Presidential address by Prof. Naeem Aslam at 48th CARDIOCON 2018


 Presidential address by Prof. Naeem Aslam
at 48th CARDIOCON 2018

Out of 17.5 million deaths due to cardiovascular
almost 80% are preventable

MULTAN: “Heart diseases have almost become an epidemic not only in our region which is part of low middle income countries (LIMC) but also all over the world. CVD is responsible for 17.5 million deaths per year globally, 80% to 86% of these deaths occur in LIMCs. This region is identified to have a higher risk of coronary heart disease (CHD) as compared to other part of the globe. Coronary Artery Disease has become astonishingly prevalent in young adults in recent years.

Pakistani population has one of the highest risks of coronary heart disease (CHD) in the world. In Pakistan, 30 to 40 per cent of all deaths are due to cardiovascular disease (CVD). The CHD deaths on Pakistan have reached about 200,000 per year that is 410/100,000 of the population. More over Pakistani population develop CAD at a much lower level of cholesterol. Except for low HDL and raised levels of lipoprotein (a) & homocysteine the patient did not have other conventional or novel risk factors for CAD. The high lipoprotein (a) & homocysteine levels has been found to be a strongest risk factor for every premature CAD disease.

PMRC 2016 Report on Hypertensionhas given alarming increase on prevalence of hypertension in our population age 18 years and above which is 50.2% awareness is 30%. 18% are getting treatment while it is controlled only in 5.5%. The major reasons for the lack of control blood pressure is unfortunately the inadequate knowledge of healthcare professional, and lack of treatment compliance of patients. One of the studies in Pakistan has shown that 28.5% of Family Physicians have lack of understanding about disease and 76.5% do not follow recommended guidelines to manage hypertensive patients. The pioneer heart transplant surgeon Dr. Christian Barnard once said “I have saved the lives of 150 people by heart transplant if I had focused on preventive medicine earlier I would have saved 150 millions”

According to WHF statement 2017 out of 17.5 million deaths due to CVD 80% are preventable. This calls for the need to initiate measure to prevent CVD in first place and then treat the ones who are affected. Comprehensive actions at country level, led by Government is the means to achieve the goals like raising public awareness, modifying risk factors, engaging business community and reorienting health information system. It is important to recognize NCD as National Health Priority. Integrating existing programs for the prevention of communicable disease with programs for the prevention of NCD & CVD is a major health goal in many LIMCs which also is need of the day of our country.

Knowledge about CAD and its risk factors is an important pre-requisite for an individual to implement behavioral changes for CAD prevention. There are striking gaps in knowledge about CAD, its risk factors, and symptoms in our population resulting in inadequate preventive behavior patterns. Educational programs are urgently required at mass communication level to improve the level of understanding of CAD in the Pakistani population and to address the common risk factors, such as smoking, obesity, unhealthy diet, lack of physical activity and high blood pressure. Beside Public and Private health care institutes, the electronic and print media can play very effective role in this noble cause of decreasing the burden of CHD & saving the lives of our young countrymen. Improving the awareness about disease and risk factors using media is cornerstone to meet the WHF goal of 20/25. I would like to our print and electronic media to please change their policies and priorities. Instead of wasting the precious time of our nation on useless political talk shows, spend it on this noble cause of saving preventable deaths of heart attack as well as other significant health issues.

Involvement of religious and community leaders to endorse the participation will also be very effective. This model has been implemented & practiced very successfully in Bangladesh through Imam Masjids in population planning and control by the government.”