Family-based prevention is better than cure for cardiovascular health
Indian study uncovers the health and economic benefits of community interventions
Research from India has shown that family-based lifestyle interventions have the potential to improve the cardiovascular health of people living in low-and middle-income countries .
Doctors in Kerala looked at lifestyle interventions delivered by non-physician health workers to families and their effectiveness in reducing cardiovascular risk in people with a family history of premature coronary heart disease .
In their approach , the researchers exploited relationships and bonds among family members to promote the adoption of healthier choices and demonstrate that by promoting a stable family lifestyle and conducive environment , it ’ s possible to effect positive lifestyle changes within families .
The study showed that 13 home visits and repeated reminders had a positive effect on adhering to therapy and controlling risk factors , such as unhealthy diets , tobacco cessation , home blood pressure monitoring , blood sugar monitoring , and an emphasis on daily exercise .
Because the family context can affect health-related behaviours , such as diet and exercise , it ’ s often difficult to change them at an individual level without the mutual understanding and support of other family members .
Data suggest that recognising and attending to family relationships helps improve the health and wellbeing of family members struggling with management of a chronic disease . Furthermore , developing a mutually engaging relationship to support physical activity , diet , and other lifestyle changes within the family helps to regulate emotional distress due to coronary heart disease in one family member .
“ Their study was an attempt to control risk factors for cardiovascular disease at the family level , either by the patient alone or with family members . Adherence to lifestyle and compliance of drugs is essential to control risk factors ,” wrote Dr JPS Sawhney , a noted cardiologist at the Sir Ganga Ram Hospital in Delhi in an accompanying editorial in The Lancet .
Radiation therapy reprogrammes heart muscle cells to be younger
Cancer technique found to be effective and longlasting when used on the heart
Radiation therapy can reprogramme heart muscle cells to what appears to be a younger state by fixing electrical problems that cause life-threatening arrhythmia without the need for invasive procedures .
One such procedure , done by threading a catheter into the heart and burning the tissue that triggers irregular heart rhythm , creates scars that block the errant signals .
The new study , however , shows that non-invasive radiation therapy normally used to treat cancer can reprogramme the heart muscle cells to be younger and perhaps healthier by fixing the electrical problem in the cells themselves without needing scar tissue to block the overactive circuits .
The research also suggests that the same cellular reprogramming effect could be achieved with lower doses of radiation , opening the door to the possibility of wider uses for radiation therapy in different types of cardiac arrhythmias .
“ Radiation does cause a type of injury , but it ’ s different from catheter ablation ,” said co-author and radiation oncologist Dr Julie K . Schwarz of the Washington University School of Medicine at the launch of the research .
“ As part of the body ’ s response to that injury , cells in the injured portion of the heart appear to turn on some of these early developmental programmes to repair themselves . It ’ s important to understand how this works because , with that knowledge , we can improve the way we ’ re treating these patients and then apply it to other diseases ,” she said .
The researchers also found that the beneficial effects of radiation continued for at least two years in surviving patients . And importantly , they were able to demonstrate in mice that a lower dose of radiation produced the same effect .
GlobalHealthAsiaPacific . com OCTOBER 2021
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