Dr Zulfikar Ahamed By Express News Service KOCHI: When human beings were hunter-gatherers, the diseases they contracted were zoonoses – those spread through animals. When man turned to agriculture, he settled on river banks and his clan stayed together. Then the most common diseases were infections. Later, as the industrial revolution was followed by the digital revolution, a new set of illnesses came into being–the lifestyle diseases or as generally put, non-communicable diseases. Approximately 50 per cent of death worldwide is due to non-communicable diseases (NCD). They include cardiovascular diseases (CVD), diabetes, accidents, mental disorders and chronic lung diseases. In India also nearly half of the deaths is due to NCD, while CVD accounts for 35 per cent of all deaths in India. The modifiable risk factors for CVD include high blood pressure, dyslipidemia (abnormality of cholesterol), diabetes mellitus, weight issues, obesity and smoking. The other lesser factors are sedentary habits, mental stress and dietary habits. Primary prevention of CVD in an adult can be achieved by controlling the above factors. Atherosclerosis- the depositing of fatty and other material on the wall of arteries supplying to the heart, brain, kidneys etc is the primary cause for CVD. Studies on young people who die during wars and accidents have shown that atherosclerosis begins in adolescence and accelerates during adulthood. Adolescents share the same CVD risk factors as that of adults. Hence, prevention of CVD should start from adolescence.In our state, nearly 10 percent of adult population has coronary heart disease, at least 30 per cent of adults has high blood pressure and 10-15 per cent of adults have diabetes. While 20-30 per cent of men still smoke. The average value of cholesterol in the blood of Keralites is higher than the optimal value. There is an increasing prevalence of obesity in the state. Studies conducted on children in the state found that at least five per cent have high blood pressure, another five per cent have obesity. High rates of insulin resistance was also noticed. In young adults of Kerala, the prevalence of all CVD risk factors is above the national averages.These findings convey a crucial message. Controlling the CVD risk factors from adolescence can reduce its burden in the young. That would translate into reduction of CVD risk factors in adults. This is the basis of preventive cardiology in the young. One has to ‘Catch Them Young’ and make young people “heart smart”. Some of the screening for CVD can be universal–high BP and obesity and some can be selective–for dyslipidemia. We,in Kerala, can also screen our adolescents for CVD risk factors, probably concentrating on high-risk population. ‘A Preventive Cardiology in The Young Clinic’ is an ideal solution. ‘At-risk population’ include those children whose parents and/or grandparents have premature CAD, high lipid values and those children who are obese, suffer from hypertension. The concept of preventive cardiology in the young can be conceptualised as a multi-disciplinary team taking care of adolescent cardiovascular health. We have termed these proposed clinics as Adolescent Cardiovascular Health Clinics as we will stress on maintaining health rather than treating morbidity. (The author is a paediatric cardiologist at KIMS Hospital. Views expressed are his own)

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