The cardio-renal-metabolic systems perform a complex interplay of physiological functions
Cardiovascular diseases (CVDs) have emerged as a growing health crisis in India. According to the Indian Council of Medical Research (ICMR), CVDs are the leading cause of death in the country, responsible for nearly 28% of all fatalities. CVDs, including heart failure and heart attacks, can have subtle symptoms that often go unnoticed until they progress and become severe. For instance, heart failure may manifest as fatigue and shortness of breath, while a heart attack might present with mild chest discomfort or indigestion-like symptoms. Recognizing these subtle signs is crucial for timely intervention and prevention of events and complications.
The cardio-renal-metabolic systems perform a complex interplay of physiological functions, which is essential for sustaining overall well-being. These systems are interconnected in such a way that dysfunction in one organ-system can significantly affect the other. NCDs (non-communicable diseases) like diabetes are some of the major risk factors of CVDs as well as chronic kidney diseases.
Diabetes and Cardiovascular Diseases
Insulin resistance and elevated blood sugar levels in people with diabetes contribute to inflammation, oxidative stress atherosclerosis, as well as dysfunction of heart and blood-vessels. All of these disorders promote the development of early-onset of atherosclerotic CVD like heart attack or stroke, as well as heart failure. These serious forms of heart diseases can lead to significant morbidity and also mortality, often in younger age. These mechanisms collectively underline diabetes as a major contributor to the problem of CVDs in India.
Diabetes increases your risk of heart disease
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Kidney Failure and Cardiovascular Diseases
Chronic kidney disease (CKD) often leads to high blood-pressure, which increases the risk of CVDs. Kidney dysfunction can also lead to fluid retention and electrolyte imbalances, straining the cardiovascular system. Additionally, CKD is associated with chronic inflammation, oxidative stress, and the accumulation of uremic toxins, all of which promote atherosclerotic CVD as well as heart failure. There is a bidirectional relationship between these two organ-systems. Heart-disease can also lead to the progression of kidney disease, through intricately linked biological pathways.
The Vicious Cycle
The interaction between NCDs like diabetes, CKD, and CVDs creates a vicious cycle, where each condition exacerbates the others. For example, uncontrolled diabetes can lead to kidney damage (diabetic nephropathy), which, in turn, further increases the risk of CVDs. Similarly, individuals with CKD are more likely to develop cardiovascular complications.
To break this cycle and effectively combat cardiovascular diseases, a comprehensive strategy encompassing lifestyle modifications, early detection, and vigilant management of diabetes, as well as heart and kidney disease, is imperative. There is also a need for widespread education and awareness around the interconnectedness of these diseases, and the overlapping risk factors, among both doctors and patients, to enable accurate diagnosis and timely treatment.
(Dr. Shraddha Bhure is a Medical Director at Boehringer Ingelheim)
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