3DHeart (Cardiovascular) Care Angina & Heart Attack (cad) Care

3DHeart (Cardiovascular) Care

Angina & Heart Attack (CAD) Care

Angina & Heart Attack (CAD) Disease

CORONARY ARTERY DISEASE (CAD)

Angina, Heart attack, coronary artery disease (CAD): A warning from Nature:

Angina and Heart-attacks occur due to blockages produced by deposition of cholesterol in the walls of the coronary arteries that supply oxygenated blood to the heart muscle. The blockage in a coronary artery starts early in the childhood and continues to build with age. When blockages reach a level of more than 70%, the person starts experiencing angina (chest pain in the centre of the chest typically radiating towards the left arm), breathlessness or palpitations on physical or mental exertion. This process of blockage due to deposition of cholesterol in the walls of coronary arteries is called coronary atherosclerosis or Coronary Artery Disease (CAD).

Sometimes a block cracks or ulcerates leading to clot formation thereby causing sudden 100% blockage of the artery, leading to heart attack. About 25 to 30% patients die in the first heart attack even before reaching the hospital. If the person who has suffered a heart attack once, does not change his lifestyle (psychological behavior, diet, exercise, sleep habits) he or she gets recurrent heart attacks that lead to many heart-related illnesses and untimely death.

India, the world leader in coronary artery disease!

CAD has assumed epidemic proportions the world over and more so in India. Heart disease is considered the number one killer as it is responsible for about 40% of the deaths all over the world. In India, about 10 to 14% (more than 50 million people) of the adult population suffer from CAD. More than 5 million people suffer fresh heart attacks every year, out of which 1.5 million die even before getting any medical assistance. Moreover, the prevalence of CAD in younger population (the 20-40 years age group) is 10 times more in Indians as compared to Americans and Europeans. 54% of Indians get all three coronary arteries diffusely diseased thus making them unsuitable for coronary bypass surgery or angioplasty as compared to only 21% in Americans and Europeans. Asian Indians living overseas have thrice more prevalence of CAD and 8 times more deaths due to CAD. Immigrant Indian physicians in the United States have 3-4 times more prevalence of CAD than native U. S. physicians. It is estimated that prevalence of CAD in India is 6 times more than the Chinese and 20 times more than the Japanese. CAD is spreading the world over at an alarming rate in both higher and lower economic strata.

Coronary Artery Disease (CAD): A challenging health problem for the 21st century

Over the last three decades the progress in by-pass surgery, angioplasty with stenting and cholesterol-lowering drugs like statins have improved the prognosis of CAD, yet the number of CAD patients remains enormous. Moreover, as India is a developing country not everyone can afford this costly approach. In spite of the best efforts made by medical professionals, the facilities have not yet reached the masses to combat the menace of CAD epidemic.

Also, these approaches do not address the root cause of CAD and are palliative in nature. It is estimated by WHO and other World Health Agencies that by the year 2010, 60% of all the heart patients in the world will be Indians.

Psychological factors: The major risk factor for CAD

Medical scientists throughout the world have been working day in and day out to find the real cause of CAD. Recently, many well designed studies have shown that psychological behavior patterns play a very important role in causation and progression of coronary blockages & formation of clots which in turn lead to angina and heart attacks.

These behaviors are categorized as Type A behavior which include attitudes like `hurry' sickness, feeling pressurized by time and work, strong likes and dislikes, perfectionist, idealistic, punctual, aggressive, competitive, polyphasic i.e. trying to accomplish various tasks at the same time, or feeling anxiety, depression, anger, cynicism, hostility, job and family stress. Other sensitive behaviours include feeling of isolation, dependence on social support or emotional support, etc. These psychological behavioral patterns lead to wrong dietary, exercise or sleeping habits and thus reduce control over hypertension, diabetes, smoking, high cholesterol levels, obesity and lack of physical activity etc which are conventional risk factors of CAD. This leads to further increase in the coronary blockages at an early age.

Is regression of CAD possible?

Some of the well-designed studies (Dean Ornish et al, Manchanda et al etc.) have shown that management of stress through Yoga/ Meditation and change to healthy diet & exercise habits can halt the progress of the above mentioned blockages and thereby reduce the frequency of angina and heart attacks. Till today, medical scientists consider CAD to be a progressive disease. This means that if one is able to stop the progression of the disease, it is reversal of the disease process.

We the medical team at J. W. Global Hospital & Research Centre, Prajapita Brahma Kumaris Ishwariya Vishwa Vidyalay, Mount Abu have been able to document a highly significant opening of coronary blockages in groups of patients who sincerely followed the 'Healthy & Happy Lfestyle Program' in more than 300 repeat angiographies. The angiographies were analyzed by an independent panel of angiographers. It has been observed that in certain cases, even the 100% calcified blockages opened up significantly. These results have given an eye-opening message to medical scientists.

A Multidisciplinary Study on Coronary Artery Disease:

We have developed a unique user-friendly Healthy & Happy Lifestyle Program to fight back the epidemic of CAD. Efficacy of this program has been evaluated in two multidisciplinary prospective research studies i.e. the Mount Abu Open Heart Trial and Abu Healthy Heart Trial - a randomized controlled study in more than 500 angiographically-documented CAD patients. These studies included psychologists, spiritualists, physiologists, endocrinologists, cardiologists, clinicians, dietitians and fitness experts, who have been working hand in hand, since February 1998.

We have worked in association with Defence institute of Physiology & Allied Sciences, Defence Institute of Psychological Research, Defence Research & Development Organization (DRDO), New Delhi and the Morarji Desai National Institute of Yoga, New Delhi. This project has been sponsored by Central Council for Research in Yoga & Naturopathy, Ministry of Health & Family Welfare, Govt. of India. The angiographically-documented moderate to severe CAD patients were referred from three tertiary cardiac care centers at Delhi, Mumbai & Ahmedabad.

Scientific presentation of CAD project results:

The report of CAD project was submitted to Ministry of Health & Family Welfare, Govt. of India in September 2004, to the Defence Research & Development Organization (DRDO) in October 2004 and to the Indian Council of Medical Research (ICMR) in March 2005. Ministry of Health, Govt. of India is planning to implement this unique, user-friendly program for primary, secondary and tertiary prevention of CAD. The results of both the trials were presented at Asia-Pacific Congress of Cardiology 2004 that was organized by World Heart Federation at Singapore and Diamond APICON 2005 at Mumbai. These results were accepted and widely appreciated by top cardiologists and clinicians from all over the world.

Brief results:

* Highly significant improvements in symptoms like Angina, breathlessness, palpitations, exercise, tolerance, left ventricle ejection fraction (LVEF)

* Healthy improvement in psychological parameters

* Highly significant reduction in drugs required for management of angina, hypertension and diabetes

* Highly significant opening of coronary blockages.

Soul-Mind-Body Medicine: A multidimensional model for health management in 21st century. The two main salient features of healthy (heal + thy) & happy lifestyle program are:

A. Self Responsibility through Self Empowerment:

Healthy= Heal+ Thy= Heal Yourself through self empowerment.

Self empowerment comes from proper & right information, education & counselling about Soul, Mind, Body & biological clock/ circadian system.

B. Change of consciousness from body/role-consciousness to soul-consciousness:

The practice of primordial state of soul-consciousness in each thought, word and action, at home/office while taking prescribed diet and exercise, is the essence of healthy & happy lifestyle program which has four basic components.

* Stress management through Rajyoga meditation(Brahma Kumaris)

* Moderate aerobic exercise

* Low fat, high fiber vegetarian diet

* Proper sleep

Unique & User-friendly approach of Healthy & Happy Lifestyle (HLS) Program:

A.) Be Natural:

Stress Management through Rajyoga Meditation:

Be soul-conscious rather than role or body conscious. Remember, "I am a knowledgeful, pure, peaceful, loveful, happy, blissful & powerful soul. I am the soul, point of light, dazzling in between the forehead, master of this physical body". Be in the remembrance of Supreme Soul.

Brahma Kumari's Rajyoga meditation is a science and art of harmonizing spiritual energy (energy of soul), mental energy (energy of mind) and physical energy (energy of physical body), through the connection with ultimate source of spiritual energy i.e. Supreme Soul for enjoying ever healthy, ever-wealthy and ever-happy life.

Rajyoga meditation is purely a mental process which involves interaction between mind and intellect to reach the stage of perfection. No fixed physical postures are required for practicing it. Support is provided by way of daily group sessions and also through individual counselling sessions by clinical psychologists and stress management experts. Sessions on defining causes of stress, importance of tackling stress, time, work, isolation, relationship, depression, fear, anger, insecurity, sleep, disease & disaster management are taught by audio-visual means & practical workshops.

B.) Eat Natural:

Low-Fat High-Fibre Vegetarian Diet:

Eat plenty of fresh fruits, vegetables, nuts, sprouts, lemon and low-fat & high-fibre vegetarian diet at proper times and in proper quantity. Avoid fried foods, red meat, egg yolk, refined sugars, maida, tea, coffee etc. Take your food in silence and soul-conscious meditative state rather than while talking, watching television or reading the newspaper.

The benefits of the prescribed diet and assistance in preparation of broad-based menu, is demonstrated practically and by audio-visual means.

C.) Be in the Lap of Nature:

Moderate Aerobic exercise:

Have a brisk morning walk with sunrise (the queen of all exercises) and evening stroll before sunset. Exercise in an oxygen-rich open environment (not indoors) in presence of sunlight. Pranayam, physical postures, shavasans etc. are not advised in this exercise schedule. Individual brisk walk is advised as per the baseline TMT levels. The scientific way of walking to get maximum benefit and to minimize risks are taught in detail. Individual counselling sessions are also arranged.

D.) Enjoy Proper sleep:

Sleep at 10.00 p.m. and getup at 4.00 a.m. Hormones which creates harmony in our body secrete in balance if we are awake and peaceful at 4.00am. The science of sleep management is taught in detail.

Programs we offer:

This unique, user-friendly Healthy & Happy Lifesytyle (HLS) Program is planned in two types to combat the menace of epidemic of CAD:

i) For prevention of angina and heart attacks - 1 day comprehensive program.

ii) For angiographically-documented CAD patients - 7 days duration in-house program.

Healthy & Happy Lifestyle (HLS) Program for Prevention of angina & Heart Attacks (7 days duration)

An intense information, education, training and counselling program: For CAD patients:

* Who have recently undergone coronary angiography (within last one year) and do not want to undergo bypass surgery or angioplasty due to various reasons e.g. not fit to undergo, do not have resources to undergo or do not want to undergo bypass surgery or angioplasty procedures.

* Who have already undergone angioplasty or bypass surgery (at least three months back and not more than 3 years). Cardiac rehabilitation is aimed at these patients in order to prevent restenosis of coronary artery and there by alleviating the need for repeat angioplasties and redo bypass surgery.

Who can participate?

1. Coronary angiography proven coronary artery diseases. Block in at least one of the coronary arteries should be more than 50%. Coronary Angiography should have been carried out within last one year. CT angio reports are also accepted. (Cartography reports are not accepted)

2. Age: 21 to 70 years.

3. Patient without significant left main stem disease.

4. No myocardial infarction (heart attack)/ unstable angina during the preceding 3 months.

5. Left ventricular ejection fraction > 25% and without left ventricular failure (L.V.F.).

6. Presently not scheduled for bypass surgery/angioplasty.

7. No other co-existing life threatening illness e.g. advanced kidney/liver failure, advanced cancer, etc.

One can not join the program under following conditions:

1. Any intervention procedure eg. Angioplasty or bypass surgery within last three months.

2. Patients suffered from acute coronary syndrome eg. heart attack or unstable angina within last 3 months.

3. Patients suffering from severe osteo-arthritis of knee joints which creates difficulty in walking.

4. Patients suffering from acute or chronic kidney disease (Serum creatinine more than 1.2 mg/dl).

5. Cartography reports not accepted. Congentional heart diseases, rheumatoid heart disease, hole in heart, valvular diseases, and dilated cardiomyopathy etc. type of diseases are not addressed in the Healthy & Happy Lifestyle program. For this, patients can take appointment on phone to visit to the OPD.

Note:

* You will be provided accommodation & food during your stay. One attendant (preferably spouse) is compulsory to accompany the participant.

* Your participation in this Healthy & Happy Lifestyle program is totally voluntary

* No formal fee is required for participating in this program but voluntary contribution (in favor of Global Hospital & Research Centre, Mount Abu) is acceptable. Your contribution is income tax deductible u/s.80-G/ 35AC.

Process of Registration:

Patients are required to send their brief case-summary, prescribed treatment, latest serum creatinine, ECG, 2 D echo (Color Doppler) report and recent angiography report (carried out within last one year) along with five rupees stamped self addressed envelope. Reports sent by email or fax will not be accepted.

Permission to attend the HLS program will be given only after your reports are reviewed by the reviewing committee. You will be informed of your participation in due course of time. Please continue to take your treatment as per advice of your physician/ cardiologist.

Healthy Heart Education & Research Foundation (HHERF):

Healthy Heart Education & Research Foundation is an organization formed by CAD patients (Dilwalas) who have benefited by adopting this unique user-friendly `Healthy & Happy Lifestyle' program, which was registered with Charity Commission, Ahmedabad (Gujarat) on 8th January 2004.

The main objective of the Foundation is to spread awareness about the CAD Program as widely as possible in India, so that maximum number of people can take advantage to combat the menace of epidemic of CAD.

Individual persons, Firms, Companies & Public Trusts, who subscribe to the objectives of the Foundation, can become its Members. The Foundation is run on the basis of the voluntary contributions received. The Contributions to the Foundation are exempt from Income Tax U/S 80G @ 50% of donated amount.

Prevention & Rehabilitation Program: (One day)

HLS Program For Prevention of Angina & Heart Attacks Program:

Who all can join?

a) Persons with high psychological risk for developing angina & heart attacks e.g.:

1. Persons engaged in highly stressful jobs eg. Executives, Businessmen, Medical Professionals etc.

2. Persons prone for type `A' behaviour, anxiety, anger, depression, isolation, lack of emotional support, lack of social support, cynicism, hostility, sensitive and emotional behaviour etc.

b) Persons who have high conventional risk for developing angina & heart attacks e.g.:

1. Persons with family history of heart disease.

2. Persons with high blood pressure.

3. Persons with diabetes.

4. Persons with high cholesterol.

5. Smokers.

6. Overweight person.

7. Sedentary persons, who do not have the habit of taking regular morning and evening walk.

Training the Trainers program: (3 day duration)

Intensive In-house Training for Medical Professionals in Healthy & Happy Lifestyle (HLS) Program for Prevention of CAD and their lifestyle related illnesses.

THE WAY AHEAD.

Having achieved and experienced a wealth of knowledge about CAD, where do we go from here?

A number of distinguished medical professionals and scientists have made phenomenal discoveries in intervening and remedying this killer disease, but now what would be logical and appropriate is to use these experiences and wisdom to start an active campaign in

1) Primary Prevention:

It would be extremely beneficial to educate children in their schools about CAD and teach them how to be smart in protecting their bodies and minds.

Children should be given the skills and techniques of managing their intellectual, physical, emotional and spiritual personalities as they grow and pursue higher studies, careers and family lives. The importance of living by a strong value system should be instilled at a young age.

Benefits of a low-fat and high-fibre diet should be conveyed to children, along with role of exercise and proper sleep.

Young adults should be motivated to go in for regular check-ups so that proper screening of hypertension, diabetes, high blood pressure etc can be carried out, and thus diseases will be diagnosed earlier on.

2) Secondary Prevention:

Adults who have already developed CAD and are to undergo by-pass surgery or angioplasty should be taught Rajyoga meditation, methods of keeping mental and emotional stability, proper diet, exercise and sleep. In this way the challenge of CAD can be faced with courage and recovery would be fast and comfortable.

In patients with border-line coronary artery disease, diffused disease, who are not fit for intervention and who do not have resources for surgery can follow this program for a healthy and happy life.

3) Tertiary Prevention:

Those who have already undergone angioplasty and by-pass surgery may be advised to enter the tertiary program, so that they do not require repeat angioplasty or redo by-pass surgery in the future.

A healthy life can be achieved for all if there is accurate and timely Intervention, intake of medicines and measures of prevention. It is valuable that techniques of the CAD regression program be spread to every nook and corner of India through the media, however personal counselling has proved to be vital in transforming a patient's health and this cannot be compensated in any way. Every person should understand the fundamentals of the disease so that there is active and positive participation in healing mind and body. Science and Spirituality are two dominating powers in our world today; harmony and balance between the two will show wonders time and again in creating healthy & happy society.

DR. SATISH KR.GUPTA

MEDICAL SUPERINTENDENT

GLOBAL HOSPITAL TRAUMA AND EYE CARE CENTRE

MD (Medicine), FCCP, FIAE, FIMSA

SR. CONSULTANT, CARDIOLOGY & MEDICINE

CAD PROJECT CO-ORDINATOR

J.WATUMULL GLOBAL HOSPITAL & RESEARCH CENTRE

SHANTIVAN- 307 510, ABU ROAD (RAJASTHAN), INDIA

E-MAIL :- [e-mail]

FAX: [phone] & 228116

PH: [phone] & 228600