Nowadays the estimated burden of heart disease in rural areas is 3-5% and 7-10% in urban populations. In Indians, heart disease occurs 5-10 years earlier than in other populations around the world affecting the people of the productive age group 35-65 years.

Our purpose should be to motivate and assist people to lower their cardiovascular risk by: Quitting tobacco use, or reducing the amount smoked, or not starting the habit;? making healthy food choices; being physically active; reducing body mass index (to less than 25 kg/m2) and waist–hip ratio (to less than 0.8 in women and 0.9 in men (these figures may be different for different ethnic groups); lowering blood pressure (to less than 140/90 mmHg); lowering blood cholesterol (to less than 5 mmol/l or 190 mg/dl); lowering LDL-cholesterol (to less than 3.0 mmol/l or 115 mg/dl); controlling glycemia, especially in those with impaired fasting glycemia and impaired glucose tolerance or diabetes; Any form of exercise reduces the risk, with those newly starting exercise achieving greatest benefit. So, no time is the wrong time for starting it.

Stopping smoking is the single most cost-effective method in the prevention of heart disease, and some benefits are seen within months of stopping. Reductions in alcohol intake, even for moderate drinkers, are associated with a reduction in risk for heart disease.

Overall our population should reduce salt intake. Salt intake is well associated with BP. Depression and anxiety, lack of social support, social isolation, and stressful conditions at work, influence major risk factors and the course of heart disease.

It's high time women should be aware of their risk for heart disease. Women are about 10 years older than men at first manifestation but lose this 10-year advantage if they smoke, have diabetes, or had premature menopause. For women, a history of a heart attack or sudden death before the age of 55 in a sister is more strongly associated with the risk of heart attack than that in a brother or parent.

Hypertension increases a 4-fold risk of heart disease in women vs. 3-fold in men and women have a 15% higher prevalence of hypertension than in men. Diabetes increases the risk of heart failure by 8-fold in women compared to 4-fold in men.

It s the duty of parents, and teaching institutions to impress upon the students, when they are young, the need of adopting a healthy lifestyle, which can really go a long way in preventing heart disease.

It is very crucial to know what are the features of a heart attack. Patients with a heart attack can have chest pain which is in the upper part of the chest, behind the chest bone spreading towards the neck and jaw, below the chest bone going to the left arm, the upper part of the tummy, neck, and jaw, left shoulder going down both arms and in between the shoulder blades. One has to notice the character of pain which is squeezing, burning, constricting, and heaviness. This pain comes from exertion, excitement, stress, and cold meals. Difficulty in breathing or shortness of breath, Sweating, Nausea/vomiting (maybe only symptoms in some diabetics, women, or elderly!). the patient may just feel weak, light-headed, fainting, dizziness

Acute coronary syndrome/heart attack results from either temporary or permanent blockage of coronary arteries. Patients with Acute Coronary Syndrome are divided into two categories on the basis of ECG results: ST-elevation myocardial infarction (STEMI) patients, and non-ST-elevation acute coronary syndrome (NSTEACS) patients.

Patients with STEMI have a well-established treatment, including drugs and percutaneous coronary intervention (PCI). 5% to 10% of patients with heart attacks have normal findings on ECG at presentation. So anyone having risk factors, pain typically suggestive of heart disease should reach a nearby health center where facilities for ECG, Troponin I, and 2D echo are available. In case it is a heart attack, PCI is the best mode of treatment.