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)