September 29 is observed as World Heart Day, an initiative by the World Heart Federation to spread awareness about cardiovascular diseases (CVD), including heart disease and stroke. The World Health Organisation (WHO) estimates that over 17.9 million people die of CVDs every year, accounting for over 31 per cent of global deaths. One-third of these deaths are premature (below 70 years). About 80 per cent of all CVDs manifest themselves as heart attacks or strokes and 75 per cent cases come from low and middle-income countries.
In 2013, the WHO developed targets to control and prevent non-communicable diseases – of which CVDs make a large part of – including a relative reduction of 25 per cent in overall mortality from CVDs by 2025. India’s National Health Policy 2017 too, aims to reduce premature mortality from CVDs, cancer, diabetes and chronic respiratory diseases by 25 per cent by 2025.
CVDs and their causes
According to WHO, CVDs are a group of disorders of the heart and the blood vessels. They include diseases such as coronary heart disease, cerebrovascular disease, rheumatic heart disease and congenital heart disease among others. Largely, these diseases are associated with lifestyle choices such as an unhealthy diet, physical inactivity, tobacco use and excessive use of alcohol, and therefore are preventable to some extent. Such lifestyle choices may lead to increased blood pressure, increased blood glucose levels and obesity. Essentially, they increase the risk of developing a heart attack, stroke and other such complications.
Given this, one of the aims of World Heart Day is to spread awareness among people about risk factors and the steps they can take to reduce their chances of developing these diseases.
CVD burden in India
In September 2018, The Lancet published a report about cardiovascular diseases in India and their risk factors as part of its Global Burden of Disease Study 1990-2016. The report noted the prevalence of CVDs in Indian states along with the disability adjusted life years (DALYs) or the number of years lost to ill-health has increased. In 2016, CVDs contributed to 28.1 percent of the total deaths, as compared to 15.2 percent in 1990. Furthermore, in Punjab, Kerala and Tamil Nadu, the prevalence of CVDs is at least 5000 per 100,000 people. Mizoram and Arunachal Pradesh are the only two states where the prevalence of CVDs is less than 3,000 per 100,000 people.
In India, the prevalence of CVDs is estimated to be around 54.5 million. The report cited high systolic blood pressure, ambient air pollution, high total cholesterol and high BMI among major risk factors contributing towards heart diseases. Significantly, smoking was the only major risk factor whose prevalence decreased since 1990. “The increasing prevalence of various lifestyle risk factors and environmental risks contributing to cardiovascular diseases across India is ominous, and this situation has to be addressed through systematic policies and action in various sectors,” the report said.
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