Often, diabetes, hypertension, smoking, high LDL-Cholesterol are cited as risk factors for developing heart attacks. The risk factors are checked regularly. Patients put in efforts to keep them under control.

 
Though the risk posed by overweight and obesity (high waist hip ratio, high Body Mass Index,) HbA1C (marker of diabetes control), high triglycerides, sedentary lifestyle (low HDL-Cholesterol), in developing heart attacks are discussed, efforts to bring them under control are not often seen.

A large study conducted by researchers across India, led by a Hyderabad-based cardiologist, has concluded that the risk posed by overweight, sedentary lifestyle, uncontrolled diabetes,  is comparable to the risk posed by each of the conventional risk factors such as hypertension, smoking, high LDL-C. And that both forms of risk factors have to be brought under control to cut down the risk of ACS including heart attack. 

HbA1C is a blood test which helps to know average blood sugar levels over the past three months. 

The study titled ‘Metabolic risk factors in first acute coronary syndrome (MERIFACS) study’ was published in the Indian Heart Journal in August. The case control study conducted in 15 health facilities across India included 2153 patients who had their first episode of heart attack and visited hospitals, and 1210 healthy people in the control group who did not have a history of heart attack and visited outpatient units for routine health check ups. 

The researchers have studied the presence of the Conventional Risk Factors, and Metabolic Risk Factors in the 2153 patients with heart attacks, and 1210 control population. 

The following observation will give an idea on why Metabolic Risk Factors have to be controlled:  the conventional risk factors were observed in 93% of the 2153 patients, the metabolic risk factors were observed in 97% of the patients. They have tested the presence of the individual risk factors too. 

“The study emphasises that to prevent heart attacks in India, preventing obesity, aggressively controlling diabetes and regular exercise are important,” said principal investigator of the study, Dr B Hygriv Rao, senior Consultant Cardiologist and Electrophysiologist, KIMS Hospital.

The principal investigator said that obesity, sedentary lifestyle and lack of aggressive treatment of diabetes is an important lacuna in our preventive treatment of heart attacks in India.

“Risk factor modification practised by doctors in India are not complete unless these factors are addressed seriously at a large scale. At an individual level, people need to follow healthy diet and do regular exercise to avoid being overweight (Target Body mass Index 23-25, and waist Hip index less than 0.9). Secondly yearly lipid profile and  screening for diabetes by doing HBA1C have to be taken up. Those with diabetes should target HBA1C < 7. As heart attacks occur in the younger population, these preventive measures should be initiated early like from 20 years of age,” said Dr Hygriv Rao.

He said that parks have to be provided in all areas so that people can walk or do other forms of exercise. Diet with appropriate portions of protein and carbohydrates have to be incorporated, to begin with in all government funded meal schemes. Our diet has a high amount of carbohydrates.