Quality healthcare also key to healthy heart: study

It comes back to the basics: the quality of your healthcare system determines your health. A study published in the New England Journal of Medicine last week has indicated that keeping a healthy heart may have as much to do with the quality of healthcare as avoiding risk factors.

The international study, led by researchers at the Population Health Research Institute at the McMaster University and Hamilton Health Sciences was conducted in 17 nations across the world, including India and Bangladesh in this region.

1,50,000 people studied

The cardiovascular risk of over 1,50,000 persons from urban and rural communities was assessed using the INTERHEART Risk score, a validated score for quantifying risk-factor burden without the use of laboratory testing. Participants were followed up for a mean period of 4.1 years.

More than 80 per cent of deaths from cardiovascular disease are estimated to occur in low-income and middle-income countries. The study set out to examine the reasons for this. It concluded that the high burden of risk factors in high-income groups might have been mitigated by better control of risk factors and more frequent use of proven drug therapies.

Salim Yusuf, principal investigator for the study, says the difference is the quality of healthcare. “We have found that healthcare is as important, if not more, than avoiding the risk factors in reducing cardiovascular disease,” he said in a release.

Lifestyle argument

This argument seems to provide a neat deflection of the ongoing policy that guides intervention in the area of non-communicable diseases. Currently, in India at least, intervention focuses primarily on and rests on the patient following certain lifestyle regimens, and a lot of activity is built around raising awareness on this aspect. Emphasis is given to following the drug regimen as well, but with this study, it becomes clear that the public health angle cannot be ignored anymore.

“It calls for strengthening the health systems as in developed nations. Even if someone gets a heart attack, they can get to the hospital faster and get top class care like in some of our best private sector hospitals,” concurs V. Mohan, one of the Indian collaborators on the study. He says the use of drugs like statins (a class of drugs to lower cholesterol levels) is routine in high-income countries, where as due to affordability issues, is very low in India.