Cardiovascular death on rise, says study

Death due to cardiovascular disease is on the rise in India, causing more than one-quarter of all deaths in the country in 2015 and affecting rural populations and young adults the most, suggests a new study.

The research found that rates of dying from ischaemic heart disease – cardiac issues caused by a narrowing of the heart’s arteries – in populations aged 30 to 69 increased rapidly in Indian villages and surpassed those in urban areas between the year 2000 and 2015.

Published in the journal Lancet Global Health on Sunday, this is the first nationally representative study to measure cardiovascular mortality in India.

In 2015, cardiovascular diseases caused more than 2·1 million deaths in India in 2015 at all ages, or more than a quarter of all deaths. At ages 30–69 years, of 1·3 million cardiovascular deaths, as many as 0·9 million deaths (68·4%) were caused by ischaemic heart disease and the remaining 0·4 million (28·0%) by stroke.

Led by Prabhat Jha, a professor at the University of Toronto, the new study found that in contrast to ischaemic heart disease, the probability of dying from stroke decreased overall, but increased in northeastern states.

A third of premature stroke deaths occurred in the Northeast though only one sixth of the population lives there. In those states, deaths due to stroke were about three times higher than the national average.

“Until now, most of the evidence of cardiovascular mortality in India has come from small, local studies or from imprecise modeling exercises. This work equips us with more detailed information that we couldn’t have predicted based on earlier studies,” said Jha.

State wise distribution of ischaemic heart disease clearly shows rising trend in most of the Indian states with Karnataka and Haryana entering the maximum risk category (more than 190 cases per 100,000) between 2001-04 and 2000-13. Odisha remains the least risky place.

“This study has shown that cardiovascular mortality in India shows unexpected patterns that have not been well characterised previously. In less than two decades, ischaemic heart disease mortality in rural India has surged and surpassed urban levels, whereas stroke mortality has diverged across geographical areas,” Jha and his colleagues reported.

“Our findings suggest that a large agenda for secondary treatment remains in India,” they said. The options can vary from wider availability of cheap and generic version of a medicine called statins to better management of diabetes and hypertension and quit smoking.

The researchers concluded that the UN Sustainable Development Goal to reduce cardiovascular mortality rates at ages 30–69 years by a third by 2030 is unlikely to be met without substantial progress in India.

This research is part of the Million Death Study, one of the largest studies of premature deaths in the world.