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Cardiac arrest and heart attack are the same thing… Cardiovascular disease (CVD) runs in my family, so there is nothing I can do to stop it… Cardiovascular disease generally affects men more than women. women…. Heart attacks among younger people are only due to excessive exercise or stress. These are some of the misconceptions among people, which lead to delays in diagnosis and ultimately poor health outcomes.
Although we see increasing awareness about the increasing prevalence of cardiovascular diseases in India, people are not aware of its occurrence, exact signs and symptoms and the right approach to seek medical help. In just three decades, India has witnessed a 2.3-fold increase in the prevalence of ischemic heart disease (IHD) and stroke. There is an alarming increase in the burden of heart failure (HF) and also acute myocardial infarction (AMI). This can be attributed to six fundamental transitions: epidemiological, demographic, nutritional, environmental, sociocultural and economic factors.
Cardiovascular diseases in India have increased from 25.7 million cases in 1990 to 64 million in 2023. In fact, Indians are more likely to develop risk factors for cardiovascular diseases at a comparatively younger age and experience more severe manifestations of the disease compared to other ethnic groups.
According to the World Health Organization, India accounts for one-fifth of deaths from cardiovascular diseases worldwide, especially among the younger population. The results of the Global Burden of Disease study put an age-standardized CVD mortality rate at 272 per lakh population in India, which is much higher than the global average of 235.
CVDs reveal a multifaceted reality in India, with implications across multiple dimensions. Epidemiological studies have consistently linked a sedentary lifestyle to increased mortality, particularly from cardiovascular diseases. For example, people who report sitting for a long time or watching television for a long time have shown increased mortality risks. About 50 percent of those surveyed believe that a sedentary lifestyle has detrimental effects on heart health equivalent to those of smoking.
Another important factor highlighted by the study was the existence of comorbidities among younger Indians, leading to an increase in cardiac events. The presence of conditions such as diabetes or hypertension in younger people adds a layer of complexity to their surveillance in disease management. Unfortunately, most people with comorbidities such as diabetes do not opt for, or are not recommended for, cardiac risk assessment as part of their disease management program. The study revealed that 75 percent of respondents had not undergone a cardiac risk assessment following a diabetes diagnosis.
Another aspect is the genetic risk factor. While a family history of CVD and excessive stress is a critical determinant of CVD risk, identifying a person’s genetic predisposition to heart disease can aid in early diagnosis and risk mitigation.
Today, people are well aware of the increasing prevalence of cardiovascular diseases in India, but knowledge about the disease itself is limited. Most people do not know the difference between different CVDs. The study mentioned above indicated that more than 60 percent of respondents did not know the difference between cardiac arrest, heart attack and heart failure.
A heart attack occurs when one of the coronary arteries becomes blocked. The heart muscle loses its vital blood supply and, if left untreated, will begin to die because it does not receive enough oxygen. Cardiac arrest occurs when a person’s heart stops pumping blood through the body and the person stops breathing normally. Heart failure, on the other hand, is when the heart does not pump normally, causing the hormone and nervous system to compensate for the lack of blood. The body can raise blood pressure, making the heart beat faster and retaining salt and water. If this retained fluid builds up, the condition is called congestive heart failure.
About 77 percent of people consider annual blood pressure checks to be ideal for heart health, indicating a clear lack of understanding about preventative and proactive measures.
To mitigate the impact of cardiovascular diseases on the Indian population, it is important to spread awareness on proactive screening and treatment of cardiovascular health. In a nation undergoing rapid epidemiological transitions, it is vital to implement a population-based disease management program that focuses on access and availability of diagnostic tools, medical treatment, and educational guidance for patients and caregivers. This will result in early and appropriate intervention for disease management and at the same time reduce healthcare costs.
Dr. Chandra is the Chair of Interventional Cardiology at Medanta Medicity.