseases and strokes can be attributed to the use of tobacco, low fruit and vegetable intake and lack of physical activity.
Though there were tremendous medical and technological advances in fighting cardiological diseases, in India only 5 % of the patients were able to utilise the facilities and get proper treatment, while the remaining 95 % were deprived of proper care. Heart diseases and diabetes were inter-related and, in fact, 40 % of the heart diseases were due to diabetes. Therefore these two streams of medicine should be tackled together and not in isolation. There were 29 million diabetics in the country in the year 1999, and the figure would touch 60 million by 2010.
Terming the scenario as alarming, Dr Ganguly called for a holistic approach of preventive cure for which the government, the hospitals and the medical fraternity, the NGOs and the community have a major role to play. Prevention is the key to effectively control deaths due to heart attacks and strokes.
Chairing the meeting, Dr Bhargava stressed the importance of regular exercise, yoga, control of stress and diet, clean environment and above all public awareness about leading a balanced life. He said the school, college and medical curricula should include preventive medicine as a subject. He also suggested wide publicity through radio, television and the print media, besides setting up a committee to study and recommend measures to evolve a national policy on preventive medicine.
Dr Talwar from All-India Institute of Medical Sciences, New Delhi, called for some kind of national programme to create awareness among the people. Focusing on CAD, hypertension, diabetes and stroke, Dr Talwar said there must be a proper balance of therapeutic and preventive solutions.
The meeting was addressed by Dr P C Rath, Senior consultant and Director, Cardiac Cath Lab& Interventional Cardiology, Apollo Hospitals, on Changing trends in cardiovascular diseases (CVD), which include coronary artery disease (CAD), rheumatic valvular heart disease, congenital heart disease, hypertensive heart disease and peripheral vascular disease. He said 17 million people died worldwide of CVD in 2001 of which 12.4 million died of CAD (78% in low and middle income countries). About 600 million people would be at risk of hypertension of which 420 million would be from low and middle-income countries. He said the risk of CAD in India was four times that of white Americans, six times that of the Chinese and 20 times that of the Japanese. The disease was common among people in the mid-40s.
As preventive measures, he suggested identification of the high-risk groups, modification of the risk factor, early diagnosis, regular medical check-up and regular exercise.
Dr Sahay, well-known diabetologist, said 30% of the patients developed diabetes before the age of 40. Many were getting it at a very young age. With the changing life styles and food habits, the disease was growing at an alarming rate. Indians had a genetic propensity to develop diabetes. It was a major problem and needed urgent attention, he said.
Dr Sudhir Naik, Medi Citi Hospital and Consultant Cardiologist, spoke about the preventive cardiology workshops conducted by Osmania University under the auspices of WHO. The first one was an evaluation of 2000 families above the age group of 30 in Karimnagar district. The second, in collaboration with the National Institute of Nutrition (NIN), involved the oil and food intake among the people. The workshops gave interesting disease profiles among the rural population, he said.
Some doctors who attended the meeting suggested combination of drugs - statins and low doses of common blood pressure lowering drugs and aspirin - given daily to patients to reduce the risk of heart attacks and strokes, though it might not be affordable to a large per cent of the patients.