It is unsurprising that heart diseases represent India’s leading cause of death. The India State-Level Disease Burden Initiative report identified cardiovascular diseases as the reason for more than 1 out of 4 deaths in our population. Our national health policy aims at a 25 per cent reduction in premature deaths in India by 2025.

Achieving this vision would require committed efforts to address the priority causes of untimely deaths, with heart diseases leading the list. And while we usually associate heart disease with heart attacks, the problem of heart failure is less recognised, understood and prioritised.

As per evidence from India, not even 1 out of every 2 individuals with heart failure survive beyond five years. Beyond this alarming death rate, which is worse than many cancers, heart failure also majorly impacts the quality of life and may necessitate frequent healthcare visits, including hospital readmission.

Heart failure, put simply, is an abnormality of the heart which leads to an inability to pump sufficient blood, as required by the body. This results in clinical manifestations like progressive breathlessness or tiredness from physical activity resulting from congestion. The morbidity in heart failure is often a result of progressive damage to the heart, resulting from a heart attack, long-standing high blood pressure, diabetes, poor lipid levels, kidney disease, obesity, anaemia or merely old age. Lifestyle risks like exposure to tobacco, lack of physical activity or balanced diet and inadequate care of health, may lead to the inability of the heart to function effectively.

Estimates suggest that heart failure affects at least 1 per cent of our adult population. However, timely recognition of heart failure may be a key challenge, that requires an improvement in the way this condition is approached today.

This is true for the subtype of heart failure (HFpEF - heart failure with preserved ejection fraction) that occurs commonly in old age, among females, hypertension or diabetes, which may possibly present with certain normal assessment reports. This could result in delayed detection unless good clinical judgment and comprehensive diagnostic methods are applied.

Morbidity and mortality are the other challenges. With the appropriate medical intervention, it is possible to significantly lower the risk of hospital admissions and cardiovascular death, in patients with heart failure. And the vital role here of motivation and family support for care of heart failure, cannot be emphasised enough.

Dr Shraddha Bhure

Dr Shraddha Bhure

(The writer is Medical Director, Boehringer Ingelheim (India). Views are personal.)

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