Prevention strategies Preventive Council Peshawar Heart Study Prof Mohammad Hafizullah Prof Mohammad Hafizullah Cardiology Department Cardiology Department Postgraduate Medical Postgraduate Medical Institute Institute Lady Reading Hospital Lady Reading Hospital Peshawar Peshawar
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Prevention strategies Preventive Council Peshawar Heart Study Prof Mohammad Hafizullah Cardiology Department Postgraduate Medical Institute Lady Reading.
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Prevention strategies Preventive CouncilPeshawar Heart Study
Prof Mohammad HafizullahProf Mohammad HafizullahCardiology DepartmentCardiology Department
Postgraduate Medical InstitutePostgraduate Medical InstituteLady Reading HospitalLady Reading Hospital
PeshawarPeshawar
Country Country YearsYears Groups ContrastedGroups Contrasted AgeAge CHD CHD Mortality Mortality
Ratio Ratio
SingaporeSingapore 1980-861980-86 South Asian vs ChineseSouth Asian vs Chinese 30-69 30-69 yrsyrs 3.83.8
FijiFiji 19801980 South Asian vs South Asian vs Melanesian Melanesian
40-59 40-59 yrsyrs 3.0 3.0
TrinidadTrinidad 1977-861977-86 South Asian vs AfricanSouth Asian vs African 35-69 35-69 yrsyrs 2.42.4
South South AfricaAfrica 19851985 South Asian vs South Asian vs
EuropeanEuropean35-74 35-74
yrsyrs 1.41.4
EnglandEngland 1979-831979-83 South Asian vs South Asian vs EuropeanEuropean
20-69 20-69 yrsyrs 1.41.4
Mortality from CAD in Indians andMortality from CAD in Indians and Pakistanis OverseasPakistanis Overseas
CAD in South Asians in UK
CAD in South Asians in UK
Early onset / malignant course
First MI 5 years earlier in average
Occurrence of first MI before the age of 40, 10
times higher (UK-Hughes 1989)
40% higher death rates across all age groups with
CAD
Two fold excess of deaths in men before the years
45
Prevalence of CAD (before 40 yrs) in the young:
West (less than 2%) South Asians (12%)
Early onset / malignant course
First MI 5 years earlier in average
Occurrence of first MI before the age of 40, 10
times higher (UK-Hughes 1989)
40% higher death rates across all age groups with
CAD
Two fold excess of deaths in men before the years
45
Prevalence of CAD (before 40 yrs) in the young:
West (less than 2%) South Asians (12%) McKeigue PM. Marmot MG. BMJ 1988;297:903.
Q: But can we fight the relentless onslaught of heart diseases?
Answer : NO
We have to PREVENT Heart problems
Ray of hope!
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EuroAction -SMOKING
Over half (58%) of the patients who were smokers prior to their coronary event had stopped by the end of the hospital programme.
One in five partners also stopped smoking cigarettes.
EuroAction- improvements in the dietary habits - pts and families Saturated fat consumption levels of patients
decreased by almost 16% (12% in partners)
Patients increased their consumption of fruit and vegetables by an average of 155 grams each day (113 grams each day for partners)
Patients increased fish consumption 58% ; (71% of partners) eating oily fish three times or more each week.
EuroAction- Physical activity
25% pts regularly active (20% of partners)
Absolute increase of 11% compared to baseline (5% in partners).
86% of pts (83% of partners) highly active; an improvement of around one-fifth against baseline.
Step counter showing an increase of 1362 steps (739 for partners) equates to around an extra three quarters of a mile each day.
Yes we can do it!
Pakistan Cardiac society established council of Preventive Cardiology
-‘preventive cardiology’. most arduous but very important job of looking after the orphan
Plan for every thing from the scratch and hopefully
develop it as a vibrant body so that we can set the program for whole of the country.
Prevention and Research
Prevention through research
Risk factors detection in major cities Risk factors in Karachi AKUH Risk factors in rural areas of Peshawar Risk factors in urban areas of Peshawar INTER HEART Heart File – wealth of data Peshawar Heart Study
PESHAWAR HEART STUDY(PHS)
CARDIOVASCULAR DISEASE RISK ASSESSMENT IN
DIFFERENT POPULATIONS OF PESHAWAR
AIMS OF PHS
To identify the risk factors for coronary artery disease (CAD) in various occupational groups of Peshawar.
Risk stratification (European Task Force risk scores).
AIMS
To determine any correlation between conventional risk factors, educational level social status and CAD risk score.
To determine risk score in “High-risk” occupations
Occupational groupsSecretariat 217Lawyers 159Journalists 150Meat related professions 156Class IV workers 157Teachers 429Nurses Total 1268
Peshawar Heart Study -Civil Secretariat
age
Total no 217 All males Age mean 42 + 9.032 Range 18- 59