 Hi everyone, Myself Dr. Jai Babu, Consultant Cardillist, Kolombesha, White Veil. Today we will be discussing about heart attacks in Yang in India. So, how common is heart attacks in India? People in India are now getting heart attacks much, much younger age. In fact, Indians get heart attacks 8 to 10 years earlier than any other ethnic group all over the world. The most unfortunate fact among this is, 44% of people in our country who develop heart attack are under the age of fit fires. Out of which, around 50% died of heart attack suddenly by sudden cardiac death. So, what causes the premature heart attack? Three most important causes which you should know. One is tobacco consumption. Second is the family state of premature heart disease in parents or siblings. That is in men less than 55 years and in women less than 60 years. And thirdly, diabetes. So, women get heart attack approximately 10 years later than men. However, in women especially diabetics or in smokers or who have family state of premature heart disease, then the women get heart attacks much earlier than premenopausal pace. The most common cause for premature heart disease by genetic origin is familial hypercholestery, which you should know. So, familial hypercholestery means grossly under diagnosed and under treated in the community. One best way to do is a non-fasting lipid profile, wherein by knowing the LDL levels or the bad cholesterol level, you can diagnose this clinical entity. Since it is an autosomal dominant condition, so the family members who are involved up to half of the family members would carry this gene. And if we can diagnose this at earlier age, we can prevent a lot of other premature heart attacks in the society. In these patients, at an earlier age, if we are able to start them on lipid-doring drugs like statins and along with lifestyle modification, we can definitely prevent a lot of premature heart attacks. The second reason being the tobacco consumption. Tobacco can be consumed in form of smoking, cigarettes, BDs or smokeless tobacco as we call the chewing tobacco. So, this increases the risk for premature heart attacks because of inflammation of the coronary arteries and by the oxidation of the bad cholesterol of the LDL and in turn increasing the platelet activity. All these together lead on to formation of clot and that could lead on to blockage of coronary arteries resulting in heart attack. The third risk factor being the diabetes. Diabetes is a very commonly associated risk factor along with hypertension and lipid disorder. This can lead on to a premature heart disease. Diabetes also prevails most for heart attack due to information of the artery walls of the coronary arteries and increased tendency for clot formation. So, controlling the risk factors, all these risk factors like diabetes, hypertension, lipid disorders will definitely prevent the genesis of the atherosclerosis or the plaque formation and lifestyle management is a very important thing that is useful for controlling this along with the drugs like statins which lower the cholesterol, anti-epotensives which control the blood pressure and anti-diabetic drugs which control the diabetes. So, all these things are essential. So, how do we prevent a premature heart attack? We live in a very highly competitive environment with intense work demand. So, all these increase the risk factors for heart disease such as pro-stress or incidence of diabetes, hypertension all these things increase. Along with this aggravating or the smoking and excessive consumption of alcohol, lack of sleep or lack of exercise. So, lifestyle modification plays a key role in preventing the premature heart attacks. This is a very simple and affordable and effective way to treat. And all you have to do is just regularly do moderate intense aerobic exercise just like brisk walking, cycling or jogging, probably even swimming 5 days a week. This is supposed to reduce your heart attacks by 30% and if you reduce DP, controlled diabetes and it will also lead on to reduction in lipids. Other things diet, predominantly what we are talking about is avoiding consumption, less consumption of trans fats and saturated fats. Trans fats is what is available with fast food centers, chips, cookies, all those things. So, avoiding them. Saturated fats are basically ghee, butter, dhalda. So, all these things constitute saturated fats. So, using them at a minimal allowable level, avoiding them or modifying them could definitely reduce your bad cholesterol. Other thing is smoking as I told reduction of smoking. So, despite all these measures, I mean among all these measures lifestyle plays a major role in controlling various factors. And use of the added statins, the anti-diabetic medicines and blood pressure medicines are also essential. So, adapting these healthy habits even when you start at a very younger age like childhood or adolescent, at a school level is as essential in preventing the premature heart attacks. That's it. Thank you.