Nursing students during a public awareness event in Amritsar on the occasion of World Heart Day on September 29

India has reason to be alarmed over matters of the heart. A global study has showed that the country leads in deaths from heart failure.

Twenty-three per cent of Indian heart patients who were part of this study did not survive, whereas only 7 per cent of Chinese succumbed.

The International Congestive Heart Failure (INTER-CHF) study was aimed at measuring mortality across a year in patients who had suffered a heart attack. Patients from China, India, Egypt, Qatar and Saudi Arabia in the Middle East, Malaysia and Philippines in southeast Asia and Argentina, Chile, Colombia, Ecuador in South America were surveyed.

The study, published recently in the prestigious Lancet Global Health journal, explored demographic, clinical and socio-economic variables associated with heart-related deaths. It was conducted in 108 centres worldwide involving 5,823 patients.

Southeast Asian countries showed 15 per cent mortality, while both South America and the Middle East had 9 per cent fatalities. Another ongoing study from the All India Institute of Medical Sciences (AIIMS) and the Indian Council of Medical Research (ICMR) has suggested that India's younger population (those under 30) is at great heart risk. Initial findings show that nearly 40 per cent of young people who have suffered a heart attack have had a history of tobacco consumption, said Dr Nitish Nayak, professor of cardiology at AIIMS. The findings suggest 35 per cent of patients who had a heart attack are below 50 and 10 per cent are under 30.

LIFESTYLE PROBLEMS

MAIL TODAY earlier reported that two out of five Delhiites had high blood pressure, according to the findings of an AIIMS study. It stated that incidence of high blood pressure had increased from 23 per cent to 43 per cent in the urban population. The rise in age-specific prevalence was highest in the youngest age group (35-44), noted the AIIMS study.

The doctors MAIL TODAY spoke to attribute lifestyle problems leading to high blood pressure, diabetes and kidney diseases to India's high heart failure death rate. They say the triggering factors are a sedentary lifestyle, intake of fatty and salty food, not eating enough vegetables and fruits, lack of physical exercise, obesity, smoking and drinking.

"Cases of heart failure in India is high among all the surveyed nations because people do not follow aggressive medication after they suffer a heart attack and it gets worse with time," said Dr Ambuj Roy, professor of cardiology at the AIIMS, one of the authors who participated in the survey.

Pointing to one of the major findings of the study, Dr Roy said: "The data suggests more patients die from heart failure in low and middle-income countries than in richer ones because heart treatment is expensive and people discontinue medication over time."

Doctors also pointed to terrible hygiene and sanitation in poorer nations which lead to high incidence of infections. "If we improve sanitation, 90 per cent of infectious diseases can be stopped," said AIIMS director Dr Randeep Guleria.

'PATIENTS DELAY HEART TREATMENT'

From India, AIIMS's Cardiothoracic Science Centre, GB Pant Hospital, Dr Rajendra Prasad Government Hospital (Tanda, Punjab), Yashoda Hospital (Secunderabad, Telangana), Indira Gandhi Government Medical College (Nagpur), Aga Khan Health Services (Mumbai), India Gandhi Medical College (Shimla), Fortis Escorts Hospital (Jaipur), Mediciti Institute of Medical Science (Hyderabad) and BM Patil Medical College (Bijapur, Karnataka) participated in the study.

Patients who were examined were aged between 18 and 59. They were undergoing treatment at academic healthcare centres, community health centres, and specialist and primary care clinics when the study was conducted.

There were about 40 per cent female and 60 per cent male patients. Of this, around 1,300 (15 per cent) were illiterate while 2,500 patients had no health insurance. Findings show that the cause of heart failure was ischemia (deficient supply of blood to body parts) in 39 per cent of cases, followed by hypertension in 17 per cent patients.

Doctors said most heart patients assume that their breathing problem is lung-related. "Patients delay heart treatment thinking that they have a breathing problem as a result they suffer heart failure. Since progression of a heart disease is slow, patients starts curtailing their physical activities and exercise. As a result, it get worse," said Dr Sujoy Shad, cardiac surgeon at Sir Ganga Ram Hospital.

He added the most common age group who suffers cardiomyopathy (a group of diseases that affect the heart muscle) is 15 to 25 years. The other group who suffers from both cardiomyopathy and heart attack is in the age bracket of 40 to 60. Urban lifestyle has been attributed as one of the major risk factors.

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