Potentially modifiable risk factors such as smoking, alcohol use, high blood cholesterol, hypertension, obesity and diabetes mellitus account for 95% of symptomatic coronary artery disease in people aged below 30, says a study by the Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram. Coronary artery diseases lead to narrowing of arteries that supply blood and nutrients to the heart. Reduced blood flow can lead to heart pain and shortness of breath, among other conditions.
The hospital used data collected from patients below 30 years of age who underwent coronary angiography for symptomatic coronary artery disease. Ninety two percent of the patients were male. The study showed that 64% of the patients in this age group were smokers, while 88% had high blood cholesterol. Only 21% were habituated to alcohol, and 4% were diabetic. The youngest patient who required a surgery was only 15 years old.
The study revealed that 34% of the patients continued smoking even after 'their index event' – i.e. when they were diagnosed with coronary heart disease – as well as counselling, hospital visits and angiograms. Seventeen percent persisted with their alcohol intake. More than 50% of the patients were physically inactive after the diagnosis and 79% didn't have enough fruits and vegetables.
It was also noted that 41% of the patients did not properly adhere to their medications. Most people cited absence of symptoms for not continuing with their medicines. "While nearly half of the medically managed patients had discontinued medicines, non-adherence was less than one-third in those who underwent angioplasty," the study said.
Follow up data also showed that chances of survival are 84%, 70%, 58% and 52% for those aged five, 10, 15 and 20 years respectively, after angioplasty.
The study found that after the onset of the disease, nearly half of the patients had only 20 or more years to live, while 30% had only 10 years to live. It noted that this was a "serious cause of concern" given most of the patients in the study were below the age of 30. This would indicate an early death for many patients with symptomatic coronary heart disease.
Non-compliance by patients and delayed presentation suggest that patients in this age group are less aware of the long-term implications of the disease at a young age. The study concludes that public education and awareness about the condition are needed.