Tobacco smoking and hypertension

Coronary artery diseases is rapidly increasing in our part of the world. The South Asian ethnic groups are especially vulnerable to coronary artery disease. The two most striking features of coronary artery disease in the South Asian population are extreme prematurity and severity of the disease, both resulting from the malignant atherosclerosis that begins at an earlier age than in other population. Triple vessel disease and complicated lesions are not common even in young people and follow a malignant course. The most important aspect of prevention is to identify individuals with high risk of coronary artery disease at an early age and aggressive modification of risk factors. Tobacco smoking and hypertension are the two most important risk factors for coronary heart disease and stroke. Both of these risk factors have very high prevalence in India, Nepal and other countries of this region. There is a synergistic interaction of tobacco smoking with hypertension and high blood cholesterol which greatly increase coronary heart disease risk as well as sudden death and stroke.