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Epidemiology and causation of coronary heart disease and stroke in India

¹ Fortis Escorts Hospital, Jaipur, India
² Government Medical College, Akola, India
³ Madras Diabetes Research Foundation, Chennai, India
⁴ Public Health Foundation of India, New Delhi, India
⁵ Population Health Research Institute, McMaster University, Hamilton, Canada

Correspondence to:
Dr R Gupta, Fortis Escorts Hospital, JLN Marg, Malviya Nagar, Jaipur 302017, India; rajeevg{at}satyam.net.in

ABSTRACT
Cardiovascular diseases are major causes of mortality and disease in the Indian subcontinent, causing more than 25% of deaths. It has been predicted that these diseases will increase rapidly in India and this country will be host to more than half the cases of heart disease in the world within the next 15 years. Coronary heart disease and stroke have increased in both urban and rural areas. Case–control studies indicate that tobacco use, obesity with high waist:hip ratio, high blood pressure, high LDL cholesterol, low HDL cholesterol, abnormal apolipoprotein A-1:B ratio, diabetes, low consumption of fruits and vegetables, sedentary lifestyles and psychosocial stress are important determinants of cardiovascular diseases in India. These risk factors have increased substantially over the past 50 years and to control further escalation it is important to prevent them. National interventions such as increasing tobacco taxes, labelling unhealthy foods and trans fats, reduction of salt in processed foods and better urban design to promote physical activity may have a wide short-term impact.