Kerala has to undertake large-scale epidemiological studies and develop its own Statewide health information system and data about the people’s health behaviour, risk factors, burden of diseases, and accessibility and affordability of care if it has to tackle its increasing burden of non-communicable diseases, Salim Yusuf, renowned cardiologist and researcher and Professor of Medicine at McMaster University, Canada, has said.
He was delivering the first Dr. C.R. Soman oration, organised by Health Action by People, here on Saturday.
What the State needed was a high-quality yet low-cost primary and secondary care system, and improved focus on simple strategies for risk factor reduction and improving the environment, Dr. Yusuf added.
The West had reduced the cardiovascular disease mortality by 50 per cent by adopting better treatment strategies and prevention methods, all of which had been discovered through research and randomised clinical trials. Most of these trials had been ethical and done with tight controls. There could be no progress in the medical field without clinical trials and epidemiological studies, he said.
The INTERHEART study, conducted in 52 countries involving 280 hospitals and 28,000 people, had showed that the impact of risk factors were the same across all regions of the world and that 86 per cent of the risk could be attributed to lipid levels, smoking, and hypertension. This meant that targeted intervention to reduce a few risk factors could have a big impact on the health front.
Analysis of the State’s data from the Prospective Urban Rural Epidemiology study (PURE), one of the largest epidemiological studies involving 663 communities across 22 countries, showed that all risk factors for cardiovascular diseases were much higher in Kerala than in the rest of the country, putting the risk among Keralites at least 30 per cent higher than the figure at the national level.Polypill
Early intervention to reduce risk factors and low cost secondary prevention strategies could go a long way in revolutionising cardiovascular disease care in India and one of the simplest, low-cost strategies in this direction was the administration of polypill, Dr. Yusuf said.
The World Health Organisation (WHO) had endorsed polypill as a strategy for cardiovascular disease prevention and even though the Indian government had approved it — the pill was already in the market — large-scale acceptance of the polypill could only be established by proving its efficacy through a clinical trial. The lukewarm response of cardiologists to polypill had not helped either, he said.