Erick Alexanderson
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National-Local Effort Needed to Combat Heart Disease

Thu, 09/07/2017 - 10:18

Q: What are the main problems the society faces in the different regions of the country?

A: There are very clear regional differences based on the cultural traits and customs of the population. For example, the folklore of each state has an impact on eating habits and this can vary widely across the country, requiring a different approach in each location. Some eating habits make people more prone to atherosclerosis, the accumulation of cholesterol in the arteries, because they eat too much fat and red meat. Also, working habits and stress levels to which each population is exposed have an impact. The northern states have a strong custom of achieving targets rapidly, so they work under a lot of stress. In higher income locations, work hours are longer, so people usually eat out and lack time to exercise, which puts people under more stress. With a lower income demographic, people have more time to move and walk. The weather and pollution also play an important role. Considering these factors, we cannot pretend that what we do in one place is applicable to others. We cannot look at Mexico as a unique concept because it is the result of a group of situations and environments. We cannot make public health solutions based on a standard citizen because there is no standard citizen.

Q: What is the association’s relationship with regional cardiology societies?

A: For the Mexican Society of Cardiology it is important to approach the organization’s regional branches. We believe there should be more cooperation between associations, so their projects can have a national health and educational impact and have access to the improvements developed in our central offices. That also creates a stronger sense of belonging. We have signed agreements with seven regional societies and we are working on more. These agreements will give them access to our expertise, databases and academic sessions. Cardiology is evolving at a high speed; what was an absolute truth 20 years ago is no longer useful. In half a century, cardiology has changed immensely and I cannot imagine what it will be like in 50 years. 

Q: What cardiac problems most plague Mexicans?

A: Cardiac diseases are the main cause of death in the Mexican population, accounting for about 127,000 deaths every year. This mortality rate is higher than that of cancer, pulmonary diseases and even diabetes. In fact, most diabetic patients die due to heart failure. Ischemic heart disease and heart attack are the main cardiac problems causing these deaths. There are many risk factors for these conditions and our population has most of them. The major ones are tobacco use, hypertension, atherosclerosis, dyslipidemia and diabetes mellitus. Then there are secondary factors like overweight, obesity, sedentarism, stress and tension. What triggers the burden of cardiovascular problems is that 20 million Mexicans are hypertensive, only a third of them know it and just a portion of those are well-treated. Plus, about 60 to 70 percent of our population has altered lipids. But since these are problems that do not generate major discomfort for a long time, people only seek care when they are experiencing grave symptoms.

Q: What are the main challenges in addressing these issues?

A: The number of patients with cardiovascular disease is rising every day. We see young people dying of a sudden heart attack. There are patients 30 or 40 years of age with heart problems due to diabetes, hypertension or obesity at a young age, and many of them never did anything about it. This is due to the Latin culture of not going to the doctor until presenting pain. In Mexico, there is no preventive culture like in Europe, the US or Canada. Besides these young people dying of heart disease, we have a population niche that did not exist before: the elderly. With the control of infectious diseases, we have increased life expectancy and people now live to 76 on average, much more than 20 years ago. Today, we have many 80-year-old patients and their probability of suffering from cardiac disease is high as these are chronic diseases caused by age. Our challenge is to take care of these two population groups and achieve the WHO objective of reducing cardiac death by 25 percent by 2025.