IGNORANCE IS NOT BLISS

Coronary heart disease is rising rapidly in India. Diabetes is also rising alarmingly. These are not diseases of rich people. Villagers and poor people are also dying of these diseases in large numbers. Yet, there remains an attitude of ignorance, denial and sheer pig-headedness about these issues in India. Even highly educated people have a shocking lack of knowledge about health issues. The general public also thinks that most doctors are corrupt and only interested in making money. So there is a severe reluctance to obtain or follow medical advice. There is also a cultural bias against going to see a doctor unless one is very sick. Taking medicines is also considered a stigma. The doctors also share some blame. There is an emphasis on doing tests and avoiding communication with the paqtient in simple language. The government seems more interested in getting votes than in improving health care. This is a recipe for disaster.

All parties need to wake up and work together sensibly. Otherwise India shining will become India dying.

More to follow regarding the task ahead.

ECONOMIC IMPACT OF HEART DISEASE IN INDIA

ECONOMIC IMPACT OF HEART DISEASE IN INDIA

Heart disease is increasing alarmingly in India. The reason for this is the presence of risk factors and lack of awareness. Both parties lack awareness: the individual and the government.

Two of the major risk factors for heart disease are diabetes and high blood pressure. India is the current diabetes capital of the world. Approximately 32 million Indians have diabetes. By 2030, 79 million Indians are expected to have diabetes. Most patients with diabetes die of heart attacks.

In 2000, 118 million Indians had high blood pressure. By 2025, 214 million Indians are expected to have high blood pressure. They are all at risk of heart attacks.

Over 30% of patients with coronary disease (which causes heart attacks) in India are below 40 years of age. In India, the death rate from heart disease in the working age population (30-59 years) is twice as high as that in the USA. In the USA, most of those killed by heart disease are above retirement age. In India, the large number of younger people dying of heart disease is likely to have an alarming effect on the economy. In 2000, India lost more than five times as many years of economically productive life due to heart disease than the USA.

The WHO uses a term called Disability Adjusted Life Year or DALY .This means that for 1 year a person is either dead or disabled. In either case, he or she cannot work for that 1 year. DALY’s lost reflect healthy years of life lost (when the person can obviously not work or be productive). This is a better way of showing the total burden of a disease compared to the death rate. A person with heart disease may not be dead, but if he or she cannot work for a year, that is a healthy year of life lost or DALY lost due to heart disease. Heart disease causes 10% of DALY’s lost in low and middle income countries.

The WHO estimates that for the year 2002, India lost 20-29 DALY’s per 1000 population (age standardized) because of coronary heart disease. Put another way, it means that for every 1000 people in India who could have worked for a year, 20-29 people lost a year of working life or healthy life due to heart disease.

In 2006, India suffered a loss of over US $ 1 billion due to diabetes and cardiovascular diseases (affecting the heart and blood vessels).

A 2% yearly reduction in cardiovascular death rates may avoid the loss of US $ 1.64 billion over 10 years in India. To achieve this, the public, doctors and the government will have to work together.

THE BURDEN OF HEART DISEASE IN INDIA

Heart disease is a broad term. Any disease affecting the heart or blood vessels is called cardiovascular disease. Coronary heart disease or coronary artery disease is the disease which causes heart attacks. Coronary arteries supply blood and nutrition to the heart. Blockages in these can cause heart attacks. These blockages are usually due to cholesterol.

Coronary heart disease is the leading cause of death worldwide. 17.5 million people died of cardiovascular disease in the world in 2005. This disease is decreasing in many developed countries. However, coronary disease is increasing in many developing or transitional countries like India.

80% of all deaths in the world due to heart disease now occur in low and middle income countries, which covers most countries in Asia. A recent study predicted that 60% of all patients with heart disease in 2010 will be Indians.

Nearly half of all patients dying in India due to heart disease are younger than 70 years. More than 30% of patients with coronary disease in India are younger than 40 years.

More patients die in India now from heart disease than from infections. A study in 45 villages in South India in 2004 found that 32% of all deaths were due to heart disease. By contrast, infections caused 13% of all deaths.

Coronary disease has almost tripled in Indian cities from 1960 (4% of the population) to 2001 (11% of the population).

Welcome to simplified heart information

Dear friends,

There is a lot of heart disease in India. Unfortunately, there is also a shortage of simple but reliable sources of unbiased information about heart disease, its diagnosis, treatment and prevention.

I am a graduate of SMS Medical College in Jaipur, India, where I was a gold medallist. I subsequently went to England, where I obtained my MRCP degree. After that, I went to the United States of America and obtained Board Certification in Internal Medicine. Following a Cardiology Fellowship at Winthrop University Hospital in New York, I became Board Certified in Cardiology and am a Fellow of the American College of Cardiology. I then practiced Cardiology in North Carolina for over 20 years, establishing and running the departments of Echocardiography and Nuclear Cardiology at our hospital. I have now returned to India for family reasons and have started a practice of Consultative Cardiology in Jaipur.

My aim is to provide a comprehensive and reliable service to increase awareness and promote health.