Home > Heart Healthy Advice: Ask the Physician

Get Heart Healthy! We’re here to help you. Follow the Indian Heart Association’s road-map to a healthy heart:

I. First, learn about India’s growing cardiovascular disease epidemic in the largest conducted risk factor study:

India has the dubious distinction of being known as the coronary and diabetes capital of the world. [This study] must prompt the government to develop public health strategies that will change lifestyles, if these risk factors are to be controlled.” – Dr. Prakash Deedwania, University of California, San Francisco, USA

Read more about this risk factor study, conducted by the Word Heart Federation , a Switzerland based NGO, here .

II. Ask the Physician: You Ask, We Explain

Based on popular feedback, we have decided to post our “Ask the Physician” topics onto our IHA Facebook page. Here’s a sample:

Question

from Mr. Krishnan of Palghat, Kerala, India:

“While the American Medical Association recommends keeping your total cholesterol level at 200, I’m told the Indian Medical Association has lowered the figure to 150. The MV Diabetes Research Centre in Chennai says a study of some 60,000 people in Chennai showed that cardiac problems started when they crossed 130. In view of this, wouldn’t it make sense to lower the cholesterol figure?”

Answer

from the Indian Heart Association:

The U.S. cholesterol guidelines are particularly based on the ATP III trial (http://www.nhlbi.nih.gov/guidelines/cholesterol/atglance.htm and http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3full.pdf). We believe the more important figure than the total cholesterol number is the LDL cholesterol number. The total cholesterol number includes the HDL level which we wish to be as high as possible. For every 10 point HDL increase above 50 for men, the risk for cardiac disease drops in half. The LDL number is of course a negative risk factor and optimally should be less than 100. Now there are new studies in the U.S. that are advocating a goal of less than 70 for LDL for individuals with diabetes (http://clinical.diabetesjournals.org/content/26/1/8.full), those with cardiac disease, and cardiac disease equivalents (peripheral vascular disease, abdominal aortic aneurysms, carotid stenosis, etc).

Total cholesterol is equal to HDL+LDL+Triglycerides/5

Certainly the study by the MV Diabetes research center in Chennai makes sense given that I believe most Indians have low HDL levels and the the remainder of the cholesterol burden is LDL and triglyceride components which cross the 130 threshold. That being said, the 200 value for the U.S. as the “optimal” total cholesterol threshold is likely too high and should be lowered.

 

Learn more about IHA’s initiative “Heart Healthy Advice: Ask the Physician”

Wonderful IHA readers have been emailing the IHA team with questions relating to cardiovascular health.

IHA physicians look forward to distilling your questions into easy to read answers. Continue to email Dr. Sishir Rao and Sevith Rao your questions and we’ll pass them onto our IHA physician team. srao@mgh.harvard.edu and sevith@indianheartassociation.org