Household air pollution has emerged as one of the key causes of cardiovascular diseases (CVDs), and 12% of all CVDs in low-income countries are attributable to it, a new report has said. Hypertension is the largest risk factor for CVD in low-income countries (which include India), followed by high non-HDL cholesterol and household air pollution.
The report is one of two from a study by the Prospective Urban and Rural Epidemiologic (PURE), both published online in The Lancet on Tuesday and presented at the European Society of Cardiology 2019. One report looks at common diseases, hospitalisation and death; the other at CVD risk factors in middle-aged adults in 21 countries.
What it means for India
In the report that looked at risk factors for CVD, researchers enrolled 1,55,722 participants between January 2005 and December 2016. These included 35,793 from five low-income countries, including India.
Household air pollution is a greater risk factor for CVD in India than diabetes, tobacco use, low physical activity and poor diet. An earlier report from a PURE study (Lancet Respiratory Medicine 2014) showed that Indians had the lowest lung function among the 21 countries studied.
At least 65% of homes in India use biomass fuel for cooking and heating. In urban areas, the use of mosquito coils, dhoop sticks and agarbattis contribute to high household air pollution.
Dr V Mohan, Director of Madras Diabetes Research Foundation and one of the study authors, told The Indian Express that household air pollution is becoming an important cause of overall and cardiovascular mortality in low-income countries. “This is actually a window of opportunity… because if the household air pollution can be controlled, we can see significant decrease in mortality including due to cardiovascular disease in India,” Dr Mohan said.
Dr Sundeep Salvi, Director, Chest Research Foundation, and an expert on the national steering committee to prevent air pollution, said the study has highlighted for the first time that household air pollution is also a leading risk factor for heart disease and deaths in India. “The major focus has been ambient air pollution that is pollution rising from motor vehicles and industries. It is now time to wake up and realise that the pollution we generate in our house is also responsible for significant adverse effects,” Dr Salvi said.
CVD and cancer
The other report, which followed 1,62,534 middle-aged adults in the 21 countries, found that CVD remains the leading cause of mortality among middle aged adults globally, but this is no longer the case in high-income countries, where cancer is now responsible for twice as many deaths as CVD. It was estimated that 55 million deaths occurred in the world in 2017, of which approximately 17.7 million were due to CVD. Dr Mohan explained that in high-income countries, people have started living longer, so deaths due to CVD have reduced, and more are now dying due to cancers.