PROPORTION OF POSITIVE STRESS TEST IN YOUNGER PATIENTS COMING TO TERTIARY CARE HOSPITAL FOR THE EVALUATION OF ISCHAEMIC HEART DISEASE. ARE WE GOING TO LOSE OUR YOUNGER WORKFORCE?

Abstract

OBJECTIVE: To study the proportion of positive exercise stress test in younger patients coming to tertiary care hospital for the evaluation of ischaemic heart disease (IHD). Our secondary objective was to find out the difference of risk profile between the relatively younger and elderly population having IHD.

METHODOLOGY: This descriptive cross sectional study was conducted at cardiology department of a tertiary care centre at Karachi, Pakistan during July 1^st 2018 to December 31^st 2018 (six months). All adult patients whose exercise tests had been turned positive were selected for the study. Patients with history of arrhythmias, conduction defects, valvular heart diseases, co-morbid conditions like cirrhosis, stroke, osteoarthritis, chronic kidney disease were excluded from the study. The risk factors of interest were hypertension, diabetes Mellitus, smoking, lipid disorders and obesity.

RESULTS: Total 85 patients were selected for the study. Out of them, 73 (85.9%) were male and 12 (14.1%) were female. Mean age of our patients was 56.2±8.7 years. Out of 85 patients, 33 (38.8 %) were falling into the category of younger (< 55 years) patients, while elderly (≥ 55years) patients were 52 (61.2%). In comparison to younger population, diabetes mellitus (34.6 vs 15.2 %; P-value = 0.04) and smoking (23.1 vs 6.1%; P-value= 0.03%) were significantly more prevalent in elderly individuals.  Prevalence of Hypertension was slightly higher in younger population (78.8 vs 73.1 %; P-value 0.5) as compare to elderly population. Similarly, younger population were found to be more obese (36.4 vs 28.8 %; P-value 0.4) as compared to elderly population. Prevalence of lipid disorder was almost equal between both the groups (40.4 vs 39.4%; P-value=0.9).

CONCLUSION: The burden of Ischaemic heart disease is growing in our younger population and every third of our ischaemic patient is among the younger age group. Although proportion of diabetes and smoking is less common in younger population, trend of hypertension and obesity is on rise.

KEY WORDS: Ischaemic Heart Disease, Younger Population, Coronary Risk factors