“Coronary heart disease and stroke are the leading causes of death in both economically developed and developing countries”( Klag 2012). India is very much affected by coronary heart disease (CHD). “Coronary heart disease (CHD) is a chronic illness with acute manifestations. Two clinical aspects are angina pectoris (pain) and myocardial infarction (heart attack). CHD refers to illnesses caused by the narrowing of the coronary arteries” (Endler 2001). This narrowing in the arteries can result in heart attacks and strokes by reducing oxygen that the heart and brain receive. In India, 50% of cardiovascular disease results in death before the age of 70%, where this statistic is much different in developed countries (Klag 2012). This percentage is much lower in developed countries with a much smaller value of 25%. This number is primarily influenced by lifestyle choices and health care opportunities available. “Different studies have reported that the prevalence of the risk factors of ischemic heart disease in Delhi are as follows: smoking 59%, obesity 41% , hypertension 22% , positive family history 17% , diabetes 10% , and hypercholesterolemia 8%” (Dehghani 2015). This is very important for India due to the act that in the last 30 years, coronary heart disease has all but doubled, but has declined by 15% in developed nations, such as the United States (Dehghani 2015). “India is going through an epidemiologic transition whereby the burden of communicable diseases have declined slowly, but that of non-communicable diseases (NCD) has risen rapidly, thus leading to a dual burden. There has been a 4-fold rise of CHD prevalence in India during the past 40 years” (Krishnan 2012).
Coronary heart diseases increase in India can be attributed to an assortment of cutural aspects and environmental aspects. “Rapid urbanization and change in lifestyle that occurred during the past two decades have led to the growing burden of coronary risk factors in India” (Krishnan 2012). The relation of smoking, history of hypertension or diabetes, waist/hip ratio, dietary patterns, physical activity, consumption of alcohol, blood apolipoproteins (Apo), and psychosocial factors to myocardial infarction have all been studied and can be attributed to CHD. “…advertisements on internet and television have led to more aggressive marketing of tobacco products and unhealthy food items… India is the third largest country in the world in both tobacco production and consumption. Of the 1.1 billion smokers worldwide, 182 million live in India” (Beaglehole 2003). The diet in India that was previously rich in fruits and vegetables, has been replaced with diets rich in calories and animal fats that are low in carbohydrates. “The study reports a relatively high prevalence of coronary risk factors among a sample of relatively young population. The prevalence of hypertension, hypercholesterolemia, obesity, physical inactivity, poor intake of fruit and vegetables has been particularly high” (Krishnan 2012). The fact that this disease is affecting the younger populations at such a rapid rate, causes fear that there may be an epidemic in the matter of years. Lifestye modification (LM) has been introduced as a possible alternative to help with the cultural lifestyle aspects present in India. By reducing the amount of tobacco smoked in the home and developing a much more healthy diet, India may be able to reverse the problems present due to CHD.
Beaglehole, R., & Yach, D. (2003). Globalisation and the prevention and control of non-communicable disease: The neglected chronic diseases of adults. The Lancet,362(9387), 903-908. doi:10.1016/s0140-6736(03)14335-8
Dehghani A, Bhasin SK, Dwivedi S, Malhotra RK. Influence of Comprehensive Life Style Intervention in Patients of CHD. Global Journal of Health Science. 2015;7(7):6-16. doi:10.5539/gjhs.v7n7p6.
Endler, N. S. (2001). International Encyclopedia of the Social & Behavioral Sciences. Toronto: York University. doi:https://doi.org/10.1016/B0-08-043076-7/03811-0
Klag, M. J. (n.d.). Goldman’s Cecil Medicine (Twenty-Fourth Edition)(24th ed., Vol. 1). Elsevier. doi: https://doi.org/10.1016/B978-1-4377-1604-7.00051-8
Krishnan MN. Coronary heart disease and risk factors in India – On the brink of an epidemic? Indian Heart Journal. 2012;64(4):364-367. doi:10.1016/j.ihj.2012.07.001.