Heart disease in indians

1. Heart Disease
in Indians

4. What is Killing Indians
• Heart Disease is the leading cause of death
• The health and family welfare ministry has
projected that India will have more than 60
million people with coronary heart diseases
by 2015
• Mortality rates for heart disease are twice
that of USA and three to five times that of
some European Countries

5. Heart Disease Incidence in India
• 32 million people with disease of the arteries
supplying blood to the heart (Coronary
Artery Disease – CAD)
• 52% of cardiovascular disease deaths occur
under 70 years
• 10% of heart attacks under 40 years

6. 35-44yrs
3%
45-54 yrs
10%
65-74 yrs
34%
>75 yrs
31%
55-64 yrs
22%
>75 yrs.
70%
65-74yrs .
18%
55-64yrs.
8%
45-54yrs
3%
35-44yrs.
1%
INDIA
USA
Proportion of all CVD Deaths 2000-30
Working Age Group (35-64 Yrs)

7. Predicting CAD in Indians
• As disease occurs at a young age
conventional risk scores are not applicable
to us
• Also preventive health check-ups are not a
regular feature as people spend out of
their pocket
• Hence most people are not aware of their
risk factors

8. Indians are Food centric
• In all celebrations which are common in India
food consumed is rich in saturated fats, Trans
fats and sugar
• Ghee and butter in North India and coconut
oil in South India are more likely to lead to
blockage in heart arteries (atherogenic)
• Reheating oil which is common in India for
deep frying results in production of trans fats
which are more atherogenic

9. INTERHEART Study
• We are not genetically predisposed to heart
disease at a young age as compared to the
western population
• The same nine risk factors are present in us.
• However the risk factors develop at a
younger age

10. Prevalence of Risk Factors in
Urban and Rural India
• Prevalence of Hypertension is 25-40% in
urban areas and 10-15% in rural areas
• And that of Diabetes Mellitus is 10-15% and
3-5% respectively
• Abnormal Cholesterol is seen in 20-35% of
people
• Abnormality of lipids (Dyslipidaemia) appears
to be the commonest factor for heart attack

11. Most common and modifiable risk
factor is Cholesterol
• World wide approx. 50% of CAD is due to
high cholesterol
• Cholesterol lowering with statins shown to
be beneficial in primary and secondary
prevention

12. Primary Prevention in Indians
• It is time for a paradigm shift in the LDL-C
dictum
• lower the better to
• earlier and lower the better