Gupta Rajeev, Khedar Raghubir S, Gaur Kiran, Xavier Denis
Eternal Heart Care Centre & Research Institute, Mount Sinai New York Affiliate, Jaipur, India.
Eternal Heart Care Centre & Research Institute, Mount Sinai New York Affiliate, Jaipur, India.
Indian Heart J. 2018 Dec;70 Suppl 3(Suppl 3):S419-S430. doi: 10.1016/j.ihj.2018.05.002. Epub 2018 May 17.
Global Burden of Disease study has reported that cardiovascular and ischemic heart disease (IHD) mortality has increased by 34% in last 25 years in India. It has also been reported that despite having lower coronary risk factors compared to developed countries, incident cardiovascular mortality, cardiovascular events and case-fatality are greater in India. Reasons for the increasing trends and high mortality have not been studied. There is evidence that social determinants of IHD risk factors are widely prevalent and increasing. Epidemiological studies have reported low control rates of hypertension, hypercholesterolemia, diabetes and smoking/tobacco. Registries have reported greater mortality of acute coronary syndrome in India compared to developed countries. Secondary prevention therapies have significant gaps. Low quality cardiovascular care is an important risk factor in India. Package of interventions focusing on fiscal, intersectoral and public health measures, improvement of health services at community, primary and secondary healthcare levels and appropriate referral systems to specialized hospitals is urgently required.
全球疾病负担研究报告称，在过去25年里，印度心血管疾病和缺血性心脏病（IHD）死亡率上升了34%。另据报道，尽管与发达国家相比，印度的冠状动脉危险因素较低，但印度心血管疾病的新发死亡率、心血管事件和病死率更高。导致这些上升趋势和高死亡率的原因尚未得到研究。有证据表明，IHD危险因素的社会决定因素广泛存在且呈上升趋势。流行病学研究报告称，高血压、高胆固醇血症、糖尿病和吸烟/烟草的控制率较低。登记数据显示，与发达国家相比，印度急性冠状动脉综合征的死亡率更高。二级预防治疗存在重大差距。低质量的心血管护理是印度的一个重要危险因素。迫切需要一套侧重于财政、部门间和公共卫生措施的干预措施，改善社区、初级和二级医疗保健层面的卫生服务，以及建立适当的转诊至专科医院的系统。
