A stitch in time saves nine; prevention is better than cure and always much more cost effective. It is 6 months since we started the mission of “No more Heart Attacks “and it is time to look back and plan our future endeavors.
Gauri Healthy Heart Project (GHHP) was started as a mission by a few likeminded persons to improve the management of patients with high blood pressure, diabetes and heart diseases related to these maladies. High BP is seen in around 30% of the adult population. Diabetes another major problem has a prevalence of around 9%. Both diseases are the leading cause of heart attacks, strokes and kidney failure. The co-existence of these 2 diseases has been reported to be around 7.5% and is a deadly combination leading to a very high possibility of getting serious vascular problems. It is well known that non communicable diseases with cardio vascular problems are increasing at a galloping speed.
The aim of GHHP since its inception in September 2020 was to go to the remoter parts of the country starting from the UT of Jammu and Kashmir and fanning out to various selected parts of India with a mission to prevent Heart Attacks and Strokes. We started in the form of camps where we evaluate around 100 patients with high BP or diabetes with or without heart disease already on treatment. Every patient is evaluated as per a set proforma with measurement of body mass index (BMI), BP, random blood sugar, lipid profile and an ECG recording. Echocardiography is also done if indicated.
Till date we have gone to 5 districts, starting from Kupwara in North Kashmir to Badgam, Pulwama before moving across the Pir Panchal to Banihal (Ramban) and then Jagti Migrant township in Nagrota (Jammu). Our next destination is Imphal in Manipur before coming back to district Udhampur in Jammu in April 2021 and then return to other districts of the valley. Ultimate aim is to cover selected districts of 6 states: Assam, Jharkhand, Maharashtra, Manipur, Gujrat and UTof J&K. This mission will be completed by 2025. We have received a very encouraging response and cooperation from the public and administration so far. The follow up of all the patients seen would be done periodically by medical personnel coopted by the GHHP for different states.
An update of our findings:
The observations from the camps carried out in 5 districts so far after evaluating have been startling. We have evaluated 587 patients (52% males) in these districts. 319 Patients (54%) had known high BP on treatment with 43% having BP more than the target of 140/90 mms Hg. Forty percent of these had BP’s more than 160/100 mms Hg making them very vulnerable to heart attacks, strokes and kidney failure. 27 % patients with uncontrolled BP also had diabetes making them sitting ducks for serious complications in the near future.
We saw 124 diabetics (21%) on treatment. Since blood sugar was being done in all patients evaluated 8 fresh cases of diabetes were detected and advised further management. The new therapies evolved during the last 6 to 7 years: SGLT2 inhibitors (canagliflozin, dapagliflozin and empagliflozin) had been prescribed in only 18% patients and GLP1 analogues (liraglutide and dulaglutide) in none.
Dyslipidemias especially high serum triglycerides was seen in 62% patients and high LDL cholesterol levels in 22% patients. Statin group of drugs (atorvastatin and Rosuvastatin) were prescribed often but in doses much lower than recommended as per the guidelines.
New initiatives on the way:
Tele-Cardiology
While we continue to carry out our camps, we have decided to carry out more measures to help the population. The first one is to set up Tele Cardiology set ups in different districts. The ultimate aim is to have one for each district. We are in the process of putting up 3 of these units, one each in Machil sector of Kupwara district, Village Hawal in Pulwama district and Jagti migrant township in Jammu.
Each unit has the capability of carrying out an ECG, measuring BP and relevant blood tests with interpretation at the site. There would be a remote connectivity of the patient with a specialist by video conferencing / telephone depending upon the communication lines available . The unit also has the capability of dispensing medicines like in a vending machine. The system would be operated by trained personnel. This service would be free of cost for the patients. Patients needing hospitalization would be directed accordingly.
Setting Up of a State of Art Cardiology Clinic:
After studying the disease patterns in 5 districts of Jammu and Kashmir, GHHP has realized the necessity of having specialized care for patients with High Blood pressure, Diabetes and related heart diseases in the UT. Keeping these needs in mind a state of Art Outpatients service is being started on 10th April 2021 in Srinagar under the banner of “, Gauri healthy Heart Clinic”. This will be manned by full time cardiologists and would provide the facility of ECG, Tread mill testing, echocardiography and doppler studies with or without stress, Holter monitoring, extended loop recording of rhythm, 24 hours ambulatory BP monitoring and Head Uptilt Testing. This paid service will have very cost-effective charges.
A similar facility will be shortly planned for Jammu city before extending it to different Indian states.
All these activities being executed and planned need finances and it is an earnest appeal for the good Samaritans and corporate houses to come forward and help the GHHP and thus the community. The CEO of the project Mr Ajaz Rashid and “Umeed Foundation” an NGO will be coordinating the contributions and donations. Email: ajazrashid@gmail.com for more details.
Prof Upendra Kaul, Founder Director GHHP, Cardiologist, is Recipient of Padma Shri and Dr BC Roy Award.