NEW DELHI, July 19: If your BP goes up each time you try to make sense of your blood pressure readings, or if your doctor's advice on cholesterol and diet management leaves you more befuddled than ever, then here's some good news for you.In the first attempt of its kind to distill India-specific guidelines from current medical wisdom, the Indian College of Cardiology (ICC) has recommended that we should aim for a cholesterol level of less than 180 mg/dl, and keep our blood pressure below 120/80 mmHg.The country's apex organisation of heart specialists has also cleared the blurred distinction between `overweight' and `obesity' by pointing out that `overweight' individuals are not immune to most of the complications associated with `obesity' - the dividing line exists only in the dictionary.But how does one define over-weight and obesity? According to the ICC, you are safe if your body mass index is less than 25 (you can ask your doctor to work out the figure). Your waist-hip ratio should be lower than 0.95 if you're a man. For women, it should be below 0.85. The hour-glass figure isn't just attractive, it's good for the heart, too.These guidelines were framed after much brain-storming by a panel of four distinguished cardiologists - Dr K Srinath Reddy, an AIIMS professor who was recently appointed co-chairman of a 12-member International Committee set up to study the `heart disease epidemic' on behalf of the Institute of Medicine; Dr Rajendra Tandon, former head of the Department of Cardiology at AIIMS, who's now with the Sitaram Bhartia Institute in New Delhi; Dr M J Gandhi, formerly with the K E M Hospital, Mumbai; and Dr V Dayasagar Rao, Chairman, ICC.Their recommendations should radically alter the prescriptions of physicians across the country. So far, blood pressure readings up to 140/90 mmHg were considered safe. Similarly, a cholesterol level of 200-220 mg/dl was regarded as fine, because the American Heart Association (AHA) said so.The ICC recommendations reflect the medical community's growing concern over Cardiovascular Diseases (CVDs) emerging as new threats to public health, contributing presently to at least 2.5 million lives lost each year in India. By the year 2020, according to the World Health Organisation (WHO) and the World Bank, CVD's will emerge as the leading cause of death and disability in the country.Explaining the guidelines to Express News Service, Reddy said he and his colleagues had consciously pegged the ideal cholesterol level at a couple of notches lower than that accepted by the AHA, because urban Indians have a genetic disadvantage.Our `good', or HDL-cholesterol count is apparently lower than that of our Western peers, which is bad news because it raises the total HDL-cholesterol ratio - the real measure as far as doctors are concerned of our cholesterol profile. The importance of cholesterol control was first demonstrated in Finland, where, between 1972 and 1993, a drop in the average cholesterol level from 276 mg/dl to 224 mg/dl led to a 33-47 per cent reduction in the number of deaths from heart attacks, CVDs, strokes and cancers.In majority of the cases, the affected persons aren't even aware that their blood pressure is high. Which is why the ICC has recommended that once you cross 30, you should get your BP measured every year.
