World Heart Day is being observed on September 29 and this year's focus is on cardiovascular disease prevention among women and children. Although poverty, malaria, AIDS and chronic diseases account for more than 53 per cent of all deaths, with people moving up the socio-economic ladder, lifestyle diseases have also emerged as a major killer, and heart disease is one of the main lifestyle diseases.

Each year CVDs kill over 8.6 million women globally. This figure is more than the total number of women who die from all cancers, tuberculosis, HIV/AIDS and malaria combined. This alarming figure has made WHO focus on CVDs among women by running the Go Red for Women Campaign to improve women's knowledge of heart disease and stroke. Improved knowledge will help them take action and achieve longer, better heart-healthy lives. 

Remember that heart disease and stroke do not affect only men or older and rich populations. CVDs affect as many women as men. Unfortunately , women's risk is grossly underestimated. You will be surprised to know that heart disease is actually the number one killer of women. It accounts for 1 in 3 female deaths. Shocking, but true it is. In this scenario it is vital that women learn the truth about their CVD risk and take action to protect themselves and their family.

Even children are vulnerable . The risk for CVDs can begin during foetal development, and increase further during childhood with exposure to unhealthy diet, lack of exercise and smoking. Modern materialistic society is exposing children to risk factors such as diets high in "bad" fats and sugar. 

Today's children are comfortable with activities such as playing computer games and watching TV programmes. They avoid physical activity. In some countries they also take up tobacco consumption at very early age or are exposed to secondhand tobacco smoke. All these are making them vulnerable to CVDs.

You must know that the heart is a muscular pump in the chest. It must beat continuously to send blood to the lungs and the rest of the body. Simply put, when the arteries get clogged with bad cholesterol, plaque, scar tissue, or calcium, the heart slows down and finds it difficult to circulate blood. This slowing down leads to problems from chest pain to heart failure to a heart attack.

Chest pain is the first symptom of a heart attack. This is brought on by exertion. And you can relieve it by taking rest. The major symptoms of a heart attack are intense chest pain, sudden cold, sweating, weakness and nausea. This is confirmed by electrocardiography, angiography and also x-ray .  

One invites CVDs through tobacco use, alcohol use, high blood pressure which is also called hypertension, high cholesterol , obesity, physical inactivity and unhealthy diets. The factors like high blood pressure and cholesterol, family history, cigarette smoking, diabetes are well known. In addition there are congenital risks. In this category people are born with these problems like imperfect heart valves and genetic problems that promote hardening of the arteries.  
 Once the problem is identified you must go in for intensive follow up which may lead to lifestyle modification, appropriate medication, exercise therapies and diet control. These can be accomplished with a combination of individual as well as group therapies.

Non-smokers who live with or spend time with people who smoke are damaging their memory, a new study has found.

The study by Northumbria University is a first of its kind to explore the relationship between exposure to other people's smoke and everyday memory problems.

Dr Tom Heffernan and Dr Terence O'Neil, researchers at the Collaboration for Drug and Alcohol Research Group at Northumbria University, compared a group of current smokers with two groups of non-smokers, those who were regularly exposed to second-hand smoke and those who were not.

Others exposed to second-hand smoke either lived with smokers or spent time with smokers, for example in a designated "smoking area," and reported being exposed to second-hand smoke for an average of 25 hours a week for an average of four and a half years.

The three groups were tested on time-based memory (remembering to carry out an activity after some time) and event-based memory (which refers to memory for future intentions and activities).

Researchers found that the non-smokers who had been exposed to second-hand smoke forgot almost 20 per cent more in the memory tests than those non-smokers not exposed.

However, both groups out-performed the current smokers who forgot 30 per cent more than those who were not exposed to second-hand smoking.

"According to recent reports by the World Health Organization, exposure to second-hand smoke can have serious consequences on the health of people who have never smoked themselves, but who are exposed to other people's tobacco smoke," Heffernan said in a statement.

"Our findings suggest that the deficits associated with second-hand smoke exposure extend to everyday cognitive function. We hope our work will stimulate further research in the field in order to gain a better understanding of the links between exposure to second-hand smoke, health problems and everyday cognitive function," he said.

 Suicide is a multi-determined phenomenon that occurs against a background of complex interacting biological, social, psychological and environmental risk and protective factors. Despite the complexity of this phenomenon, suicide can be prevented.

On average, almost 3000 people commit suicide daily. For every person who completes a suicide, 20 or more may attempt to end their lives. The sponsoring International Association for Suicide Prevention, the co-sponsor WHO and other partners advocate for the prevention of suicidal behaviour, provision of adequate treatment and follow-up care for people who attempted suicide, as well as responsible reporting of suicides in the media.

 At the global level, awareness needs to be raised that suicide is a major preventable cause of premature death. Governments need to develop policy frameworks for national suicide prevention strategies. At the local level, policy statements and research outcomes need to be translated into prevention programmes and activities in communities.     

The problem

• Every year, almost one million people die from suicide; a “global” mortality rate of 16 per 100,000, or one death every 40 seconds.
• In the last 45 years suicide rates have increased by 60% worldwide. Suicide is among the three leading causes of death among those aged 15-44 years in some countries, and the second leading cause of death in the 10-24 years age group; these figures do not include suicide attempts which are up to 20 times more frequent than completed suicide.
• Suicide worldwide is estimated to represent 1.8% of the total global burden of disease in 1998, and 2.4% in countries with market and former socialist economies in 2020.
• Although traditionally suicide rates have been highest among the male elderly, rates among young people have been increasing to such an extent that they are now the group at highest risk in a third of countries, in both developed and developing countries.
• Mental disorders (particularly depression and alcohol use disorders) are a major risk factor for suicide in Europe and North America; however, in Asian countries impulsiveness plays an important role. Suicide is complex with psychological, social, biological, cultural and environmental factors involved.

 Effective interventions

• Strategies involving restriction of access to common methods of suicide, such as firearms or toxic substances like pesticides, have proved to be effective in reducing suicide rates; however, there is a need to adopt multi-sectoral approaches involving many levels of intervention and activities.
• There is compelling evidence indicating that adequate prevention and treatment of depression and alcohol and substance abuse can reduce suicide rates, as well as follow-up contact with those who have attempted suicide.

Challenges and obstacles

• Worldwide, the prevention of suicide has not been adequately addressed due to basically a lack of awareness of suicide as a major problem and the taboo in many societies to discuss openly about it. In fact, only a few countries have included prevention of suicide among their priorities.
• Reliability of suicide certification and reporting is an issue in great need of improvement.
• It is clear that suicide prevention requires intervention also from outside the health sector and calls for an innovative, comprehensive multi-sectoral approach, including both health and non-health sectors, e.g. education, labour, police, justice, religion, law, politics, the media.