Heart disease affects rich and poor alike

Heart disease affects rich and poor alike

JAKARTA (JP): Coronary heart diseases, long popularly believed
to be a "rich man's affliction", turn out to also be a major
health problem for the poor. In fact, in certain cases, the poor
are more prone to heart problems than the rich.

Senior heart specialist Dr. Lily Ismudiati Rilantono, in a
lecture marking her installment as professor at the School of
Medicine of the University of Indonesia on Saturday, said people
from the lower social-economic brackets are several times more
likely to experience heart problems.

Quoting recent studies conducted in Southampton, England,
Rilantono said certain prenatal and post-natal conditions,
related to the poor diet of pregnant women, increase risks of
heart diseases and strokes.

In England, those categorized as "high risk" include people
from lower social-economic class and low birth-weight infants.

"We should pay greater attention to this trend, especially in
connection with Indonesia's lower economic groups," she said. "We
should seek correlation between retarded fetal growth and the
condition of placenta, with risks for heart diseases."

She quoted another study which shows that formula-fed babies
are seven times more likely to suffer from damage in blood
vessels, a condition leading to heart failure, than breast-fed
babies.

"The process of arteriosclerosis (the constriction of blood
vessels) does not start with aging," she said. "The problem
starts even when a baby is not yet born, so the strategies to
prevent it should also start that early."

Lily's lecture was on The role of scientific research and
development for the management of cardiovascular problems which
she delivered before a panel of professors and several government
officials.

She expressed concern that the frequency and variety of heart
disease has increased at greater rate than medical research and
development anticipated.

The 1992 Household Health Survey carried out by the Ministry
of Health shows that cardiovascular diseases are now the top
killers and cause 15 percent of deaths nationwide.

Third rank

According to a similar survey in 1986, the disease ranked
third below diarrhea and acute lower respiratory tract infections
with a figure of slightly below 10 percent, while in 1972 it
ranked eleventh among the top causes of death in the country.

Experts on heart disease have been concerned about the speed
with which the disease increases. They linked the trend with the
growing "coronary prone behavior," a life-style centered in
consumerism, stiff competition, lack of exercise and over-
consumption of fatty foods, usually identified with
industrialized societies.

In the penultimate survey it was predicted that the disease
would top the list by the year 2000, but, as it turned out, it
did so in 1992. "The speed is too high for Indonesia, which has
not actually reached a stage of development similar to
industrialized countries," Rilantono said.

She also expressed concern that the current sophisticated
medical intervention for coronary heart diseases have not yielded
the desired results.

In a technique called balloon valvuloplasty, where a catheter
is inserted into the valves of the heart, there is a 30 percent
possibility that the condition will recur, she said.

Rilantono called on her colleagues to study and identify new
risks of heart diseases other than the known factors of smoking,
obesity and hypertension.

She also called for the establishment of a national commission
for cardiovascular problems and a comprehensive solution to the
problem.

She specifically asked manufacturers of canned or instant
foods and dairy products to join the campaign against heart
diseases, and the Health Ministry to implement the food labeling
regulation.

Rilantono was born in Bandung in December 1932, and was a 1991
fellow of the American College of Cardiology as well as former
president of the Asian Society of Pediatric Cardiology.

A mother of two, she is also known for her involvement in
various campaign for maternal and infant welfare. She founded the
Foundation for the Welfare of Indonesian Children in 1979. (swe)