Premature coronary artery disease in Indians and its associated risk factors

Abstract

Of particular concern to India is not only the high burden of cardiovascular diseases (CVDs), but also the effects of these diseases on the productive workforce aged 35-65 years. Heart diseases are rising in Asian Indians 5-10 years earlier than in other populations around the world. The mean age for first presentation of acute myocardial infarction in Indians is 53 years. Coronary artery disease (CAD) that manifests at a younger age can have devastating consequences for an individual, the family, and society. Prevention of these deaths in young people is a nation's moral responsibility. A strategy involving prevention of CVDs long before their onset will be more cost-effective than providing interventions at a stage when the disease is well established. We review the rising trends in CAD with particular emphasis on prevalence of premature CAD and the associated risk factors in young Indian CAD patients. Action strategies to reduce the risk are suggested.

Figure 1

Leading causes of death worldwide in 2002 (age 15–59 years). Source: WHO 2003. Abbreviations: Cerebrovasc Dis, cerebrovascular disease; Chrn Obs Pulm Dis, chronic obstructive pulmonary disease; IHD, ischemic heart disease; LRI, lower respiratory infections; TB, tuberculosis.

Figure 2

Rising trends of cardiovascular disease prevalence in North India. Source: Mathur 1960; Padnavati 1962; Gupta and Malhotra 1975; Gupta et al 1995; Chadha et al 1997; Reddy 1998.

Figure 3

Odds ratio for myocardial infarction risk factors worldwide; old (>53 years) versus young (<53 years). Data sourced from Yusuf et al 2004.

Figure 4

Odds ratio for myocardial infarction risk factors worldwide; men versus women. Data sourced from Yusuf et al 2004.