Heart disease hits Indians6th May 2008
A new study into patterns of heart disease in India has found that the disease is often more severe and strikes a younger segment of the population than in developed countries.
A research team led by Denis Xavier, associate professor at St. John's National Academy, Bangalore, analysed data compiled on 20,937 heart attack patients in 50 Indian cities between 2001 and 2005.
The data, collected from 89 clinical centres, was then compared with similar studies in developed countries.
The Indian patients were more likely to have a severe form of heart disease, which was found in 60% of cases studied, compared with around 40% in developed countries.
Indian patients also showed a mean age of 57 years, much younger than the mean of 63–68 years in developed countries.
One of the factors affecting the results may be the relative poverty of the patients in India, where three-quarters of the patients studied were of low socioeconomic status.
Lack of education and poor access to emergency care mean that poorer patients receive medical attention later than richer ones. They are also less likely to get the most efficiacious life-saving treatment.
In fact, differences in treatment were a greater contributor to mortality rates between rich and poor than differences in risk factors.
Many patients might also have not shown up on the records at all, if they died before reaching the hospital, the researchers said.
Xavier said no similar data had been available from a developing country before the study, which was published in The Lancet.
India is expected to account for 60% of the global heart disease burden by 2010.
Heart disease is a major cause of death in poorer countries, with 80% of the 7.1 million deaths due to heart disease in 2001 found in developing countries.
The number of men with heart disease in developing countries is expected to rise by 137% between 1990 and 2020, and the number of female heart disease patients by 120%. That compares with just 30–60% in developed countries.
Experts say India is probably representative of other nations facing similar socioeconomic challenges.
Kim Eagle, cardiology professor at the University of Michigan Medical Center, said that the increasing obesity epidemic, high rate of smoking in certain populations, and variable availability of modern medications and treatments had created a situation where coronary prevention efforts were falling behind.
He said poorer countries should learn from successful strategies to reduce risk factors for heart disease which already existed in Western nations, citing banning smoking from public places, increasing taxes on tobacco and promoting awareness of diet as possible public health interventions.
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