00:00Have you ever thought why people who appear healthy and have been exercising, eating right
00:05and staying away from smoking and drinking and importantly doing regular health check-ups
00:12are still dying of heart attacks? Well, what if I told you that Indians are not doing the right
00:17type of health check-up at all and most of us are missing the important red flags?
00:23A large Indian study which has been done by Delhi's GB Pump Hospital has found that widely
00:30used global heart risk calculators may be failing to identify the majority of at-risk patients
00:37raising concerns about delayed diagnosis and missed prevention in a country already battling
00:44rising cardiovascular disease. Cardiovascular disease remains one of the leading causes of
00:49death in India and this study actually highlights a crucial gap in prevention strategies. The
00:55takeaway for all of us is clear. Relying solely on global risk models may not be enough. A
01:01more tailored India-centric approach combining medical data with clinical judgment could be
01:07key to identifying at-risk individuals earlier and preventing life-threatening events later.
01:13For individuals, this also serves as a reminder, normal test results do not always mean low risk.
01:19A deeper, more personalized assessment could make all the difference. I decode in this report.
01:37With that, we are looking at sudden heart attacks. This is not news nor is it shocking anymore. Well, there
01:44are theories around why people as young as 40 are dying. It's a mystery though to some extent. Though lifestyle
01:50changes and environmental factors seem to be the culprits here.
01:55But doctors are now throwing the light on an important fact. A lot of people are testing, we do know.
02:02But the tests we are doing to rule out a possible heart attack in the near future may not be
02:09simply good enough or sufficient enough.
02:14Well, standard health checkups don't always detect hidden cardiovascular risk. Researchers have looked back at data in a retrospective study
02:26which was done in about 5,000 plus Indian patients.
02:30Well, these were people who had already experienced a fast heart attack. Most of these people were not flagged as
02:36high risk beforehand.
02:38Around 80% were classified as low or moderate risk using standard tools.
02:46When we used the Western risk scores to Indian heart attack patients, we saw that 80% of people were
02:53low risk and moderate risk were classified as low risk.
02:55Based on this, we studied the 5,000 people.
02:57When all the patients had scored in the score, we got results.
03:011, 2, 6 or 6 scores, we got these findings.
03:04And we reached the conclusion that if we go to the doctor, then our calculator should be customized for India
03:14and indigenous.
03:14So, yes, the models over there need modification when we apply to our population and this needs to be modified
03:24for the genes, for the demography, for the dietary habits and lifestyle behavior.
03:32So, why and how do Indian patients behave differently?
03:36We have always had sort of a dyslipidemia pattern where, you know, the LDLs have been borderline normal to high
03:43normal, high triglycerides and low LDLs.
03:46And this sort of creates a lipid milieu which is extremely sort of atherogenic.
03:53And to add to that, we have a lot of insulin resistance, primarily because of our phenotypes.
04:00And that sort of is the core which sort of drives vascular events amongst Indians or Southeast Asians if I
04:07have to sort of look at the entire bracket.
04:10Well, what this study has found is that heart disease in Indians happen even much earlier, the average age of
04:17about 54 years.
04:19It can develop even when the weight looks normal and cholesterol doesn't look alarming.
04:25We have much lower BMI cutoffs than our Western counterparts.
04:30We tend to have much more visceral fat.
04:32So, we are the so-called thin fat Indians.
04:35And this abnormal dysfunctional adipose tissue or visceral fat, abdominal fat, epicardial adipose tissue, all these visceral fat structures can
04:47be extremely harmful to us in the long run.
04:50Hidden metabolic problems, insulin resistance, early stage of diabetes, higher diabetes risk even at normal weight is a major driver
04:59of our disease in India and it often goes undetected.
05:05Misleading cholesterol profile, typical expectation is high LDL which means danger.
05:12But in Indians, LDL may actually look okay.
05:17But low HDL, good cholesterol or high triglycerides can be overlooked.
05:23Remember this combination is dangerous but often underestimated by standard tests.
05:30So, what are the exact blood tests and scans that actually detect this hidden risk?
05:37Generally, you know, we do annual head screen which is also called as comprehensive cardiac check-up, CCC.
05:44CCC basically comprises of, you know, blood tests to see for the function of the different organs, body organs, vital
05:51organs.
05:52And also, it does ECG and echocardiogram if there's anything suspicious is observed.
06:01The tests that you can accurately do can be, say, body composition scales analysis.
06:07It can be a DEXA scan.
06:11Nowadays, there is very interesting development of what is known as an ultra low-dose CT scans which look at
06:18the visceral fat and are able to quantify how much is the visceral fat in the entire thorax or in
06:25the abdomen.
06:26So, in the entire thorax or abdominal area, they can calculate the visceral fat for you.
06:29So, MRIs can be handy especially for, you know, quantifying the liver fat or so-called the osteototic liver disease
06:37or fatty liver disease as we used to call it earlier.
06:39Thanks a lot.
06:39Here we go.
Comments