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Coronary Artery Disease in Indians

Dr Santhosh SatheeshAssistant Professor, Department of Cardiology,

Jawaharlal Institute of Post Graduate Medical Education and Research(JIPMER), Pondicherry, India

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Distribution Of Deaths By Leading Cause

Groups, World, 2002

Source: WHO CVD Atlas 2002

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INDIA Alarming CAD Epidemic!

India has the largest number of people dying due

to Coronary Artery Disease in the world

World Health Organization (WHO) estimates that60 percent of the world's cardiac patients will be

Indian by 2010.

India has the highest number of patients with

Diabetes

CAD responsible for 32% of all Deaths in India

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Trends in CAD in India

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1960 1990 2000

Other Cardiac

CAD deaths

Reddy KS: Cardiovascular diseases in India. World Health Stat Q 1993; 46:101

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Predictions of the increase in the number of

productive years lost due to CAD

between 2000 and 2030

South Africa - 28 percent

China - 57 percent

Brazil - 64 percent

India - 95 percent

Leeder S, Raymond S, Greenberg H, et al: A RaceAgainst Time: The Challenge of Cardiovascular Disease inDevelopingEconomies, New York, Columbia University, 2004

20% CAD deaths in the USA and Europe < 70yrs

50% of CAD Deaths in India in

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Cardiovascular Disease in India

Coronary Artery Disease the leading

cause of death Rheumatic Heart Disease still a problem in

areas with poor socio economic conditions

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Coronary Artery Disease in Indians

Different from the Rest of the World

Initial indicators that Indians have a higher

predilection for CAD from studies on

Indians living abroad

CAD rates among overseas Asian Indians

worldwide are 50% to 400% higher than

people of other ethnic origin irrespective ofgender, religion, diet or social class.

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Coronary Artery Disease in Indians

Higher Rates

2-4 fold higher prevalence, incidence, hospitalization, mortality

Greater Prematurity

10 yr earlier onset of first MI

10 fold higher rate of MI and death

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Age-standardized death rates from heart disease

among Indian men per 100,000 per year compared

to other ethnic groups in

Canada, UK, Singapore and South Africa.

I= Indians, B=blacks, W=whites, C=Chinese, M= Malays

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Prevalence of heart disease among

non-Indian Americans compared to Indians in

the US in the CADI Study

Framingham Offspring Study (first column).

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Higher Risk-

Redefine the risk factorsRisk Factor AHA/ESC Indian

Age -Men

-Women

>45

>55

>25

>35

BP >140/90 >120/80

Obesity (BMI) >25 >23

Central Obesity Male

Female

>102 cm

>88 cm

>90

>80

Lipids LDL

TG

HDL( m/f)

>130

>150

150

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