Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-27T22:14:22.037Z Has data issue: false hasContentIssue false

Cardiovascular diseases in the developing countries: dimensions, determinants, dynamics and directions for public health action

Published online by Cambridge University Press:  22 December 2006

K Srinath Reddy*
Affiliation:
All India Institute of Medical Sciences, Ansari Nagar, New Delhi – 110 029, India
*
*Corresponding author: Email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The global burden of disease due to cardiovascular diseases (CVDs) is escalating, principally due to a sharp rise in the developing countries which are experiencing rapid health transition. Contributory causes include: demographic shifts with altered population age profiles; lifestyle changes due to recent urbanisation, delayed industrialisation and overpowering globalisation; probable effects of foetal undernutrition on adult susceptibility to vascular disease and possible gene–environment interactions influencing ethnic diversity. Altered diets and diminished physical activity are critical factors contributing to the acceleration of CVD epidemics, along with tobacco use. The pace of health transition, however, varies across developing regions with consequent variations in the relative burdens of the dominant CVDs. A comprehensive public health response must integrate policies and programmes that effectively impact on the multiple determinants of these diseases and provide protection over the life span through primordial, primary and secondary prevention. Populations as well as individuals at risk must be protected through initiatives that espouse and enable nutrition-based preventive strategies to protect and promote cardiovascular health. An empowered community, an enlightened policy and and energetic coalition of health professionals must ensure that development is not accompanied by distored nutrition and disordered health.

Type
Research Article
Copyright
Copyright © CABI Publishing 2002

References

1Murray, CJL, Lopez, AD. Global Health Statistics. Global Burden of Disease and Injury Series. Boston, MA: Harvard School of Public Health, 1996.Google Scholar
2Chockalingam, A, Balaguer, V. Impending Global Pandemic of Cardiovascular Diseases. Barcelona: Prous Science, 1999.Google Scholar
3World Health Organization (WHO). The World Health Report. Geneva: WHO, 1999.Google Scholar
4Murray, CJL, Lopez, AD. Global Comparative Assessments in the Health Sector. Geneva: World Health Organization, 1994.Google Scholar
5Reddy, KS, Yusuf, S. Emerging epidemic of cardiovascular disease in developing countries. Circulation 1998; 97: 569601.CrossRefGoogle ScholarPubMed
6Pais, P, Pogue, J, Gerstein, H, et al. Risk factors for acute myocardial infaraction in Indians: a case control study. Lancet 1996; 348: 358–63.CrossRefGoogle Scholar
7Gupta, R, Gupta, VP, Ahluwalia, NS. Educational status of coronary heart disease and coronary risk factor prevalence in rural population in India. Br. Med. J. 1994; 307: 1332–6.CrossRefGoogle Scholar
8Pearson, TA, Jamison, DT, Trejo-Gutierrez, H. In: Jamison, DT, ed. Disease Control Priorities in Developing Countries. New York: Oxford University Press, 1993; 577–99.Google Scholar
9Krishnaswamy, S, et al. Demands on tertiary care for cardiovascular diseases in India: analysis of data for 1960–89. Bull. World Health Org. 1991; 69: 325–30.Google Scholar
10Suh, I. Cardiovascular mortality in Korea: a country experiencing epidemiologic transition. Acta Cardiol. 2001; 56: 7581.CrossRefGoogle ScholarPubMed
11Reddy, KS. In: Yusuf, S, Cairns, JA, Camm, AJ, eds. Evidence Based Cardiology. London: BMJ Books, 1998; 147–64.Google Scholar
12Yao, C, Wu, W, Wu, Y. The changing pattern of cardiovascular disease in China. World Health Stat. Quart. 1993; 46: 113–8.Google ScholarPubMed
13Bulatao, RA, Stephens, PW. Global Estimates and Projections of Mortality by Cause. Preworking Paper 1007. Washington, DC: Population Health and Nutrition Department, World Bank, 1992.Google Scholar
14Barker, DJP, Martyn, CN, Osmond, C, et al. Growth in utero and serum cholesterol concentrations in adult life. Br. Med J. 1993; 307: 1524–7.CrossRefGoogle ScholarPubMed
15Enas, EA, Mehta, J. Malignant coronary artery disease in young Asian Indians. Thoughts on pathogenesis, prevention and therapy. Clin. Cardiol. 1995; 18: 131–5.CrossRefGoogle ScholarPubMed
16Drewnowski, A, Popkin, BM. A dietary intervention trial for nutritional management of cardiovascular risk factors. Nutr. Rev. 1997; 55: 34.Google Scholar
17Lang, T. The public health impact of globalisation of food trade. In: Shetty, PS, McPherson, K, eds. Diet, Nutrition and Chronic Disease. Chichester: Wiley, 1997; 173–87.Google Scholar
18World Health Organization (WHO). Tobacco or Health: First Global Status Report. Geneva: WHO, 1996.Google Scholar
19InterAmerican Heart Foundation. Heart Disease and Stroke in the Americans 2000. Dallas, TX: InterAmerican Heart Foundation, 2000.Google Scholar
20McMahon, S. Blood pressure and the risk of cardiovascular disease. N. Engl. J. Med. 2000; 342: 50–2.CrossRefGoogle Scholar
21Reddy, KS. Hypertension control in developing countries: generic issues. J. Hum. Hypertens. 1996; 10: S338.Google ScholarPubMed
22Cooper, R, Rotimi, C, Kaufman, J, et al. Hypertension treatment and control in sub-Sharan Africa: the epidemiological basis for policy. Br. Med. J. 1998; 316: 614–7.CrossRefGoogle Scholar
23Fuentes, R, Ilmaniemi, N, Laurikainen, E, et al. Hypertension in developing economies: a review of population-based studies carried out from 1980 to 1998. J. Hypertens. 2000; 18: 521–9.CrossRefGoogle ScholarPubMed
24Arroyo, P, Fernandez, V, Loria, A, et al. Hypertension in urban Mexico: the 1992–93 national survey of chronic disease. J. Hum. Hypertens. 1999; 13: 671–5.CrossRefGoogle Scholar
25King, H, Aubert, RE, Herman, WH. Global burden of diabetes, 1995–2025. Prevalence, numeric estimates and projections. Diabetes Care 1998; 21: 1414–31.CrossRefGoogle ScholarPubMed
26Ramachandran, A, Snehlatha, C, Latha, E, et al. Rising prevalence of NIDDM in an urban population in India. Diabetologia 1997; 40: 232–7.CrossRefGoogle Scholar
27Reddy, KS. Cardiovascular disease in India. World Health Stat. 1993; 46: 101–7.Google ScholarPubMed
28Ramachandran, A, Snehlatha, C, Dharmaraj, D, et al. Prevalence of glucose intolerance in Asian Indians. Urban–rural difference and significance of upper body adiposity. Diabetes Care 1992; 15: 1348–55.CrossRefGoogle ScholarPubMed
29Rose, G. Sick individuals and sick populations. Int. J. Epidemiol. 1985; 14: 3284.CrossRefGoogle ScholarPubMed
30Stamler, J, Stamler, R, Neaton, JD. Blood pressure, systolic and diastolic and cardiovascular risks: US population data. Arch. Intern. Med. 1993; 153: 598615.CrossRefGoogle ScholarPubMed
31Puska, P, Tuomilehto, J, Aulikki, N, et al. The North Karelia Project 20 Years Results and Experiences. Helsinki: National Public Health Institute, 1995.Google Scholar
32Dowsen, GK, Gareboo, H, George, K, et al. Changes in population cholesterol concentrations and other cardiovascular risk factor levels after five years of non-communicable disease intervention programme in Mauritius. Br. Med J. 1995; 311: 1255–9.CrossRefGoogle Scholar