Heart Disease in India Is Catching Up to the West

The rate of heart disease in India may be catching up with more developed nations, with new findings from one Indian city suggesting a 10-fold increase in coronary artery disease in urban areas over the past 40 years.

``The prevalence of coronary artery disease among urban South Indians is increasing rapidly and is now approaching the figures reported in migrant Asian Indians,'' report Dr. Viswanathan Mohan and colleagues at the Madras Diabetes Research Foundation in Chennai, India.

They note that while increased rates of artery disease have been found among Indians who migrate, little has been known about trends among those living in the Indian subcontinent.

Experts say that as developing countries become better at warding off infectious diseases, they will increasingly have to deal with populations living long enough to become susceptible to the chronic ailments common in developed nations--notably, heart disease.

And, according to Mohan's team, the population of India is expected to have a sharp increase in the prevalence of heart disease in the next two decades as a result of economic growth and lifestyle changes. Western diets and high rates of inactivity and obesity are key lifestyle risk factors for heart disease.

In this study, the investigators looked at coronary artery disease among more than 1,200 adults aged 20 and older in the city of Chennai in South India. All were assessed for diabetes and coronary artery disease, and for associated risk factors such as high blood pressure, cholesterol levels, smoking and alcohol use and high body mass index.

The researchers found that 11% of the population had coronary artery disease. Those who were diabetic were also more likely to be diagnosed with coronary artery disease, as were those with known risk factors such as older age and high cholesterol.

The results are published in the September issue of the Journal of the American College of Cardiology.

Given that heart disease is likely to become more and more common in India, much larger studies should be conducted, Drs. Salim Yusuf and Stephanie Ounpuu of McMaster University in Ontario, Canada, write in an accompanying editorial.

This study, they note, ``could potentially be the foundation for future larger and longer-term studies.''
Mohan's team goes further, suggesting that ``urgent steps'' are now needed to head off heart disease among urban Indians--including increasing exercise levels, modifying eating habits and possibly ``making aggressive use'' of cholesterol-lowering drugs.

SOURCE: Journal of the American College of Cardiology 2001;38:682-687