The Indian Heart Watch (IHW) study has revealed the truth behind the prevalence, awareness, treatment and control of key risk factors that are driving the country’s growing cardiovascular disease (CVD) epidemic, in a first-of-a-kind presentation of data at the World Congress of Cardiology .

The study assessed the prevalence of different “lifestyle” and biological CVD risk factors across the country – and results show that these risk factors are now at higher levels in India than in developed countries and regions such as the USA and Western Europe.

Seventy-nine per cent of men and 83 per cent of women were found to be physically inactive, while 51 per cent of men and 48 per cent of women were found to have high fat diets. Some 60 per cent of men and 57 per cent of women were found to have a low intake of fruit and vegetables, while 12 per cent of men and 0.5 per cent of women smoke.  

Moreover, the prevalence of biological and metabolic risk factors was also found to be high. Overweight and obesity was reported in 41 per cent of men and 45 per cent of women. High blood pressure was reported in 33 per cent of men and 30 per cent of women, while high cholesterol was found in one-quarter of all men and women. Diabetes (and or metabolic syndrome) was also reported in 34 per cent of men and 37 per cent of women.

“India has the dubious distinction of being known as the coronary and diabetes capital of the world,” said Prof. Prakash Deedwania, University of California, San Francisco, USA. “These results show why - and must prompt the government to develop public health strategies that will change lifestyles, if these risk factors are to be controlled.”

According to the IHW, urban social development is also playing a role in the development of CVD risk factors. Risk factors such as smoking, high fat intake and low fruit/vegetable intake were shown to be more common in less developed cities, while physical inactivity was seen to be more prevalent in highly-developed cities. Accordingly, metabolic risk factors such as obesity, high blood pressure and high cholesterol were seen to be more prevalent in more highly developed cities.

“These results show that improving urban planning and overall living conditions are critical to the curb the CVD epidemic in India,” said Dr. Rajeev Gupta, Fortis Escorts Hospital, Jaipur, India. “But, this can not be the extent of government efforts which have to include improvements in basic amenities, healthcare facilities and, perhaps most importantly, education that will enable people to take responsibility for their own actions.”

Indeed, the results of the IHW study showed that even among literate middle-class urban Indians there is a low awareness and control rates of these risk factors. Of the approximately one-third of study participants found to have hypertension, only about half (57 per cent) were aware of their high blood pressure, only 40 per cent were on treatment and only 25 per cent had adequate control. This is in contrast to more than 75 per cent awareness in most high and middle-income countries, where more than 50–60 per cent of people with high blood pressure are controlled.  

The study took place over a five-year period (2006–2010) and involved 6,000 men and women from 11 cities across various regions of India was conducted under the chairmanship of Professors Prakash Deedwania (University of California San Francisco, Fresno, USA) and Rajeev Gupta (Fortis Escorts Hospital, Jaipur, India).