Indian heart disease 'more severe than in West'

April 30, 2008 Heart disease in Indians is often more severe and occurs in younger people than in developed countries, a study has found.

Publishing their findings in The Lancet last week, an Indian-Canadian team of researchers analysed data on 20,937 people who suffered heart attacks, collected from 89 centres spread across 50 cities in India from 2001–2005.

They then compared this data with similar studies in developed countries.

The researchers found that 60 per cent of the patients had a severe form of heart disease, compared with around 40 per cent in developed countries. Indian patients are also younger, with a mean age of 57 years rather than 63–68 years.

Three-quarters of Indian heart disease patients are from low socioeconomic backgrounds. The poorer patients receive medical attention late, for reasons including lack of awareness of the symptoms and poor access to ambulances.

Poorer Indians are also less likely to receive treatments proven to save lives. The study indicates that higher death rates in poor patients are not because of differences in risk factors, but because of differences in treatment.

And the actual number of deaths could be higher as many patients might have died before reaching the hospital, the researchers say.

"Prior to this study, we did not have data of similar nature and magnitude from a developing country," Denis Xavier, associate professor at St. John's National Academy, Bangalore, and lead author of the study, told SciDev.Net.

Eighty per cent of the 7.1 million deaths due to heart disease in 2001 took place in poor countries, and India is expected to account for 60 per cent of the heart disease burden by 2010.

Between 1990 and 2020, the number of men with heart disease in developing countries is expected to increase by 137 per cent, and women by 120 per cent, compared to 30–60 per cent in developed countries.

"India is a likely representative of other nations facing similar socioeconomic challenges," says Kim Eagle, cardiology professor at the University of Michigan Medical Center, United States, and author of an accompanying comment article about the research in The Lancet.

"The increasing obesity epidemic, high rate of smoking in certain populations, and variable availability of modern medications and treatments creates a situation where coronary prevention efforts are far from optimal," he told the Science and Development Network.

Eagle says India — and developing countries in general — could take cues from developed countries' successful strategies to reduce risk factors for heart disease, such as banning smoking from public places, increasing taxes on tobacco and promoting awareness of diet.