What needs to be done to reduce the burden of heart disease?

For prevention of cardiovascular diseases (CVD’s) experts point out two types of interventions: population-wide and individual, which are recommended to be used in combination to reduce the greatest cardiovascular disease burden

What needs to be done to reduce the burden of heart disease?

CVD’s are a group of disorders of the heart and blood vessels. Examples of population-wide interventions that can be implemented to reduce CVDs include:

  • Comprehensive tobacco control policies
  • Taxation to reduce the intake of foods that are high in fat, sugar and salt
  • Building walking and cycle paths to increase physical activity
  • Strategies to reduce harmful use of alcohol
  • Providing healthy school meals to children

Dr Ranjeet Patil, cardiologist from Pune, said, “At the individual level, for prevention of first heart attacks and strokes, individual health-care interventions need to be targeted to those at high total cardiovascular risk or those with single risk factor levels above traditional thresholds, such as hypertension and hypercholesterolemia.”

Dr Patil added, “The former approach is more cost-effective than the latter and has the potential to substantially reduce cardiovascular events. This approach is feasible in primary care in low-resource saettings, including by non-physician health workers.”

For secondary prevention of cardiovascular disease in those with established disease, including diabetes, treatment with the following medications are necessary.

  • Aspirin
  • Beta-blockers
  • Angiotensin-converting enzyme inhibitors
  • Statins

Dr C Manake, cardiologist from Pune, said, “The benefits of these interventions are largely independent, but when used together with smoking cessation, nearly 75% of recurrent vascular events may be prevented. Currently there are major gaps in the implementation of these interventions particularly at the primary health care level.”

In addition costly surgical operations are sometimes required to treat CVDs. They include:

  • Coronary artery bypass
  • Balloon angioplasty (where a small balloon-like device is threaded through an artery to open the blockage)
  • Valve repair and replacement
  • Heart transplantation
  • Artificial heart operations

Medical devices are required to treat some CVD’s. Such devices include pacemakers, prosthetic valves, and patches for closing holes in the heart.