Heart Health

21 April 2011

Bleak outlook on Indian health

More young urban adults in India are developing obesity, high blood pressure and diabetes, suggesting that rising rates of cardiovascular disease could be in the future.

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More and more, young urban adults in India are developing obesity, high blood pressure and diabetes, suggesting that rising rates of cardiovascular disease could be in the future, a new study finds.

Among 1,100 young adults from New Delhi, all three conditions became steadily more common over the 7 years of the study.

At the outset, when the average study participant was 29 years old, about 50% had waistlines that fit the criteria for abdominal obesity. Seven years later, that was true for 70%.

Meanwhile, rates of high blood pressure rose from 11% to 34% among men, and from 5% to 15% among women. Diabetes also became a growing problem, with the rate rising from 5% to 12% among men, and from 3.5% to 7% among women.

Researchers have warned that the "remarkable changes" in such a short time suggest that these young adults could have high rates of heart disease and stroke down the road.

The findings, reported in the Journal of the American College of Cardiology, add to a bleak outlook for Indians' heart health.

Heart disease not uncommon

The country of 1 billion-plus was estimated to account for 60% of the world's heart disease cases in 2010. And a recent study found that people in India and other South Asian countries suffer their first myocardial infarction at age 53, on average, 6 years earlier than the rest of the world.

Dr Dorairaj Prabhakaran, who worked on the new study, wasn't surprised at how common heart disease risk factors were even in this young population.

"Given the rapid socioeconomic and demographic transitions in India, I was not surprised at the high incidence rates," Dr Prabhakaran, a cardiologist at the Centre for Chronic Disease Control in New Delhi, said.

Western-style diet to blame

Western-style diets often catch the blame for feeding obesity and its associated health problems, Dr Prabhakaran noted. But such eating habits are not that common in India.

"Many popular Indian foods are unhealthy, as they are rich in sugar and saturated fat," said Dr Prabhakaran.

And while the study looked only at young adults in New Delhi, Dr Prabhakaran said that heart risk factors in rural areas of southern India have risen quickly in the last decade and are near the levels seen in urban areas.

"Reducing cardiovascular disease and its risk factors requires a policy response," Dr Prabhakaran said, "particularly tobacco control, making fruits and vegetables available locally and affordable, and an enabling environment to improve physical activity."

Heart disease and its risk factors put a "huge" financial burden on the Indian people and healthcare system, Dr Prabhakaran and his colleagues point out.

The annual cost of treating diabetes, for example, consumes anywhere from 5% to 34% of personal income in India.

Tobacco control

An editorial published with the study agreed on the need for tobacco control and other public policies aimed at improving heart health in India.

Health education is not enough because "smoking, sedentariness, and poor diet do not arise in a vacuum," write Drs Gilles Paradis, of McGill University in Montreal, Canada, and Dr Arnaud Chiolero of the University of Lausanne in Switzerland.

"The task is daunting," they add, "but we have a moral obligation to support the global fight against (cardiovascular disease) and chronic diseases, which are the pandemic of the twenty-first century."

(Reuters Health, Amy Norton, April 2011)

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