In a country where heart diseases are the biggest killers, claiming around 1.7 million lives every year, how do doctors evaluate one’s chances of developing a severe heart condition, say, 10 years on? While there are some question-based tools called cardiovascular risk scales to ascertain a person’s future risk of heart diseases, these were developed for the Caucasian population. Now, 70 years after the world’s longest-running heart study began in the Framingham town of Massachusetts and resulted in the development of the most commonly used Framingham cardiovascular risk scale, an Indian hospital chain and software giant Microsoft Corporation have come up with the first one for Indians.
The Apollo group of hospitals collected data from four lakh health checkups conducted at its hospitals between 2010 and 2017 while Microsoft used its AI (Artificial Intelligence) Network for Healthcare. “Finally, we looked at a pool of 31,000 patients to work out a 21-point scale that can help doctors predict a patient’s risk for heart disease,” said Dr J Shiv Kumar, chief of cardiology, Apollo Hospitals. The scale is in trial at the group’s hospitals.
The Indian National Family Health Studies show that one in eight Indians suffers from high blood pressure, said Anil Bhansali of Microsoft India (R&D) Pvt Ltd. “Despite the enormous number of cases, doctors in India are unable to identify the probability of cardiovascular disease when patients come for their regular checkup,” he added. The joint project’s objective was to develop an intelligent system to accurately determine the risk using artificial intelligence and clinical expertise, he said. In trials, so far, the new scale has shown 67 percent accuracy in prediction of heart disease against 31 percent by Framingham, said Dr Kumar. Cardiovascular risk scales look at a patient’s family history and blood parameters to work out the likelihood of heart disease. The Framingham scale, for instance, asks seven questions about a person’s weight, smoking habits, cholesterol counts and the maximum pressure in blood pressure.
Dr Naveen Garg from Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, who did a study on the best heart heart risk scale for Indians last year, told, “Only Western scales are in use at present. In our study, which appeared in the Indian Heart Journal, we wanted to find out which of these scales are best suited for the Indian population.” His study zeroed in on the JBS scale. “Western scales concentrate on weight and height as Europeans tend to be heftier, but we Indians are different.” Dr Shiv Kumar said while western scales give a lot of importance to LDL (bad) cholesterol; it doesn’t appear to be the most important factor for Indians. “Smoking is an important parameter for western scales but in India tobacco should be the bigger factor,” he said. Similarly, diastolic blood pressure and physical activity were found to be important factors for Indian hearts. Dr Prafulla Kerkar, who heads Parel’s civic-run KEM Hospital’s cardiology department, said there is a great need for an Indian cardiovascular scale. Another cardiac specialist said there are several scales but accuracy is the key. – TOI