Cardiac arrest and heart attack are the same….Cardiovascular diseases (CVDs) run in my family, so there is nothing I can do to stop it…. CVDs generally affect men more than women…. Heart attacks among younger people are only because of excessive exercise or stress. These are some of the misconceptions among people, resulting in delayed diagnosis and ultimately poor health outcomes.
Although we see that there is a growing awareness about the increasing prevalence of CVDs in India, people are not aware of the onset, the exact signs and symptoms, and the right approach to seek medical aid. In just three decades, India has witnessed a 2.3-fold surge in the prevalence of ischemic heart disease (IHD) and stroke. There is an alarming rise in the burden of heart failure (HF) and acute myocardial infarction (AMI) as well. This can be attributed to six fundamental transitions―epidemiological, demographic, nutritional, environmental, social-cultural, and economic factors.
CVDs in India have escalated from 25.7 million cases in 1990 to 64 million in 2023. In fact, Indians are more likely to develop CVD risk factors at a comparatively younger age, experiencing more severe manifestations of the disease when compared to other ethnic groups.
According to the World Health Organization, India accounts for one-fifth of CVD deaths worldwide, especially in the younger population. The results of Global Burden of Disease study state an age-standardised CVD death rate of 272 per one lakh population in India, which is much higher than the global average of 235.
CVDs reveal a multifaceted reality in India, with implications across various dimensions. Epidemiological studies have consistently linked sedentary lifestyle with increased mortality, particularly from CVDs. For instance, individuals reporting prolonged sitting or extensive television viewing have shown higher mortality risks. Around 50 per cent of respondents of a survey believe that sedentary behaviour has an equivalent detrimental effect on heart health as smoking.
Another important factor highlighted by the study was the existence of co-morbidities among younger Indians, leading to a rise in cardiac events. The presence of conditions like diabetes or hypertension in younger individuals adds a layer of complexity to their vigilance in disease management. Unfortunately, most people with co-morbidities such as diabetes do not opt for, or, are not advised for cardiac risk assessment as part of their disease management programme. The study revealed that 75 per cent of the respondents have not undergone cardiac risk assessment following a diabetes diagnosis.
Another aspect is the genetic risk factor. While a family history of CVDs and excessive stress is a pivotal determinant of CVD risk, identifying one's genetic predisposition to heart ailments can aid in early diagnosis and risk mitigation.
Today, people are much aware about the growing prevalence of CVDs in India, but the knowledge about the disease itself is limited. Most people do not know the difference between the various CVDs. The study mentioned above indicated that more than 60 per cent of the respondents did not know the difference between cardiac arrest, heart attack and a heart failure.
A heart attack is when one of the coronary arteries becomes blocked. The heart muscle is robbed of its vital blood supply and, if left untreated, will begin to die because it is not getting enough oxygen. A cardiac arrest is when a person's heart stops pumping blood around the body and one stops breathing normally. A heart failure, on the other hand, is when the heart doesn’t pump normally, causing the hormone and the nervous systems to compensate for the lack of blood. The body may raise the blood pressure, making the heart beat faster and causing it to hold on to salt and water. If this retained fluid builds up, the condition is called congestive heart failure.
Around 77 per cent of people find annual blood pressure checks ideal for heart health, indicating a clear lack of understanding on preventive and proactive measures.
To mitigate the impact of CVDs on India's population, it is important to spread knowledge about proactive cardiovascular health screening and management. In a nation undergoing rapid epidemiological transitions, it is vital to implement a population-based disease management programme that focuses on access and availability of diagnostics tools, medical treatment and educational guidance to patients and caregivers. This will result in early and right intervention towards disease management while reducing health care costs.
Dr Chandra is the chairman of interventional cardiology at Medanta Medicity.