Contrary to the general notion, cardiovascular disease is becoming an important preventable cause of events (heart attacks and stroke) and death even among the rural population in India, a study shows. The study involved 5,641 adults aged 25-64 years living in a rural area near Chennai and followed up for nearly eight years. There were 96 deaths — 79 from heart attacks and 17 from stroke. There were 59 adults who suffered but did not die from heart attack and stroke.
The study, which began in 2005, was carried out in five villages in Tiruvallur district near Chennai. While baseline data were collected in 2005 and two follow-up surveys were carried out in 2008-2009 and 2013-2015.
The study was carried out by a team led by Dr. Prabhdeep Kaur from the Chennai-based National Institute of Epidemiology (ICMR-NIE). The results were published in the journal BMJ Open .
Hypertension, which is a huge risk factor for cardiovascular disease, was prevalent in 21.6% of men and women, while tobacco use was high both among men (nearly 35% smokers) and women (43% smokeless tobacco). Central obesity was also high both among men (20.2%) and women (26.4%). Alcohol use was high among men (28.6%), while diabetes, which was self-reported, was 4% in both men and women.
“Two-thirds of people who developed cardiovascular disease died. This could have been prevented. The risk factors were causing two times or more risk of cardiovascular disease,” says Dr. Kaur. “Reducing tobacco use and treating hypertension and diabetes and keeping them under control could have halved the number of people getting stroke or heart attack.”
Hypertension was a risk factor for both men and women. In the case of men, smoking turned out to be a big risk factor while it was central obesity and diabetes that were risk factors for women.
“With cardiovascular disease becoming an important preventable cause of death in rural areas, there is a compulsion to focus our attention on rural areas too,” says Dr. Kaur. “Early diagnosis, treatment and regular follow-up to ensure control of hypertension and blood sugar will help people through their lifetime.”
Dr. Kaur does agree that getting people to achieve control of hypertension and blood sugar is a huge challenge. With an estimated burden of 200 million people in India, hypertension is the most important noncommunicable disease risk factor. Many studies have shown that reducing hypertension by 20 mm mercury in people aged 4-69 years can help achieve a 50% reduction in coronary heart disease.
However, as per a May 2019 study published in PLOS Medicine, In India, only about 45% of people with hypertension were even aware of their diagnosis, hardly 13% were under medication and a paltry 8% had hypertension under control.