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Dr K K Aggarwal

Prevention strategy relies on lifestyle

By Dr K K Aggarwal
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Stenting may not always be the answer to treating heart disease with stable angina.

A German study has shown that patients with stable coronary artery disease who were put on an exercise regimen had significantly higher rates of event–free survival than those who had undergone percutaneous coronary intervention (PCI). In the study, 70% of patients in the exercise program had event–free survival –– no stroke, heart attack, or death –– compared with 50% of stented patients after four years.

Exercise is an important part of any type of prevention, and it should be instituted for “anyone with stable coronary heart disease.”

The study on stenting versus exercise was a continuation of a pilot study first reported in 2004 in the journal Circulation. That study of 101 male patients found that after one year, 88% of patients who exercised had event-free survival compared with 70% of stented patients.

The updated data reflect an additional 100 patients, who performed moderate intensity exercise for two weeks under hospital supervision, and then were given an exercise bike to continue their regimen at home. Patients with stable angina exercised at 80% of their threshold, and that after four weeks of exercising, their angina threshold increased.

The clear message for patients is to get 30 to 60 minutes of moderate–intensity aerobic activity every day, noting that 30% of heart disease could be prevented by 2.5 hours of walking per week.

Stress may increase smoking habits

By Dr K K Aggarwal
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Stress increases the risk of heart attack by pushing people toward bad habits. A British study published in the Journal of the American College of Cardiology suggests that people with psychological stress had a 50% increased risk of a cardiovascular disease event over the follow–up period.

The reasons were higher smoking rates and low exercise levels of individuals who were stressed.

In the study over a 7-year follow–up period, incidence of cardiovascular events –– heart attacks, stroke, bypass surgery and the like –– was 50% higher among the people with a high level of depression and anxiety when compared to happier people. Smoking and lack of physical activity explained about 63% of the increase, with smoking alone responsible for 41%.

Alcohol intake explained less than 2% of the increase, with high blood pressure assigned 13% of the blame. All such patients should be treated with combined physiological approaches with intensive lifestyle changes to reduce modifiable risk.

Lifestyle tips

By Dr K K Aggarwal
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� Set goals: For example to add one fruit serving in a meal every day � Measure progress: Count the distance traveled in 6 minutes every day. An improvement of 30 meters in distance walked is significant. � Make goals that are achievable. For example, don�t set a goal of a daily 5 mile run if you�re out of shape. � Make realistic goals: Quitting smoking or losing weight without a doctor�s help may not be realistic but an additional fruit serving a day is a small, manageable step toward better health. � Set time commitments: Pick a date and time to start.

Prevention strategy relies on lifestyle

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , | | Comments Off on Prevention strategy relies on lifestyle

Stenting may not always be the answer to treating heart disease with stable coronary artery disease. A German study has shown that patients with stable coronary artery disease who were put on an exercise regimen had significantly higher rates of event-free survival than those who had undergone percutaneous coronary intervention (PCI). In the study, 70% of patients in the exercise program had event-free survival — no stroke, heart attack, or death — compared with 50% of stented patients after four years. Exercise is an important part of any type of prevention, and it should be instituted for “anyone with stable coronary heart disease.”

The study on stenting versus exercise come was a continuation of a pilot study first reported in 2004 in the journal Circulation. That study of 101 male patients found that after one year, 88% of patients who exercised had event-free survival compared with 70% of stented patients. The updated data reflect an additional 100 patients, who performed moderate intensity exercise for two weeks under hospital supervision, and then were given an exercise bike to continue their regimen at home. Patients with stable angina exercised at 80% of their threshold, and that after four weeks of exercising, their angina threshold increased.

The clear message for patients is to get 30 to 60 min of moderate-intensity aerobic activity every day, noting that 30% of heart disease could be prevented by 2.5 hours of walking per week

Prevention strategy relies on lifestyle

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , | | Comments Off on Prevention strategy relies on lifestyle

Stenting may not always be the answer to treating heart disease with stable coronary artery disease. A German study has shown that patients with stable coronary artery disease who were put on an exercise regimen had significantly higher rates of event-free survival than those who had undergone percutaneous coronary intervention (PCI). In the study, 70% of patients in the exercise program had event-free survival — no stroke, heart attack, or death — compared with 50% of stented patients after four years. Exercise is an important part of any type of prevention, and it should be instituted for “anyone with stable coronary heart disease.”

The study on stenting versus exercise come was a continuation of a pilot study first reported in 2004 in the journal Circulation. That study of 101 male patients found that after one year, 88% of patients who exercised had event-free survival compared with 70% of stented patients. The updated data reflect an additional 100 patients, who performed moderate intensity exercise for two weeks under hospital supervision, and then were given an exercise bike to continue their regimen at home. Patients with stable angina exercised at 80% of their threshold, and that after four weeks of exercising, their angina threshold increased.

The clear message for patients is to get 30 to 60 min of moderate-intensity aerobic activity every day, noting that 30% of heart disease could be prevented by 2.5 hours of walking per week.

Prevention strategy relies on lifestyle

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , | | Comments Off on Prevention strategy relies on lifestyle

Stenting may not always be the answer to treating heart disease with stable coronary artery disease.

A German study has shown that patients with stable coronary artery disease who were put on an exercise regimen had significantly higher rates of event–free survival than those who had undergone percutaneous coronary intervention (PCI). In the study, patients in the exercise program had higher event-free survival –– no stroke, heart attack, or death –– compared with stented patients after four years.

Exercise is an important part of any type of prevention, and it should be instituted for “anyone with stable coronary heart disease.”

The study on stenting versus exercise come was a continuation of a pilot study first reported in 2004 in the journal Circulation. That study of 101 male patients found that after one year, 88% of patients who exercised had event–free survival compared with 70% of stented patients.

The updated data reflect an additional 100 patients, who performed moderate intensity exercise for two weeks under hospital supervision, and then were given an exercise bike to continue their regimen at home.

Patients with stable angina exercised at 80% of their threshold, and that after four weeks of exercising, their angina threshold increased.

The clear message for patients is to get 30 to 60 minutes of moderate–intensity aerobic activity every day, noting that 30% of heart disease could be prevented by 2.5 hours of walking per week.

Lifestyle can prevent 50% of common cancers

By Dr K K Aggarwal
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More than 50% of cancers could be prevented if people simply change lifestyles, according to Graham Colditz, PD, DrPH, from the Washington University School of Medicine in St. Louis, Missouri at the Union for International Cancer Control (UICC) World Cancer Congress 2012.

Among the “biggest buys” from lifestyle intervention is smoking cessation. One third of cancer in high–income countries is caused by smoking.

Being overweight or obese causes approximately 20% of cancers today. If people could maintain a healthy body mass index (BMI), the incidence of cancer could be reduced by approximately 50% in 2 to 20 years.

Poor diet and lack of exercise are each associated with about 5% of all cancers. Improvement in diet could reduce cancer incidence by 50% and increases in physical activity could reduce cancer incidence by as much as 85% in 5 to 20 years.

Eradicating the main viruses associated with cancer worldwide by implementing widespread infant and childhood immunization programs targeting three viruses — human papillomavirus and hepatitis B and C — could lead to a 100% reduction in viral–related cancer incidence in 20 to 40 years.

Tamoxifen reduces the rate of both invasive and noninvasive breast cancer by 50% or more, compared with placebo, at 5 years.

Raloxifene has been shown to reduce the risk for invasive breast cancer by about 50% at 5 years.
Bilateral oophorectomy in women carrying the BRCA1 or BRCA2 gene, although rare, has been associated with a 50% reduction in breast cancer risk among high-risk women.

Aspirin is associated with a 40% reduction in mortality from colon cancer.

Screening for colorectal cancer has a similar magnitude of mortality reduction (30% to 40%).

How to prevent getting lifestyle diseases including heart attack

By Dr K K Aggarwal
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Wild animals do not get heart attack, blood pressure, diabetes or stroke. These are all lifestyle disorders. But they can occur in a lion caged in a zoo, a rabbit in a laboratory or a pet dog in the house.
The biggest challenge, therefore, in cardiology internationally is – how to prevent development of lifestyle diseases including heart attack.

Most lifestyle disorders are linked to abdominal obesity, which is the latest epidemic in the society in the west. It is also becoming an epidemic in urban India and is now gradually shifting to the middle class. It is linked to eating white sugar, white rice, white maida and not exercising.

Traditionally, Indian sages knew that Indians are prone to getting abdominal obesity, therefore, they promoted observing fast at least 80 days in a year which involves one fast every week, one extra fast on Ekadashi and two Navratras of nine days each at the onset of summer and winter. Traditionally, the Indian fast includes not eating cereals on the fast day. Avoiding cereals 80 days in a year does not allow a person to develop metabolic syndrome and insulin resistance, which is responsible for inflammation of arteries and subsequent lifestyle disorders including heart attack and paralysis.

The other challenges at an international level in cardiology involve safer alternatives for surgery and angioplasty. Today, most angioplasties with stenting and bypass surgeries last for 6–10 years. We want such procedures to last lifelong, obviously with control of risk factors. Stents may be needed, which can be resorbed completely.

A large number of patients die because cardiac transplant facilities are not available in many countries, especially the Asian countries. Every country should have all transplant–friendly laws so that any patient who dies in an accident and is brain dead, but has a living heart ends up as a heart living brain dead donor. In India, thousands of patients die every year for want of a heart donor.

Diastolic dysfunction, heart failure and atrial fibrillation are the other new epidemics of the society. In diastolic dysfunction, the heart does not relax properly and leads to breathlessness on exertion. It is again linked to obesity. If not treated in time, it causes enlargement of the left smaller chamber of the heart called left atrium. This leads to atrial fibrillation, where the heart beats are irregularly irregular. This is the commonest cause of paralysis in elderly age group.

Most lifestyle disorders are also linked to eating high salt diet and/or a diet high in transfats. Every country must come out with its policy and guidelines in which they must restrain various restaurants and hotels from using trans fats in their food and limiting the content of salt in their dishes.

They are also challenges for cardiologists. A cardiologist must practice what he preaches. A patient will not listen to the cardiologist if he/she (the cardiologist) is overweight and has abdominal obesity, drinks excessive alcohol or smokes.

Cardiologists internationally also face legal threat. Most of the law suits in the west are filed against cardiologists, especially those linked to the need of putting a stent or doing bypass surgery. Clear cut guidelines should be laid down and impunity should be given to doctors, if they follow those guidelines.

It is a duty of the cardiological association of every country to come out with transparent and standard guidelines in the treatment of heart diseases and when not to put devices in a patient.
Due to lucrative packages, a large number of cardiologists are shifting towards interventional cardiology. Very few people, a time will come, will remain in clinical, preventive or diagnostic cardiology. It will be sad scenario to watch, if it happens.

Young doctors and medical students should devote their life to combat these challenges. They must learn the principles of Vedic philosophy, especially ethical earning. They must follow the principles of counseling as taught by Lord Krishna to Arjuna. Krishna took 18 counseling sessions. In the first, he only listened, in the second he counseled in great detail, from 3 to 17, he gave reasoning at every stage and in the last session, he revised.

The budding doctors must remember that the word ‘Dr.’ as a prefix is given to them as an honour which differentiates them from the society. These prefixes or suffixes are not even available even to Prime Minister or President of India. They must maintain nobility of the medical profession.

In Islam, one of the five pillars mentioned is compulsory charity. The budding doctors should decide at this stage that throughout their life they will involve in doing 10% of charity on a daily basis.

Lifestyle can prevent 50% of common cancers

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , | | Comments Off on Lifestyle can prevent 50% of common cancers

More than 50% of cancers can be prevented if people simply change lifestyles, according to data presented by Graham Colditz, PD, DrPH, from the Washington University School of Medicine in St. Louis, Missouri at the Union for International Cancer Control (UICC) World Cancer Congress 2012.

Among the “biggest buys” from lifestyle intervention is smoking cessation. One third of cancer in high-income countries is caused by smoking.

Being overweight or obese causes approximately 20% of cancer today. If people could maintain a healthy body mass index (BMI), the incidence of cancer could be reduced by approximately 50% in 2 to 20 years.

Poor diet and lack of exercise are each associated with about 5% of all cancers. Improvement in diet could reduce cancer incidence by 50% and increases in physical activity could reduce cancer incidence by as much as 85% in 5 to 20 years.

Eradicating the main viruses associated with cancer worldwide by implementing widespread infant and childhood immunization programs targeting 3 viruses–human papillomavirus and hepatitis B and C– could lead to a 100% reduction in viral–related cancer incidence in 20 to 40 years.

Tamoxifen reduces the rate of both invasive and noninvasive breast cancer by 50% or more, compared with placebo, at 5 years.
Raloxifene has been shown to reduce the risk for invasive breast cancer by about 50% at 5 years.

Bilateral oophorectomy in women carrying the BRCA1 or BRCA2 gene, although rare, has been associated with a 50% reduction in breast cancer risk among high–risk women.

Aspirin is associated with a 40% reduction in mortality from colon cancer.

Screening for colorectal cancer has a similar magnitude of mortality reduction (30% to 40%). Tobacco, alcohol, and diet, lack of physical activity, and obesity– accounted for more than half of all cancer.

  • For men who have never smoked, heart disease presents their greatest risk for death at any age, exceeding the odds of dying from lung, colon and prostate cancer combined.
  • Male smokers face a lung cancer risk that is greater than the odds of heart disease taking their lives after age 60, and is tenfold higher than the chance of dying from prostate and colon cancer combined.
  • The chances of dying from heart disease and breast cancer are similar for nonsmoking women until age 60, when heart disease becomes a greater risk.
  • For female smokers, dying from lung cancer or heart disease is more likely than dying from breast cancer after age 40.

 

Prevention Strategy Relies on Lifestyle

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , , | | Comments Off on Prevention Strategy Relies on Lifestyle

Stenting may not always be the answer to treating with stable heart disease.

A German study has shown that patients with stable coronary artery disease who were put on an exercise regimen had significantly higher rates of event–free survival than those who had undergone percutaneous coronary intervention (PCI). In the study, 70% of patients in the exercise program had event–free survival –– no stroke, heart attack, or death –– compared with 50% of stented patients after four years.

Exercise is an important part of any type of prevention, and it should be instituted for “anyone with stable coronary heart disease.”

The study on stenting versus exercise come was a continuation of a pilot study first reported in 2004 in the journal Circulation. That study of 101 male patients found that after one year, 88% of patients who exercised had event–free survival compared with 70% of stented patients.

The updated data reflect an additional 100 patients, who performed moderate intensity exercise for two weeks under hospital supervision, and then were given an exercise bike to continue their regimen at home.

Patients with stable angina exercised at 80% of their threshold, and that after four weeks of exercising, their angina threshold increased.

The clear message for patients is to get 30 to 60 minutes of moderate-intensity aerobic activity every day, noting that 30% of heart disease could be prevented by 2.5 hours of walking per week.

Lifestyle can prevent 50% of common cancers

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , | | Comments Off on Lifestyle can prevent 50% of common cancers

More than 50% of cancer could be prevented if people simply change lifestyles according to Graham Colditz, PD, DrPH, from the Washington University School of Medicine in St. Louis, Missouri here at the Union for International Cancer Control (UICC) World Cancer Congress 2012.

Among the “biggest buys” from lifestyle intervention is smoking cessation. One third of cancer in high–income countries is caused by smoking.

Being overweight or obese causes approximately 20% of cancer today. If people could maintain a healthy body mass index (BMI), the incidence of cancer could be reduced by approximately 50% in 2 to 20 years.

Poor diet and lack of exercise are each associated with about 5% of all cancers. Improvement in diet could reduce cancer incidence by 50% and increases in physical activity could reduce cancer incidence by as much as 85% in 5 to 20 years.

Eradicating the main viruses associated with cancer worldwide by implementing widespread infant and childhood immunization programs targeting 3 viruses — human papillomavirus and hepatitis B and C — could lead to a 100% reduction in viral–related cancer incidence in 20 to 40 years.

Tamoxifen reduces the rate of both invasive and noninvasive breast cancer by 50% or more, compared with placebo, at 5 years.

Raloxifene has been shown to reduce the risk for invasive breast cancer by about 50% at 5 years.

Bilateral oophorectomy in women carrying the BRCA1 or BRCA2 gene, although rare, has been associated with a 50% reduction in breast cancer risk among high–risk women.

Aspirin is associated with a 40% reduction in mortality from colon cancer.

Screening for colorectal cancer has a similar magnitude of mortality reduction (30% to 40%).

Tobacco, alcohol, and diet, lack of physical activity, and obesity — accounted for more than half of all cancer.

The seeds of heart blockages are born while a person is in his adolescence or childhood. Prevention, therefore, must start right at that age, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India, Padma Shri Dr. S.C. Manchanda and Dr. A.K. Jhingan, Diabetes Specialist, in a joint statement. They were participating in an open house group discussion organized at Ryan International School, Vasant Kunj as a part of the 19th MTNL Perfect Health Mela being organized by the Heart Care Foundation of India in association with Department of Health, Government of Delhi.

The doctors said that heart attack cannot be given or accepted as a Gift. It takes minimum 15 years to live a lifestyle against the laws of nature to develop early blockages. Heart disease, therefore, is reversible and gives you enough time to reverse. They also said that in diet one should adopt the principle of moderations and variety and include all seven colours and six tastes in their diet.

Noted Kathak Dancers, Nalini and Kamalini, who were celebrity guests said that aerobic dance in any form should be part and parcel of school health programme. Traditional dances are better than western dance as classical traditional dance is a mix of yoga, meditation, relaxation and exercise.

The main Perfect Health Mela will start on 7th November, 2012 at Constitution Club of India and will have a mix of exhibitions, competitions, workshops, seminars, entertainment incorporating all pathies under one roof. The entry to the Mela will be free. The programme will also be aired on 7th November, 2012 6pm on Fit Delhi Dilli Aaj Tak.

Stenting may not always be the answer to treating heart disease with stable.

A German study has shown that patients with stable coronary artery disease who were put on an exercise regimen had significantly higher rates of event-free survival than those who had undergone percutaneous coronary intervention (PCI). In the study, 70% of patients in the exercise program had event-free survival — no stroke, heart attack, or death — compared with 50% of stented patients after four years.

Exercise is an important part of any type of prevention, and it should be instituted for “anyone with stable coronary heart disease.”

The study on stenting versus exercise come was a continuation of a pilot study first reported in 2004 in the journal Circulation. That study of 101 male patients found that after one year, 88% of patients who exercised had event-free survival compared with 70% of stented patients.

The updated data reflect an additional 100 patients, who performed moderate intensity exercise for two weeks under hospital supervision, and then were given an exercise bike to continue their regimen at home.

Patients with stable angina exercised at 80% of their threshold, and that after four weeks of exercising, their angina threshold increased.

The clear message for patients is to get 30 to 60 minutes of moderate-intensity aerobic activity every day, noting that 30% of heart disease could be prevented by 2.5 hours of walking per week.

More than 50% of cancer could be prevented if people simply change lifestyles according to Graham Colditz, PD, DrPH, from the Washington University School of Medicine inSt. Louis,Missourihere at theUnionfor International Cancer Control (UICC) World Cancer Congress 2012.

Among the “biggest buys” from lifestyle intervention is smoking cessation. One third of cancer in high-income countries is caused by smoking.

Being overweight or obese causes approximately 20% of cancer today. If people could maintain a healthy body mass index (BMI), the incidence of cancer could be reduced by approximately 50% in 2 to 20 years.

Poor diet and lack of exercise are each associated with about 5% of all cancers. Improvement in diet could reduce cancer incidence by 50% and increases in physical activity could reduce cancer incidence by as much as 85% in 5 to 20 years.

Eradicating the main viruses associated with cancer worldwide by implementing widespread infant and childhood immunization programs targeting 3 viruses — human papillomavirus and hepatitis B and C — could lead to a 100% reduction in viral-related cancer incidence in 20 to 40 years.

Tamoxifen reduces the rate of both invasive and noninvasive breast cancer by 50% or more, compared with placebo, at 5 years.

Raloxifene has been shown to reduce the risk for invasive breast cancer by about 50% at 5 years.

Bilateral oophorectomy in women carrying the BRCA1 or BRCA2 gene, although rare, has been associated with a 50% reduction in breast cancer risk among high-risk women.

Aspirin is associated with a 40% reduction in mortality from colon cancer.Screening for colorectal cancer has a similar magnitude of mortality reduction (30% to 40%).

Tobacco, alcohol, and diet, lack of physical activity, and obesity — accounted for more than half of all cancer.

 

A person with pre-hypertension, systolic upper blood pressure between 120-140 mmHg and diastolic lower pressure between 80-90 mmHg, is more than three times likely to have a heart attack and 1.7 times more likely to have heart disease than a person whose blood pressure is lower than 120/80 mmHg.

Systolic blood pressure is the pressure against the artery wall when the heart beats and diastolic blood pressure is the pressure when the heart is at rest between the heart beats. Normal blood pressure is lower than 120/80 mmHg and hypertension is a blood pressure more than 140/90 mmHg or higher.

Research has shown that if pre-hypertension is aggressively treated 45% of all heart attacks can be prevented.

Lifestyle such as weight control, regular physical activity and changes in diet are recommended for people with pre-hypertension. The importance of pre-hypertension has been enlisted as one of the top 10 recent advances in cardiology.

Every effort should be made to lower the blood pressure below 120/80 mmHg.