Speakers highlight the importance of preventive strategies to manage heart diseases


World Heart Day meeting at DUHS
Speakers highlight the importance 
of preventive strategies to 
manage heart diseases

KARACHI. Heart diseases are going up and hypertension deaths have gone down all over the World because of preventive measures and life style changes. However, in Pakistan Infectious diseases are still the major problem while heart diseases and death due to hypertension has increased. These views were expressed by Prof. Azhar Masood Faruqui former Executive Director of NICVD while speaking at a seminar to celebrate the World Heart Day, at DUHS on 26th September 2019. The meeting was, organized by Department of Cardiology DUHS headed by Prof. M. Nawaz Lashari. Mr. Imran Ismail, governor of Sindh was the chief guest in the inaugural session. Prof. Muhammad Saeed Qureshi VC DUHS, Prof. Amjad Siraj, Principal Dow Medical College and other faculty members and staff of DUHS attended the event.

Prof. Nawaz Lashari in his welcome remarks said that by making just a few small changes to our lives, we can reduce our risk of heart disease and stroke, as well as improving our quality of life and setting a good example for the next generation.

Dr. Abdul Rasheed Khan was the first speaker in first scientific session and discussed Diet and Heart Diseases. Ischemic heart disease, he stated is a major cause of death. According to one of the study in Pakistan it accounts around 25% of all deaths and it is expected this percentage is bound to rise in future if prompt preventive measures are not taken. The major cause of ischemic heart disease is narrowing of the vessels due to fat deposition and plaque formation. Number of factors leading to fat deposition are smoking, lack of exercise, family history and unhealthy diet. As part of healthy diet we should eat plenty of fruits and vegetables, fiber rich whole grains, fish, nuts, legumes, seeds and try eating some meals without meat. Select lower fat dairy products and poultry (skinless) limit sugar sweetened beverages and red meat. Avoid fried fast food and processed foods containing vegetable shortening. Reduce intake of refined sources of carbohydrates with higher glycemic indices and include legumes like backed beans, soybeans, lentils and tofu in diet, he added.

Department of Cardiology Dow University of Health Sciences (DUHS) organized a seminar
to celebrate World Heart Day, on 26th September, 2019. Group photograph taken in the
inaugural session shows from (L to R) Prof. Ishtiaq Rasool, Dr. Najma Patel, Prof. M.
Nawaz Lashari (Host) Prof. Azhar Masood Faruqui (Guest of Honor) Prof. Mansoor
Ahmed, Prof. Muhammad Saeed Qureshi VC DUHS, Mr. Imran Ismail, Governer
of Sindh (Chief Guest). Prof. M. Ishaq and other.

Prof. M. Ishaq talking about Prevention of Cardiovascular Diseases said that about 20 million people die every year due to heart diseases and major burden is in South Asia because of its population. Prevention is better than cure but we do not practice it. Factors that promote the process of atherosclerosis are tobacco use, physical inactivity, unhealthy diet, harmful use of alcohol, raised blood pressures, sugar level, cholesterol and obesity. Mortality due to CHD has declined in USA in the recent years. Prior 1985 it was because of life style changes, smoking cessation, decrease in dietary fat intake, increased leisure time physical activity. After 1985 medical management, coronary care units, electrical defibrillators, thrombolytic, emergent angioplasty, aspirin, beta blockers Ace inhibitors and statins has helped a lot to prevent deaths.

Continuing Prof. Ishaq said that we should eat Fruits and vegetables, grain products every day, choose low fat products, switch to fat free milk /skimmed milk. Regular exercise is essential to maintain a physical activity that keeps you fit and matches the calories you take. The cigarette caseation help to reduction in heart attack which starts decreasing within 24 hours of quitting smoking, within one year of quitting CHD risk decreases significantly and within two years it reached the level of nonsmokers. Smoking, salt, saturated fat, Sugar, sedentary living and stress are the six poisons for heart. Seven simple ways to live healthy are to avoid smoking, be physically healthy, eat heart healthy diet, keep healthy weight, blood sugar control, cholesterol and blood pressure healthy , he added

Dr. Najma Patel discussed risk assessment of pregnancy in women with structural heart defects Incidence of CHD, she stated is around 8.1% in the World. Advances in medical and surgical treatment has led to more than 85% of these infants surviving to adulthood. In next few decades one in hundred adults will be having CHD and half of these will be women. Most women are diagnosed first time during pregnancy and sometime parents hide the facts, many are diagnosed after multiple pregnancies. Counseling of those diagnosed earlier is not done properly. Couples when aware of the problem do not avoid pregnancy if it has been advised but surprisingly they are ready for abortion.

Risk assessment Dr. Najma Patel pointed out is part of pre-conception planning and assessment which includes cardiac risk of mothers, obstetric risk of fetus, risk of CHD in offspring etc. Potential hazards during pregnancy and labour are arrhythmias, CCF, increased cyanosis, thromboembolic events, dissection of aorta and hemorrhage due to bleeding in diathesis in cyanotic patients. Vaginal delivery carries a lower risk of complications for both the mother and the fetus than C section. The early postpartum period is potentially dangerous. Oxytocic drugs such as oxytocin and ergometrine should be used with great care. Combined oral contraceptives should be avoided in patients at risk of thromboembolism. Women with CHD have higher risk for maternal and fetal complications, all women preconception or during pregnancy should be referred to ACHS, pediatric cardiologists who has small or mild lesion irrespective of symptoms, postoperative or intervention. There must be close collaboration among cardiologists, ACHD specialist or pediatric cardiologist, obstetrician, anesthetist and neonatologist. For prevention of CHD general, practitioners and pediatricians should be involved, they can play a pivotal role in reducing both atherosclerosis related CVD and RHD.

Dr. Sumbal Nasir talked about kidney involvement in cardiac diseases and said that CRS can generally be defined as a pathophysiological disorder of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other organ. Heart disease can cause kidney disease, but kidney disease can also cause heart disease. Heart disease is the most common cause of death among people on dialysis. When kidneys are not functioning well, they cannot support the other parts of the body as they should. This can cause problems with the heart.

In second scientific sessions Prof. Mansoor Ahmed talked about basic approach to bifurcation case base approach. Update on heart failure was presented by Prof. Zahid Jamal, impact of diabetes mellitus in hear diseases was the topic of Prof. Zaman sheikh’s presentation. Prof. Nusrat Shah talked about management of heart diseases in pregnancy, Prof. Nabila Soomro discussed rehabilitation of cardiac patients while Prof. Rifat Tanveer talked about management and rehabilitation of post-surgery cardiac patients. An awareness walk and tree plantation was also part of World Heard Day activity.

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