Winter Chill Ups Risk of Stroke & Heart Attack: As Patiala Freezes, Doctors at Columbia Asia Hospitals, Patiala Advice Caution

Elderly people and heart patients must take adequate precaution against the cold

Patiala, 16th January 2017: As the mercury dips to single digits across north India, doctors at Columbia Asia Hospitals, Patiala are advocating greater caution especially for heart patients and elderly people who face increased risk of heart attacks and strokes in extreme chilly conditions.
Over the past few days, temperatures have radically plummeted across Punjab including in Patiala which has been recording minimum temperatures below 5 degrees Celsius.

Doctors say extreme winter chill increases the risk of heart attacks, particularly in patients who have pre-existing cardiovascular conditions.

“The loss of heat from body or a fall in body’s internal temperature is dangerous for people living with cardiovascular disease. People with coronary heart disease often suffer angina or chest pain when exposure to cold weather. Clinical evidence suggests that incidence of heart attacks increase during winters. In fact, studies in several countries have shown that the number of heart attacks and even heart attack related deaths increase in the colder months. Exposure to extreme cold puts excessive pressure on the heart as it pumps warm blood to all parts of the body. Besides cholesterol levels also tend to fluctuate significantly with the change in the season, which may leave people with borderline high cholesterol with greater cardiovascular risk during the winter months. This is why vulnerable people are advised against taking excessive physical strain during winters since it has further increase the risk. ,” says Dr. Jeewan Mittal, Consultant Cardiologist at Columbia Asia Hospitals, Patiala.

As the city freezes, there is a need to increase awareness among people and educate them to take preventive measures. Risk of strokes also increases significantly during winters, even in patients who are on blood pressure medication. This is why it is important to get have your blood pressure checked regularly during winters and meet your doctor to seek advice on the need for altering medication.

“During winters the level of blood pressure tends to be higher, and there is also a rise in levels of certain proteins in the blood stream. Patients of hypertension tend to have higher blood pressure during colder months. Therefore, they must make sure they are checking their blood pressure regularly even if they are on medication. Besides, during the season, heart also has to work harder in a bid to ensure that warm blood reaches all corners of the body and the body retains heat. Sometimes, this strain can be excessive for people who already have a weak heart. This is why it is the elderly who are most at risk in winters,” explains Dr. Deepak Katyal , Consultant Cardiologist Columbia Asia Hospital, Patiala
Cardiovascular disease are on the rise in India since the past few years including in Patiala. This means we have a large number of people living with existing heart conditions and hypertension. All these people need to exercise a lot of precaution during extreme cold. According to the Global Burden of Diseases Study conducted by WHO, by 2020 India will have more than 4.77 million deaths a year due to cardiovascular diseases and 2.58 million deaths due to coronary heart diseases.

To prevent the heart from excessive stress, heart patients should avoid indulging in exhausting tasks that overstress them. However, indulging oneself with light yet regular exercise or physical activities is always advisable.
“Many heart attacks are also caused due to hypothermia, the condition of having an abnormally low body temperature suddenly. This happens when a person in inadequately dressed to meet the needs of winters. A common mistake people make is that they wear a heavy but single woolen clothing. This is inadequate to protect the body heat. It is important to cover the body in layers of clothing as this protects the heat from escaping the body. Several lighter layers are much better than one heavy cover,” says Dr. Jeewan Mittal

However, all this doesn’t mean that you give up your daily exercise routine during the inert months. A daily moderate to heavy exercise of atleast 30 minutes is highly advisable to prevent lifestyle disease such as diabetes, cardiovascular disease and even some forms of cancer.
Tips to protect your heart in winters:
Dress yourself up in several layers of clothing
Avoid indulging in physically straining tasks
Try to stay indoors after sunset as the temperature drops significantly during night hours
·         Avoid your daily walks and adopt a mild exercise regime indoors to prevent exposure

About Columbia Asia Hospitals Pvt. Ltd.

Columbia Asia Hospitals Pvt. Ltd. is the only company in India to utilize 100% foreign direct investment (FDI) route in the hospital sector.

About Columbia Asia Group of Companies

The Columbia Asia Group is owned by more than 150 private equity companies, fund management organizations and individual investors. The group currently operates eleven facilities in India and has presence in Ahmedabad, Bangalore, Gurgaon, Ghaziabad, Kolkata, Mysore, Patiala and Pune. The company also operates hospitals in Malaysia (11), Vietnam (3), and Indonesia (3). The Indian management operations are managed from its office in Bangalore.

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First of its kind Stroke Rehabilitation in India study - FAmily Led RehabiliTaTion aftEr Stroke in INDia – The ATTEND Trial released

Ø  Supported by the National Health & Medical Research Council (NMHRC) of Australia, the study was coordinated by Christian Medical College, Ludhiana and the quality of the implementation monitored by the Indian Institute of Public Health, Hyderabad with George Institute for Global Health providing technical support for implementing the study.

 New Delhi: 03 November 2016: The first of its kind Stroke Rehabilitation in India study - FAmily Led RehabiliTaTion aftEr Stroke in INDia – The ATTEND Trial was released today, highlighting that it is imperative to invest in stroke units and multidisciplinary rehabilitation centers to improve outcome after stroke. It is estimated that 1.6 million people have a stroke in India every year with early case fatality rates ranging from 27% to 41%. This equates to  1.5 million people having a stroke each year, and a further 500,000 people, each year, living with stroke disability. Although there is a paucity of data on the long-term consequences of stroke on families in India, anecdotal evidence indicates a significant burden, particularly in rural areas. Stroke is the third commonest cause of death in the adult population.



Present on the occasion were Dr Soumya Swaminathan, Director General ICMR, Dr Richard Lindley, Professor, The George Institute for Global Health, Australia, Prof Srinath Reddy, President, Public Health Foundation of India, Dr Jayaraj Pandian, Professor and HoD, CMC Ludhiana, Dr Damodar Bachani, Deputy Commissioner MoHFW and Prof GVS Murthy, Director Indian Institute of Public Health, Hyderabad.



In his address Prof GVS Murthy, Director Indian Institute of Public Health, Hyderabad and the Co-Investigator of the ATTEND Trail said, “ There is an urgent need to establish well quipped and staffed accessible and affordable stoke care units supplemented with family supported care.”



The ATTEND Trial is a multicentre, randomised, blinded outcome assessor, controlled trial, which looked at whether a family-led caregiver-delivered home-based rehabilitation intervention versus usual care is an effective, affordable early supported discharge strategy for those with disabling stroke in India. The Trial was conducted at 14 centres across India. This is one of the largest stroke trials ever undertaken. 1250 stroke patients were followed up over six months. The study was supported by the National Health & Medical Research Council (NMHRC) of Australia. The study was coordinated by Christian Medical College, Ludhiana and the quality of the implementation monitored by the Indian Institute of Public Health, Hyderabad. The George Institute for Global Health provided the technical support for implementing the study.



The findings from the study categorically support the establishment of high quality comprehensive stoke units across India increasing to about a 100 from the present 30 such centres. Results of the study and policy implications were presented at a workshop in Delhi on 3rd November 2016. The workshop was organized by the Indian Institute of Public Health, Hyderabad in collaboration with the George Institute India and the Christian Medical College, Ludhiana.
• 1250 patients with mild to moderate disability from 14 hospital sites across India over two year period.
• The intervention was delivered as planned and as per the study protocol.

a)      Average of 3 hours hospital training and 3 hours of total home visits were provided to intervention patients.

b)      Carers and patients reported 18 hours of training in the first month after discharge.

The intervention was completely safe.

Recommendations for Stroke Rehabilitation in India:


These results suggest that it is imperative to invest in stroke units and multidisciplinary rehabilitation centers to improve outcome after stroke.

Government should include these stroke units, multidisciplinary rehabilitation centres as part of Prime Ministers vision of 100 smart cities.

Unmet needs with about half of stroke survivors reported problems with mobility, depression, pain at six months. Emphasis should be on making hospitals, buildings, public transport more accessible for the people with disabilities.

There is need to strengthen and invest more in primary prevention campaign given the high prevalence of various risk at young age of patients in ATTEND study. (i.e. 3/4th had hypertension and 40% had diabetes).

There is also a need to focus on generating employment for survivors with disabilities as the huge number of them belongs to economically productive age group and were the main income earners of the family.

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THE WORLD STROKE ORGANIZATION ROAD MAP FOR QUALITY STROKE CARE HAS BEEN LAUNCHED

Medtronic joins the Global Framework for Stroke Care on World Stroke Day 

DUBLIN and HYDERABAD, India – Oct. 27, 2016 – In recognition of World Stroke Day,  Medtronic plc (NYSE:MDT) and the World Stroke Organization (WSO) joined together for the third year to raise awareness of stroke and discuss the Road Map for Quality Stroke Care at a press conference held today at the World Stroke Congress in Hyderabad, India. Yesterday, WSO launched the Road Map, which provides the framework for the implementation, monitoring and evaluation of stroke services globally. Medtronic is one of the sponsors of the Road Map. India was chosen for the launch to coincide with the World Stroke Congress in Hyderabad and World Stroke Day.  

The Road Map will provide guidance for local healthcare officials and stroke care clinical groups for the selection of evidence-based recommendations, approaches to implementations in clinical practice and the calculation of performance measures to create an environment of continuous quality improvement. 

 Patient with Dr Sannareddy Rajesh Reddy (Neurosurgeon, Apollo Institute of Neurosciences, Hyderabad)

 Patient with Dr Suresh Giragani (Consultant Interventional Radiologist, Yashoda Group of Hospitals, Hyderabad)

Werner Hacke (Incoming President, WSO)_ Dr Jeyaraj Pandian_ Stephen Davis (Immediate Past President, WSO) and Dr Nagesh Uppuluri (Sr Director, Medtronic Neurovascular)

"India is facing a stroke epidemic. The Road Map’s introduction is timely and will help our country take positive steps to address the impact of this disease,” said Jeyaraj Durai Pandian, head of neurology, Christian Medical College (CMC), Ludhiana, Punjab, India. 

Currently, the stroke incidence in India is much higher than Western industrialized countries. With a population of 1.2 billion, 1.8 million people suffer from stroke and one-third of those afflicted die annually.[i] A 2013 study showed that approximately 23 percent of Indians are unaware of stroke warning symptoms.[ii] 

Advances in stroke treatment have been significant in recent years and stroke treatment guidelines have begun to reflect those changes; however, many countries, including India, are still struggling to implement the latest guidelines and ensure that patients are getting the appropriate treatment within the recommended time frame.  

“Every day we see the impact that innovative treatment solutions can have on acute ischemic stroke patients,” said Madan Krishnan, vice president of Indian Sub-continent at Medtronic. “We are committed to working with our partners to ensure that stroke patients in India and across the world have access to the right treatment at the right time.” 

In addition to improving stroke care, Medtronic through its partnerships with WSO and the American Heart Association/American Stroke Association is focused on raising awareness of the signs and symptoms of stroke. The signs of stroke may include drooping or numbness in the face; sudden weakness or numbness of one arm; trouble speaking; trouble seeing; loss of balance; or severe headache with no known cause. If someone is exhibiting any of these symptoms, even if the symptoms go away, it is important to seek medical attention immediately.  

“The speed at which someone gets medical attention during a stroke is critical to the opportunity for complete recovery. On World Stroke Day and year-round, WSO works to improve awareness of this devastating disease,” said Professor Werner Hacke, president, World Stroke Organization. “Ensuring proper treatment is available is the second part of the equation. Through our new Road Map, we are helping to improve the processes of care and, ultimately, positively impact patient outcomes.”

In 2016, WSO and Medtronic’s partnership has focused on the treatability of stroke, recognizing that although stroke is a complex medical issue, there are ways to significantly reduce its impact. In addition, awareness of stroke signs and symptoms plays a critical role and is a focus of the partnership’s efforts. 

"On World Stroke Day, WSO and Medtronic are working to increase stroke awareness and ensure people know that stroke is treatable,” said Stacey Pugh, vice president and general manager of the Neurovascular business, which is part of the Restorative Therapies Group at Medtronic. “With treatment options such as the Solitaire stent retriever plus IV-tPA, patient outcomes can be improved. We are committed to continuing to fight stroke, not only through awareness efforts, but also by providing innovative stroke treatment solutions." 

Each year on World Stroke Day Medtronic encourages people to take 2 minutes to learn about the signs of stroke and then tell 2 people about those signs as part of the global “Take 2…Tell 2” campaign. People can share their stroke stories by visiting http://www.take2forstroke.com and by posting on social media using the hashtag #take2forstroke. Raising awareness can help others recognize the signs of stroke and potentially help save a life. 

About Medtronic

Medtronic plc (www.medtronic.com), headquartered in Dublin, Ireland, is among the world’s largest medical technology, services and solutions companies – alleviating pain, restoring health and extending life for millions of people around the world. Medtronic employs more than 88,000 people worldwide, serving physicians, hospitals and patients in approximately 160 countries. The company is focused on collaborating with stakeholders around the world to take healthcare Further, Together.

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Daily Exercise Not Enough; Doctors Advocate Need to Find Ways to Become Less Sedentary at Work

Sitting is the New Health Hazard

Daily Exercise Not Enough; Doctors Advocate Need to Find Ways to Become Less Sedentary at Work

·         Recent studies say that prolonged sitting poses major health hazard to people even if their exercise daily

·         Essential to break extended sitting by standing or walking a few minutes every hour 

New Delhi, 3 October 2016: Prolonged sitting, without frequent standing or walking breaks in between, is emerging as one of the most serious health hazards of the 21st century! In fact, doctors and cardiologists today are counting prolonged sitting among leading risk factors for cardiovascular and other diseases, much like smoking and high blood pressure.

While the ill effects of sedentary lifestyles have been well-known for quite some time now, recent research has concluded that even people who exercise daily face increased health risks if their jobs and lifestyles require them to sit for long hours at a stretch.

According to Dr Amar Singhal, Senior Interventional Cardiologist and Head, Department of Cardiology, Action Heart Institute, Sri Balaji Action Medical Institute, New Delhi, the number of hours you sit at a stretch is directly proportional to the risk of cardiovascular disease including heart attacks and stroke.

Most urban professionals today spend more than half of their waking hours sitting at work, or commuting, and in front of computers or televisions at home. The duration of sitting sometimes extends for hours at a stretch. New evidence suggests that such people face a significantly higher risk of mortality from cardiovascular disease, diabetes, and even cancer, even if they exercise daily or head to the gym at the end of the day. 

Physical inactivity has been identified by the World Health Organization as the fourth leading risk factor for global mortality causing an estimated 3.2 million deaths globally.

“Most people believe that prolonged sitting hours will not be hazardous if they exercise 30 minutes daily. However, we now have evidence to conclude that daily exercise does not undo the damage caused by long hours of sitting at a stretch. In addition to 30 minutes of exercise daily, we need to break from the sitting position every hour for a few minutes to make sure our body retains its healthy functioning processes. 

“Apart from ensuring 30 minutes of moderate exercise daily, we also need to find ways to become less sedentary at work by adopting simple measures like getting up from the chair and walking around the workplace every hour, incorporating standing work stations in offices or conducting meetings while standing,” says Dr Amar Singhal.

Healthy blood circulation is key to several health parameters. In people who sit for hours at a stretch, blood circulation remains slow for extended periods of time daily. This makes the heart arteries more prone to clogging, causes elevated cholesterol and high blood pressure. At the same time, sedentary habits are also associated with declined insulin response, making an individual more prone to type 2 diabetes.

“Unlike two decades back when a genetic predisposition was the leading risk factor for cardiovascular disease, today poor lifestyle habits are the main driver of an individual’s risk. The bane of sedentary lifestyles is upon us. Most of us spend around 8 hours sitting at a stretch at work; then we again sit in our vehicles or in public transport while riding home. Once home, the television sets are waiting for us. Obesity, diabetes, hypertension and cardiovascular disease are a natural corollary. This is why we are also witnessing an increase in incidence of heart diseases in young men and women,” adds Dr Singhal. 

Tips to Become Less Sedentary at Work:

Park your car at a distance from your office, so that you walk at least 15 minutes on your way to work and back

Make sure to stand up from a sitting position once every hour and take a five-minute walk around the workplace

Stop using the intercom, walk to the colleague you want to talk to

Ask your office administration to install standing workstations to allow employees take frequent breaks from sitting

Avoid taking phone calls while sitting, make it a habit to walk around the desk whenever you take a phone call

Ensure 30 minutes of exercise – walking, jogging, gyming – at least five days a week

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Stroke: The New Health Epidemic That is Going Unseen

·        Stroke cases have increased 20-fold over the last 25-30 years

·        Doctors say lifestyle changes need to be taken more seriously 

New Delhi, 30th June 16: It hits suddenly, when people least expect it, and when it does, it hits hard, and most often, with little reprieve. Stroke in India, and in fact, in the world, is unfortunately getting to be more common than it was a quarter of a century ago.

“While we have no official numbers for this, rough estimates suggest that in India, the numbers for stroke stood at 5-10 per 1,00,000, 25-30 years ago. Today, we have 100-120 people per lakh. Conditions like obesity, diabetes and hypertension predispose our population to stroke, especially because these set in 10 years earlier in India than they do in the West. This is worsened by poor lifestyle habits, such as smoking, sleep deprivation, an unhealthy diet and all the stress we take in our industrialized world today,” says Dr Shamsher Dwivedee, Chairman,Neurology, Vimhans PrimaMed Super Speciality Hospital, New Delhi.

A stroke takes place when the arteries to the brain are affected. They are blocked, because of which blood may not reach a part of the brain. This may take place by either a clot in the artery or a rupture. People living with certain kinds of health problems are more vulnerable to stroke. Those living with diabetes are two to four times more likely to have strokes, while high blood pressure is the leading cause of stroke. Stroke risk also increases with age, especially in women. In fact, worldwide, it kills more women than men. However, what worries doctors is that younger people are coming in with stroke today, simply because of poor lifestyle choices.

“Unlike a heart attack, a brain attack is often much more difficult to recover from. The loss to the family is great, as the person is often left disabled or left less productive, the cost of rehabilitation is a lot, and the burden to the nation needs to be taken into account, in terms of both human potential and monetary loss. The best way to avoid a stroke is simply to lead a life that is healthy: quit smoking, restrict alcohol, eat a balanced diet, exercise, and reduce stress. Yearly medical check-ups to ensure that the numbers are in check (diabetes, blood pressure, cholesterol), and more frequent doctor monitoring if any conditions already exist, can help to minimize the stroke complication,” says Dr Dwivedee.

Besides prevention, the country also needs stroke awareness, so that people can get to a hospital in time, to save lives and so the stroke causes minimal damage. Typical stroke symptoms are detected through FAST: Face drooping, Arm weakening, Speech difficulty, Time to call emergency. “Keeping this information at the top of the mind can help many people reach the hospital in time,”says Dr Dwivedee.The focus of neurologists at Vimhans is now: creating an awareness for risk reduction, quick detection and diagnosis and appropriate management.

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