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“Instead of imposing a blanket price control on cardiac stents a differential pricing is more appropriate. Differential pricing that rewards advancement in technology can be a game changer for healthcare in India. India needs more new products from around the globe and can gain much from the vast global experience of innovators in its fight against its double burden of disease. The intent is to increase the choices for the patients.”
— Praveen Chandra, Chairman Interventional and Structural Heart Cardiology, Medanta – The Medicity

“Over the past decades, coronary interventions, such as, coronary angioplasties have emerged in a big way and evolution of DES has become finer. Technology has the potential to improve the quality of patient’s life. So, considering the ongoing cardiovascular disease burden, the government needs to focus on innovation friendly policies, to ensure both the domestic and global stent manufacturers can bring in advanced quality stents to the Indian market.”
— Dr Sundeep Mishra, Professor of Cardiology Department at AIIMS, New Delhi.

“Price capping policies in the recent years may soon deprive both patients and doctors the freedom to choose from advanced quality cardiac stents, as most may not be available in future. Capping the price has only disincentivized innovation. We must not forget that positive clinical outcomes depend on the analogy of the patient as they can reflect different medical conditions. So, requirement of the appropriate stent should be considered. Hence, the concept of “one-size-fits-all principle does not hold ground and differential pricing should be considered.”
—Dr Bharat Rawat, Associate Director, Cardiology, Medanta Super Speciality Hospital, Indore

“The increasing burden of cardiac disease in India is worrisome and must be brought under control. Higher rates of indoor and outdoor pollution, combined with a shift towards a sedentary lifestyle and an increase in life threatening habits such as smoking, vaping and other drug abuse, particularly in the urban youth, poses a threat to the heart health of the nation. Unfortunately, incidences of heart attacks have been occurring in very young age groups, even between the ages of 20-30. India is home to the largest youth population, and we must ensure that we pass down healthy lifestyle habits to the next generations. It is also important to keep heart health in check with regular screenings, to catch early signs of a deteriorating heart so that the damage can be managed or reversed. No matter the age, a healthier diet and active lifestyle can bring incredible health benefits to the body, including the heart.”
— Dr. Ganeshakrishnan Iyer, lead consultant, CTVS surgery, Aster CMI Hospital

“In India, the incidence of heart disease and mortality has increased significantly over the past 30 years that have coincided with an increasing burden of non-communicable diseases. The human body is naturally programmed to respond to life-threatening situations. The brain sparks off a cascade of hormones and chemicals that speeds up your heart rate and breathing, elevates your blood pressure and boosts the glycogen supply to your muscles. Stress triggers inflammation which results in the narrowing of the coronary arteries thus increasing the possibilities of a heart attack. Constant stress also makes it difficult to maintain healthy habits, such as following a good diet, getting enough exercise, abstaining from smoking, and getting adequate sleep. It is also important to educate people about taking the requisite preventive measures and adopting naturopathy practices, mindfulness and yoga can mitigate their risk of heart disease.”
— Dr Srividya Nandakumar Sr. Naturopath, Jindal Naturecure Institute

“As India’s disease epidemiology shifts towards greater incidence of non – communicable diseases, there is an imminent need to unleash preventive healthcare strategies at the primary healthcare level. Equipping our primary health practitioners to correctly assess risk factors, effectively manage chronic conditions such as diabetes and hypertension and timely diagnose and refer heart disease can go a long way in cutting rate of mortality. According to WHO, almost 80% of premature heart disease and stroke is preventable by timely action. Integrating primary healthcare physicians into a national prevention model for cardiovascular disease can reap rich dividends in terms of prevention of disease and reducing its curative cost burden. Primary healthcare practitioners and non – physicians like nurses must be effectively trained to assess risk factors of all patients visiting their clinics irrespective of the health complaint they come up with. People with high-risk factors must be made to undergo diagnostic tests to rule out diabetes, elevated blood pressure as well as poor cholesterol levels. At the primary care level, hypertension is also preventable through a proper diet, physical exercise and a well-tailored hypertension control program to reduce the incidence of stroke, heart disease, and kidney disease. At the same time, the primary physicians must also be trained to advocate healthy eating and living habits to all patients visiting their clinics. Consumption of local fruits and vegetables should be promoted along with the reduction in intake of salt, refined sugars and trans fat. Control of diet and physical activity will result in a reduction in the incidence of obesity, hypertension, high cholesterol levels, and diabetes. People must also be educated to identify signs of a cardiac event and the need to immediately respond to them. Thus, Making the ‘Fit India’ campaign more than a slogan and making it a mass movement at the grassroots is critical to our collective fight against cardiovascular diseases and other lifestyle ailments.”
— Savitha Kuttan, CEO, Omnicuris

“The rising incidence of non-communicable diseases in general and cardiovascular diseases, in particular, has been the most notable trend in the healthcare scene of India over the past 25 years. It is estimated that following a healthy lifestyle can help prevent over 80 percent of coronary heart disease cases, 50 percent of ischemic strokes, 80 percent of sudden cardiac arrest, and over 70 percent of premature deaths caused by heart disease. Clinical efforts at preventing heart disease have mostly been secondary or primary. Primary prevention involves controlling these risk factors by making the necessary lifestyle changes and taking medication. However, we need to focus more on primordial prevention. It involves educating people to help prevent inflammation, atherosclerosis, and endothelial dysfunction, and thereby prevent risk factors such as high cholesterol, high blood pressure, obesity, and cardiovascular events. The more we push primordial prevention, more people will successfully protect themselves against heart disease. This must be done at the community level by engaging primary healthcare providers, nurses, midwives etc who must be trained to educate communities about the risk of heart disease and the need for adopting the life lifestyle measures to prevent it.”
— Rajesh Ranjan Singh, CEO, Wadhwani Institute for Sustainable Healthcare (WISH) 

“Depression and Cardiovascular Diseases (CVD) have major association, up to 15 per cent of patients with CVD and 20 per cent of patients who have undergone Coronary Artery Bypass Grafting (CABG) suffer from Depression hampering their recovery from the primary event. Prolonged Depression after a coronary event can increases the risk of mortality to 17 per cent, as has compared to 3 per cent risk in patients who don’t suffer from Depression. This is caused by certain Depression triggered physiological changes such as increased Heart rate, increased blood clotting, increased pro-inflammatory markers like CRP, etc. It also increases pain and hampers with cardiac rehabilitation post-surgery. American Heart Association has now recommended that all cardiac patients be screened for Depression, so that early treatment can be instituted.”
— Dr Zakia Khan, Interventional Cardiologist, Fortis Hospital, Kalyan

“Any form of obesity is bad, but some forms are worse. Look at yourself in the mirror, if you look like an Apple i.e. if your belly or waist is bigger than your hips then you have Truncal obesity. This excessive fat around your vital organs like intestines, is harmful and leads to hypertension, diabetes and increases the levels of bad cholesterol. Don’t be an apple. Moderate aerobic exercises daily for 30 minutes at least on 5 days a week, calorie restriction by reducing the portions of your meal, avoiding red meats, high fat dairy products, refined carbohydrates, aerated drinks, oily foods and replacing these with whole grains, fruits, vegetable and low fat dairy products is the way to go.”
— Dr Vivek Mahajan, Interventional Cardiologist, Fortis Hospital, Kalyan

“Cardiovascular Diseases are the leading cause of death and loss of productive years globally. The major risk factors leading to a spike in the incidence of heart disease are bad food habits, Hypertension, air pollution, high cholesterol and tobacco usage. In majority of the cases, there were multiple factors. As the socio-economic status of Indians has increased in the last 2 decades, the incidence of Cardiovascular Disease has increased, indicating that Coronary Artery Disease is more of a lifestyle disease now. Diabetes and Chronic Kidney Disease (CKD) account for smaller amounts of Atherosclerotic CVD in India. Dietary abnormalities such as low intake of fruit, vegetables, nuts, and seafood-derived Omega-3 Dats, coupled with elevated Sodium exposure, intake of processed meats, low intake of fiber and whole grains, accounted for more disease in India. Ambient air pollution, persistent organic pollutants, and exposure to solid fuels are larger risks to the population in India. Studies suggest that higher incidence of heart ailments increased Abdominal Obesity, type 2 Diabetes Mellitus, and Dyslipidemia.”
— Dr Nilesh Gautam Senior Consultant Interventional Cardilogy, SL Raheja Hospital, Mahim

“Indians are being affected by Coronary Artery Disease 10 years ahead of their western counterparts. Today, 7 per cent of youngsters (between the age of 25 -35 years), 12-15 per cent of non-Diabetic and 21 per cent Diabetic young Indians (between 35-60 years) are diagnosed with Coronary Artery Disease. This is attributed to physical inactivity, wrong dietary choices i.e. high intake of junk foods, carbohydrates and oily foods, excessive smoking (75 per cent), alcohol consumption, substance abuse, and high stress due to poor work-life balance. Prevention should start from childhood and be supplemented by regular cardiac screening in schools and colleges every 3 -4 years; regular physical exercise programs in schools, colleges and workplaces is a must; an active yoga session can be conducted daily. Reduction of sugar intake, carbonated drinks and salt (sodium) in foods is absolutely essential.”
— Dr Manoj Pradhan, Senior Consultant, CVTS Surgery, SL Raheja Hospital, Mahim

“The breakthrough in non-surgical heart aortic valve replacement is steadily gaining popularity in India and is turning out to be a boon to the people suffering from aortic valve disease. Previously patients who were deemed high risk for open heart surgery were offered TAVR (Transcatheter Aortic Valve Replacement) procedure but now very recently this non-surgical method of valve replacement (TAVR) is approved for non high-risk patients thus making this procedure as first choice compared to open heart surgery. Today, we send TAVR treated patients home in less than 48 hours after the valve replacement is done non surgically. The TAVR procedure is a highly skilled procedure. The interventional cardiologist inserts the catheter — a narrow, long tube in a large artery in the groin. The valve is then implanted in the heart through this catheter.”

— Dr Ganesh Kumar, Head of Cardiology Dept at Dr L H Hiranandani Hospital, Mumbai