Heart Disease Risk Factors in India

Heart disease doesn't just happen overnight.  It's a lifelong progression, not the result of one bad choice but a series of bad decisions over a prolonged period of time measured in years.  When I think of the typical patient w/heart disease, I picture the average overweight/obese Caucasian American.

But when I think of the major cause of death in other parts of the world, I think more of infection & trauma rather than of chronic diseases.  However, in just a few years, that image may soon change with the continued population explosion of India, which is predicted to surpass China in terms of population by the year 2025.

In a study just published last week in the Journal of the American College of Cardiology, the authors document the rapid worsening of cardiovascular risk factors after following for just 7 years the remaining 1,100 participants of the New Delhi Birth Cohort, while aging from 29yo to 36yo on average .

Specifically, the authors noted that body mass index increased by 2-3kg/m2 in both men & women while waistlines increased by 6cm in both over such a remarkably short period of time.  What's problematic is that prior to the increase, these individuals were already considered overweight by the International Obesity Task Force criteria for Asians (BMI >23kg/m2) and met International Diabetes Federation criteria for central obesity in South Asians (waist >90cm in men and >80cm in women), both of which are considerably more strict than for Caucasians.

Systolic blood pressure was noted to increase by 12mm Hg in both men & women, moving from normal into pre-hypertension in the former.  While total cholesterol increased by 5mg/dL in both men & women, luckily LDL cholesterol did not change in either, although fasting glucose changed from normal to impaired fasting in men only.

We know from experience that unless acted upon (inertia anyone?), these cardiovascular risk factors will only get worse with the passage of time.  And with progressive worsening, we can only expect a dramatic increase in cardiovascular events (which accounted for 25% of deaths as of January 2008).  The fuse is lit and it is short.  Given the difficulty we have dealing w/heart disease in America, I can only begin to imagine the nightmare of heart disease in India in just 2 decades.