By the year 2020 cardiovascular disease may surpass the infectious diseases, making it a world's number one cause of mortality, says WHO report. Yet another report by WHO mentions that cardiovascular disease caused less than 10% of the total deaths worldwide in 1900, while its contribution in 2000 increased to 28% and by 2010 it is expected to cause 36.3% deaths.

Lt. Col. J.K. Sharma, a cardiologist with Military Hospital Cardiovascular Thoracic Center, Pune, told this correspondent that the situation in India is quite alarming. Heart disease rates have doubled in the last 30 years. Around 52% of deaths due to heart disease occur at less than 65 years of age compared to 22% of deaths, which occur in this age group in the developed countries.

"Coronary heart disease rates are five to ten times higher under the age of 40 years compared to western countries, which is a great loss for the Indian economy," said he.

Elaborating various reasons for this advancing epidemic Lt. Col. Sharma said, "Demographic shifts with an advancing life expectancy and expanding middle aged section of the population, life style changes propelled by urbanization, industrialization and globalization, the possible impact of low birth weight and possible contribution of gene environment interactions are the main determinants of this advancing epidemic."

He further added that continued improvement in economic circumstances result in higher total calories intake with higher fat content whereas mechanization leads to lower daily calories expenditure. This disparity leads to higher mean body mass index, plasma lipid levels, and blood pressure and blood sugar levels. These changes set the stage for hypertension and atherosclerosis.

He stressed on evolving a national policy for heart disease control. The policy that aims at primordial prevention, primary prevention, school health programmes and low cost strategies. Tobacco and hypertension controls are clear priorities, he said.

Describing heart disease as a challenge to India, he felt the need of the dedicated involvement by medical professionals in the preventive programmes, active participation of the community at large and proactive state policies on health matters. "The state policies in prevention of the heart diseases in particular will go a long way in halting the looming epidemic of heart disease," said Lt. Col. Sharma.