Abstract

CARDIOVASCULAR DISEASE IN INDIA – A CHALLENGING TASK AND REVIEW STUDY

*Dr. Suhail Jandial MD Kayachikitsa, Dr. Kshama Gupta MD and Sharir Rachana

ABSTRACT

The noncommunicable diseases commonly include cardiovascular disease (CVD), various cancers, chronic respiratory illnesses, diabetes, and so on which are estimated to account for around 60% of all deaths. CVDs such as ischaemic heart disease and cerebrovascular such as stroke account for 17.7 million deaths and are the leading cause.1 In accordance with the World Health Organization, India accounts for one-fifth of these deaths worldwide especially in younger population. The results of Global Burden of Disease study state age-standardized CVD death rate of 272 per 100000 population in India which is much higher than that of global average of 235. CVDs strike Indians a decade earlier than the western population.2 For us Indians, particular causes of concern in CVD are early age of onset, rapid progression and highmortality rate. Indians are known to have the highest coronary artery disease (CAD) rates, and the conventional risk factors fail to explain this increased risk. There are no structured data collection methods regarding the cardiac mortality and morbidity for Indian subcontinent, and also majority of deaths happen at home without knowing the exact cause of death. Hospital-based CV morbidity and mortality data may not be representative of overall CV disease burden. In India in 2016, CVDs contributed to 28·1% of total deaths and 14·1% of total disability-adjusted life years (DALYs) compared with 15·2% and 6·9%, respectively in 1990.3 Within India, the rates of CVD vary markedly with highest in states of Kerala, Punjab and Tamil Nadu. Moreover, these states also have the highest prevalence of raised cholesterol levels and blood pressure. At present, India has the highest burden of acute coronary syndrome and ST-elevation myocardial infarction (MI). Another significant problem in India, among other CVD's, is that of hypertensive heart disease, with 261,694 deaths in 2013 (an increase of 138% in comparison with 1990). Rheumatic heart disease remains in epidemic proportions in India with an estimated prevalence of 1.5-2 per 1000 individuals. Migrant Asian Indians have a 3-time higher prevalence of CAD than the native population. Indians are liable to get hospitalized 2–4 times more frequently for complications of CAD, in comparison with other ethnic groups, and admission rates are 5–10 times higher for populations younger than 40 years. The prevalence of CAD in Indians living in India is 21.4% for diabetics and 11% for nondiabetics. The prevalence of CAD in rural parts of country is nearly half than that in urban population.

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