India witnesses the rise in number of heart disease cases over the past couple of decades. A large section of the population has adopted an unhealthy lifestyle combined with decreased physical activity, stress, eating unhealthy foods, increased intake of saturated fats and tobacco.
There are roughly 30 million heart patients in the country and two lakh surgeries are being performed every year.
On the occasion of the World Heart Day, health experts and cardiologists have stressed on the need to develop a comprehensive approach to combat heart disease in India, which is on its way to becoming an epidemic in the country.
Inflammation is common for heart disease and stroke patients and is thought to be a sign or atherogenic response.
Neither Muzaffar nor Manish could initially understand the cause of the silvery red swollen patches on their body parts which spread within weeks. Although the initial attempt to self-medicate by the men, both in their mid-30s, went in vain, they also started experiencing mild chest pain.
For the two residents of Bijnour in Uttar Pradesh, proper treatment was not possible, following which they visited a prominent Delhi-based hospital and consulted health experts at various levels.
Both got diagnosed with fatty, cholesterol-rich plaque in their blood vessels that doctors said was a major warning for heart attack in the near future.
Muzaffar and Manish are now undergoing cardiac treatment at Sri Balaji Action Medical Institute at Paschim Vihar in west Delhi.
The doctors at the hospital say that one of the most common factors being witnessed among cardiac patients is inflammation, even if this has not scientifically proved.
Health experts, going by their clinical experience, say that 80 to 90 percent of cardiac patients suffer from inflammation and white and red patches that aggravates without proper treatment.
"Although it's not proven, but we need to understand that over half of heart attacks are happening in people with normal cholesterol levels. Abnormal cholesterol in the absence of inflammation will rarely cause attacks," said Pradeep Gadge, consultant diabetologist at Mumbai-based Gadge's Diabetes Center.
The doctor, who is also a visiting consultant at the Mumbai-based Breach Candy and SevenHills hospitals, said that there are various types of heart diseases where inflammation is seen, including viral myocarditis - which is the inflammation of heart muscle.
"However, if we consider coronary heart disease, it's an ongoing process which may not be completely curable or reversible. In such cases one may need drugs like statins lifelong to keep the inflammation in check," said Gadge.
He added that inflammation anywhere in the blood vessel could lead to problems with coagulative mechanism and cause interference with blood flow, leading to ischemic problems of many organs.
According to National Health Profile released by the health ministry, the prevalence of heart failure in India due to coronary heart disease is over 6 million, with an annual incidence of 491,600-1.8 million.
Pratik Soni, Senior Consultant (Cardiology) of the prominent Mumbai-based Wockhardt Hospitals, said that inflammation could occur anywhere in the body if something triggers it there.
"Inflammation of the inner layer that lines the chamber of the heart is known as endocarditis. One major cause of endocarditis is by way of entry of germs into the bloodstream," said Soni. He said germs could enter blood through the mouth, or through a catheter placed in one's veins, finally traveling to the heart through the blood stream.
Asked about the link between inflammation and heart diseases not being proved, he said, "It is believed that chronic inflammation can happen due to several other reasons such as obesity, a low-grade infection or high blood cholesterol. There is need for more research on the subject. However, the point to be noted is that inflammation has been found in several patients who are not obese or even do not have any kind of infection. This is the reason more research is required."
Terming the problem of inflammation in cardiac patients being decades old, Neeraj Bhalla, director and head of cardiology at Delhi-based BLK Super Specialty Hospital, said while the concept is not new, it has gained momentum recently due to the rising number of cases.
"If one adopts a healthy lifestyle early in life, it can significantly cut down your inflammatory burden and lower your lifetime risk of developing heart disease. Even if you switch to a healthy lifestyle in middle age or later, you can still significantly reduce your risk of heart attack, stroke and premature death," Bhalla added.