Dr. Ramesh Kawar

This is Dr. Ramesh Kawar and I’m interventional cardiologist attach to Bombay Hospital, Beach Candy Hospital, Surana Group of Hospitals and in Malad Lifeline Hospitals. I’m in the field of interventional cardiology from last 20 years doing an intervention for coronary and non-coronary situations. For vulvar situations, for congenital heart diseases and other interventional fields. Today we are going to talk on hypertension. As you know hypertension is a very common illness which is affecting as a non-communicable disease which is affecting Indian population at large.

If you see the prevalence of hypertension in India in rural population is somewhere around 5-7% while in urban population it is around 10%. So a huge chunk of our population is suffering from hypertension. Unfortunately, diagnosis and the treatment of hypertension remains poorly managed in the sense that almost 25 % of our patients are not diagnosed. Though they are suffering from hypertension around to the latest ACCH guidelines. Almost 25% remains undiagnosed, roughly around 25% they are diagnosed but they are not treated properly.

Similarly, around 25% of these patients who are diagnosed are treated poorly. Only 25% of our patients who are suffering from hypertension is are being treated properly. So there is a roughly 25% rule. It is important to treat patients with hypertension why? Because if we keep these patients untreated they are going to land up in a lot of cardiovascular disease problem like patients suffering from a stroke because of either ischemic stroke or bleed in the brain or they may suffer a heart attack like myocardial infarction or die from erythema because of hypertensive heart disease.

They may also suffer from kidney problem and lead to end-stage renal disease and dialysis. They may suffer from a retinal problem with loss of vision. So it is very important to treat and control their blood pressure so as to prevent all these deadly diseases. Now there are various stages of hypertension. Normally we say that a patient whose normal blood pressure is less than 120mm systolic and less than 80mm diastolic then we call as stage 1 hypertension where your blood pressure systolic blood pressure is between 132-139.

Earlier was 142-149 but now with the latest guidelines, 2017 ACCH guidelines recommend that any person who is having systolic blood pressure between 132-139 and a diastolic blood pressure of 80-89 is classified as stage 1 hypertension. And anything more than 140mm of systolic and more than 90mm of diastolic is classed as class 2 hypertension or stage 2 hypertension. Respective their stage we have to take a proactive step to control their blood pressure either by non-pharmacological means or by pharmacological means.

Non-pharmacological means should we tried for each and every patient whatever stage is, it is very important and there are various ways in which you can control blood pressure. If you are obese then reduction of weight will help you in controlling your blood pressure, reduction of salts intake less than 2-3 grams per day will help you in reducing your blood pressure. Similarly increasing potassium intakes like fruits-vegetable lot of vegetables and fruits especially fruits containing citrus fruits like juicy fruits like oranges, sweet limes all these will help in bringing down your blood pressure.

Regarding the salt intake, you have to avoid all the salty things like a pickle, pepper, baked products, processed foods, junk foods, you have to avoid all these to reduce your salt intake. Home cook food is best. Besides salts and potassium and weight reduction, other non-pharmacological majors which will help you in controlling your blood pressure is sedation of smoking if you are smoker, reduction of alcohol to less than 60ml per day for adult males and less than 30ml for women should encourage.

Then also regular physical activities is very very important in controlling your blood pressure. You should walk to at least 30-45minutes of the brisk walk at least 5-6 days a week if not for all days but the minimum for 5 days a week and 30-45minutes of brisk walking. You can also do yoga, meditation and other things to control your blood pressure. If your blood pressure doesn’t come under control with these majors then one can start with pharmacological treatments. You have to control your blood pressure by whatever means.

Even if you have to take 1 medicine 2 medicines 3 or even 4 number of medicines it is very very important to keep them under control with the help of drugs which are very effective in controlling your blood pressure. If you control your blood pressure properly you are less likely to suffer from other cardiovascular disease mortality. So it is very very important to control your blood pressure. Be aware about your blood pressure and try to control it by whatever means which includes non-pharmacological treatment as well as pharmacological treatment. So to book an appointment with me you can contact me through lybrate.com.

A heart attack can wreak havoc, throwing a person's life completely off balance. The condition, also known as Myocardial Infarction, often catches a person unawares. As per a survey, close to 7.35 lakhs people (both men and women) suffer from a cardiac arrest and associated disorders in the US every year. Early diagnosis and preventive measures can make a world of difference. Unfortunately, many people ignore or tend to miss out on the early symptoms characteristic of a heart attack.

A heart attack can be very much averted. All you need to do is, listen to your body and pay attention to the following warning signs. Act before it is too late.

1. Indigestion, nausea: Nausea, vomiting or indigestion is important, yet most commonly ignored early symptoms of a heart attack. More common in women than their male counterparts, the symptoms are often mistaken for over exhaustion or stomach upset. Nausea, in particular, can be triggered by many conditions and hence the negligence. A person may also complain of stomach ache or heart burns.Though the symptoms may appear to be nothing serious, seeking an immediate medical assistance will not hurt either. A little alertness will only help you in the long run.
2. Pain and discomfort in the chest: This is a warning that should be taken seriously by all means. This symptom can be an indication of a condition as serious as a blocked artery, an important trigger for a heart attack.
3. Dizziness: Seldom will you find people losing their sleep over something as common as dizziness. While the lack of a sound sleep can make a person feel dizzy and light headed, the symptom (often accompanied by chest pain) could also be an outcome of a low BP (triggered by improper functioning of the heart). Look for the symptoms carefully and act accordingly.
4. Sharp pain episodes: Many people experience a sharp pain that originates in the chest and gradually spreads outward towards the arms. The symptom is a clear indication of a heart problem, ignoring which will only spell doom. Sometimes the pain can also spread to the jaw or the throat.The symptom is a strong warning that your heart needs immediate care and attention.
5. Sudden and unexplained sweating: Sweating due to hot and scorching summer is understood but unexplained sweating can be dangerous.
6. Over exhaustion: If small or regular chores that you could do in the wink of an eye are suddenly leaving you tired and exhausted (climbing the stairs for instance), it is time for you to consult a doctor.
7. Irregular heartbeat: The irregular beating of the heart can also be an indication of a heart problem.
8. Swollen feet: A heart problem can interfere with the ability of the heart to pump blood. As a result, the affected person may have swollen feet, ankles, and legs.
9. Cough: A cough that lingers for long (often accompanied with a pink mucus) is an important indication of a damaged or diseased heart.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Open heart surgery is a heart procedure. Although the number of open heart surgeries performed over the past few decades has reduced significantly, however, it is still an important surgical procedure to fix critical heart ailments.

Here is a quick fact-checker about this procedure:

• The Coronary Artery Bypass Graft or CABG is one of the frequently performed procedures in the open-heart surgery space. This is a procedure that is related to fixing the blocked arteries of the heart. A study conducted by the National Institutes of Health revealed that most patients who had undergone CABG become angina-free within a span of five years.
• This is one of the few surgeries where a doctor needs to make a deep incision close to 2-2.5 inch through the breastbone to separate muscle and get access to the heart.
• The patient is hooked to a heart-lung machine before the proceedings begin. This machine pushes blood to the body. It helps the doctor to stop the heart and perform the procedure. Once the procedure is over, the doctor closes the incision made through the breastbone with sternal wires. Then the surgeon gives a minor electric shock to the patient to restart the heart. Subsequently, the patient is taken off from the heart-lung machine.
• The patient might find himself tangled with many tubes as he wakes for the first time after the surgery. These wires take the fluid out of the body. They serve as a temporary pacemaker for the patient.
• It is important to get a clarification from the surgeon as to from which location of the body would the veins be taken from to perform CABG. Most doctors prefer the vein from the leg. However, recent studies have shown that veins can be extracted from the internal chest wall. This results in a speedy recovery for the patient.
• The patient is kept in an ICU for a couple of days before he is shifted to the general ward where he spends close to a couple of weeks before he is released. After the patient gets home, the typical recovery time for the patient is approximately 6-8 weeks.
• One has to usually deal with heightened emotions after an open-heart surgery. Studies have shown that over 20 percent of the CABG patients suffer from depression, anger, and other emotional problems. This typically lasts for a year till everything becomes normal.

In case you have a concern or query you can always consult an expert & get answers to your questions!