Dr Charitha Ganagdharan
Heart Diseases is one of the leading causes of death across the world including India. India has witnessed an alarming increase in heart diseases over the past decade. Estimates from India suggest that the prevalence of heart disease and stroke has gone up by 50% in the past 25 years. There are differences among states for heart diseases in India with the highest prevalence in Kerala, Punjab and Tamil Nadu. In Indians, problems related to the heart develop earlier, when compared to global populations and manifest differently in men and women. Mortality (rate of death) due to heart diseases is significantly seen higher in men than women and mostly seen in a population younger than 70 years.
Problems in the heart have caused more than 62.5 million deaths in India in 2016. Ischemic Heart Disease (caused due to little space in arteries for blood flow) and stroke account for the majority of mortality due to heart diseases in India (approximately 15- 20%). Reducing premature deaths in economically productive age groups require urgent action across India.
There was a time when infectious diseases were prominent but now, there is an acute rise in non-communicable, lifestyle disorders in India in a short span of time. The rise in heart diseases is because of the low consumption of fruits and vegetables, high consumption of salts, trans-fat and red meat, tobacco use and low physical activity. Lifestyle problems like high blood pressure, high cholesterol and high fasting blood glucose also contribute to the heart disease burden.
The burden of Heart Diseases in Diabetics
Increase in the number of people with Diabetes is also seen in India: Heart Diseases commonly occur in people with Diabetes. The risk of developing heart disease and dying from the same is 2 to 4 times higher in a person with diabetes. Diabetes leads to Atherosclerosis (deposition of fats, cholesterol and other substances on the inner artery wall), restricting blood flow. The increased risk of Atherosclerosis or stroke is related to the sugar levels in diabetic patients. Diabetic patients are advised for routine heart check-ups as a preventive measure. There are several treatment options for heart diseases in diabetic patients like surgery, aspirin therapy, but diet and exercise are highly recommended in these patients. Look up the other articles in this edition to know more!
There has been a decrease in the number of deaths due to heart diseases in Europe. To achieve similar gains, India should focus on preventive measures of maintaining a healthy lifestyle, behaviours associated with optimum levels of blood pressure, cholesterol, glucose and body weight while decreasing the use of tobacco and alcohol, to reduce premature deaths due to problems in the heart.
Working our way out
Other ways to intervene is by working on governmental policies like increase taxes on tobacco, sweetened beverages, banning advertisements on any harmful products and smoke-free policies for tobacco control etc. Management of diabetes and hypertension for the Indian population could begin by spreading awareness specially to the younger generation, obtaining the right medication, strengthening health systems and policies. Achieving universal health coverage including financial risk protection will benefit the right to health for Indians. India needs to focus on all stakeholders, including policymakers, programs, capacity building and research arenas to address the progression of the heart disease epidemic. Follow up more on preventive measures in the next article.
Shivani Prabhu has contributed to this article.