Heart failure is a growing public health problem and is considered to be the most common cause of hospitalisations among patients 65 years and older of both sexes. However, the trend can be seen where the lifetime risk of developing heart failure for those over the age of 40 years is rising.

The increasing prevalence of heart failure is most likely secondary to the ageing of the population, increased risk factors, better outcomes for acute coronary syndrome survivors, and a reduction in mortality to improved management of chronic conditions. Despite advances made in heart failure treatment, the prognosis of the condition worsens over time, resulting in frequent hospitalisations and premature deaths. Therefore, it is important to identify the risk factors for heart failure early as it is preventable.

According to an Indian research study, nearly twenty-five per cent of heart failure patients are less than forty-five years of age and sixty-seven per cent of heart failure patients diagnosed are of less than fifty-five years of age vis-a-vis one rarely sees a heart failure case less than forty-five years age group in Western Countries" Dr RK Jaswal, Interventional Cardiology, Fortis Hospital, Mohali. Effective treatment of comorbidities and risk factor reduction can decrease the chance of developing heart failure. But, in India, there is not much awareness about the progress of the disease, its symptoms, management and treatment.

Hence, The Times of India took the initiative and launched Beat Heart Failure in partnership with Novartis, with an aim to create awareness among common people about heart failure and educate people about its management and treatment options available to help reduce the mortality rate due to the disease. To achieve this goal, multiple discussions were conducted with the expert doctors of the leading hospitals of the country to share their knowledge about the disease and share the best practices.

Mr Anil Vinayak, Group Chief Operating Officer, Fortis Healthcare said - "In order to identify, manage and treat heart failure, which affects a little over 1% of India's population, mass awareness initiatives like this one are crucial. Cardiology & Cardiovascular Sciences is a Centre of Excellence at Fortis Healthcare, and expert doctors at our facilities across the country offer treatments and care in line with international benchmarks. As knowledge partners in the Beat Heart Failure campaign, they have touched upon several minute aspects of heart failure from medical management to surgical interventions, focusing on empowering people with easy-to-understand information."

Continuing the collaborative approach, the following doctors from Fortis Hospital, Mohali, have joined:

• Dr RK Jaswal: Interventional Cardiologist
• Dr Rajat Sharma: Cardiac Electrophysiologist
• Dr Karun Behal: Interventional Cardiologist

Our heart is the most vital and tolerant organ in the body remarked, Dr Jaswal. It beats unceasingly to supply blood to all parts of the body. Heart failure occurs when the heart cannot pump blood commensurate with the body's requirements. It is a slowly progressive disease that develops over time due to several reasons. Eventually, heart failure sets in if the factors harming the heart are not medically corrected. People would do better to be on guard to get an initial assessment by a cardiologist on seeing symptoms such as slight shortness of breath.

India possibly is among the nations having a large share of heart failure incidence. Adding a note of caution, Dr Sharma said that Indians are genetically more prone to coronary artery disease. The origin of heart failure in India on account of cardiomyopathy and other heart muscle conditions is similar to that of Caucasians.

Dr Karun added that coronary artery disease is the primary cause of heart failure. Coronary artery disease means the obstruction in the artery supplying blood to the heart muscles. As the blood supply slowly decreases or gets blocked, the heart muscle weakens, resulting in heart failure. We are witnessing clustering of heart failure causes like hypertension, obesity, diabetes, smoking, eating junk food, and a sedentary lifestyle in the patients.

Socio-psychological stress levels have also gone up. These are potential risk factors that may precipitate blocking of coronary artery diseases and ultimately heart failure. A prominent strategy may be to focus on minimising the risk factors for reduction in heart failure cases. It's also very important to focus on lifestyle.

Compared to the rest of the world, India is seeing a considerable rise in the prevalence of heart disease amongst youngsters on account of genetic factors and an unhealthy lifestyle. Dr Jaswal made a statement that Indians are paying the price of the rising affluence with growth in heart disease.

"Prevention is better than cure," said Dr Karun. Heart Failure can be better managed if diagnosed early. Doctors stressed that symptoms of heart failure could be very subtle. If a person has not developed heart failure but has the risk factors or has developed heart failure's clinical signs and symptoms, this is stage one of heart failure. If medicines are introduced on time, and lifestyle changes are made, the quality and longevity of life can be improved. Strict compliance with medications is critical.

Not all patients with risk factors develop heart failure. One of the major initiatives can be identifying the population at risk of developing heart failure. The population at risk would include people with a family history of hypertension, coronary artery disease, and other risk factors. However, an aggressive prevention strategy in a community would focus on identifying by a close screening of the population at risk to prevent them from sliding into the abyss of heart failure, elaborated Dr Sharma. Management of people already identified with heart disease would need a different established approach.

Mandatory executive health checkups for all above the age group of thirty years irrespective of the risk factors is important to prevent heart failure from spreading amongst the youngsters. This kind of clinical evaluation and screening would be a big shot in the arm to identify risk factors and correct them. The community would be better prepared and forewarned to face any emergent eventuality of heart failure, averred Dr Jaswal.

He added that not every patient with heart failure would die. Before nineteen eighty-five, no treatment was available. Observational studies have shown that people were killed in six months, but now ninety-seven per cent of people survived and lived a meaningful, good quality of life. Patients admitted to cardiac care units have a rule of three. This means that one-third of the patients will die, one third will need subsequent re-hospitalisation, and one third will be okay, elaborated Dr Jaswal.

Counselling the youngsters and training them to adopt a healthy lifestyle are important pillars to cut down the menace of heart disease, remarked Dr Sharma. He added poor lifestyle is eventually a deathbed for any heart disease. An appropriate healthy lifestyle is essential even after diagnosis to reduce the progression of the disease. If any unknown symptoms develop, visiting a specialist is necessary. Self-diagnosis and prescription are extremely dangerous.

It is incredibly critical to be under the guidance of a cardiologist, said Dr Karun. Regular surveillance and follow-up have a tremendous improvement in the symptoms. Heart failure clinics were established to improve the prognosis of heart failure patients. They consist of a team of a cardiologist, a dietitian, and a counsellor.

Indians love to live in denial and will not make the necessary lifestyle changes to live a healthy life. One-fourth of what you eat keeps you alive, and the rest keep your physician alive. It is necessary to keep diet under strict regulation.

Carbohydrates that include sugar and sweets are the biggest enemy and should be immediately stopped. The amount of salt taken by Indians daily is almost fifteen grams, three times normal. The daily intake of salt should be five grams. The fluid intake should be restricted. Cessation of smoking alcohol is essential. The doctors ended with a message that heart failure is manageable at every stage. Patient compliance is important to take medicine on time, do regular follow-ups and instil a healthier lifestyle.