Why India leads in cardiovascular diseases

The two main reasons cited were lack of insurance coverage which prevents people from getting preventive health check-ups and the time taken to reach a hospital.

The concept of health check-ups does not exist in the Indian community, said Dr Sampat Kumar,head of Cardiothoracic and Neurosciences Department at the All India Institute of Medical Sciences AIIMS in Delhi. Neither schools nor employers,insist on a health check up prior to admission or employment. Without mandatory health check-ups it is difficult to change the figures in Indias favour.

The researchers gathered data from 20,468 coronary patients admitted to 89 hospitals spread over 50 cities. They found that of 20,468 patients given a definite diagnosis,60 per cent showed evidence of a heart attack,compared with 40 per cent in developing countries.

With an average age of 60,these Indian patients were also younger by three to six years than their counterparts in richer nations.

The startling find was that the use of tobacco,high levels of lipids in the blood due to diets rich in saturated fat,and hypertension among Indians were the same as elsewhere in the world.

But the only difference causing such a high disease burden and mortality was the time-gap in getting medical attention.

Compared to the 140 to 170 minutes taken to get patients to a hospital in developed countries,it takes Indians an average of 300 minutes.

This time difference is due to traffic delays,use of public/private transport rather than the ambulance and a lack of awareness of symptoms, stated the research.

Another reason cited in the study,which contributes to India shouldering majority of the worlds cardiac patients,was poverty. The authors stated that financial condition prevented most Indian patients where 75 per cent of healthcare expenses are paid out-of-pocket from obtaining preventive surgeries and treatment.

While most of these findings were acknowledged,none of the reasons had been measured comprehensively,keeping in mind the time taken,financial factors,insurance coverage and available services prior to this study.

This registry is a major milestone,since it provides the first comprehensive view of the epidemic of acute coronary syndrome in India and helps identify opportunities for improvement in care, notes cardiologist Kim Eagle in a commentary,which accompanied the study in The Lancet.

As the Indian economy grows,there is a possibility of further increase in incidence of cardiovascular disease before we see a decline similar to that being witnessed in developed countries, he warned.