While cardiovascular disease is the cause of over a quarter of Indian deaths each year, in a counter-intuitive trend, the mortality rates for rural populations due to this condition have surpassed those in urban areas, according to a new study, published on Friday.
The study is titled “Divergent trends in ischaemic heart disease and stroke mortality in India from 2000 to 2015: a nationally representative mortality study”. Cardiovascular disease caused 2.1 million deaths in India in 2015, over a fourth of the total. For those aged between 30 and 69 years, nearly 70% of the deaths were due to ischaemic heart disease — caused by narrowing of the arteries, a condition that often culminates in fatal heart attacks.
For that age bracket, the probability of dying from that cause increased from 10.4% to 13.1% for men and from 4.8% to 6.6% for women. “Although ischaemic heart disease mortality at ages 30–69 years was lower in rural areas compared with urban areas at the start of the study, rural rates rose rapidly, surpassing urban rates by 2015 in both sexes,” the study found.
“The assumption is that urbanisation is leading to rising rates of heart disease. But in fact, what we showed is that it’s the rural areas of India that had an increase in ischaemic heart disease mortality. In the urban areas, it’s been flat or there’s been a modest decline. That suggests a significant role for untreated hypertension or undertreated diabetes,” Prabhat Jha, director of the Centre for Global Health Research at St Michael’s Hospital in Toronto and senior author of the study said.
This research is based on data from the Million Death Study, a large-scale exercise that has been in progress in India since 2001 and was conducted in collaboration with the Registrar General of India and medical agencies in the country.
Another significant finding was that younger adults, especially those born after 1970, have the highest rate of death due to heart problems caused by narrowing of the heart’s arteries.
“As India has gotten fatter, including in the urban and rural areas, hypertension and diabetes have increased substantially, but the treatment for those have lagged behind. That might be what’s at play here,” Jha said.
The study also examined prevalence of death due to stroke and found “the probability of dying from stroke decreased overall, but increased in India’s North-Eastern states, where a third of premature stroke deaths occurred and only one sixth of (India’s) population lives.