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Changes in the prevalence and social distribution of cardiovascular disease and risk factors in India
  1. Daniel J Corsi
  1. Correspondence to Dr Daniel J Corsi, OMNI Research Group, Department of Obstetrics, Gynecology and Newborn Care, Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada; dcorsi{at}

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It is evident that cardiovascular disease (CVD) and its associated risk factors comprise a major and increasing burden of death and disability in India.1 In 2015, the Global Burden of Disease (GBD) study reported that ischaemic heart disease (IHD; the most common form of CVD) was the leading cause of premature mortality in India, after previously being ranked fifth a decade earlier.2 Over the decade from 2005 to 2015, premature IHD mortality increased by 11% compared with the next three leading causes: neonatal preterm birth, neonatal encephalopathy, and lower respiratory infection which, over the same period, each exhibited a greater than 30% reduction.2 This trend indicates clear changes in the burden of premature mortality away from communicable, maternal and neonatal conditions and towards CVD and other non-communicable diseases at an aggregate scale in India. Although CVD mortality may be the overall leading cause of death, summary statistics such as the GBD, while important, mask large variation in the distribution of CVD and risk factors along certain dimensions, for example, by region or state3 (figure 1) or socioeconomic status (SES),4 which have been identified by studies of the determinants and correlates among individuals.

Figure 1

State level diabetes prevalence among men and women 18 years of age and older, 2012–2013. Authors’ calculation from the District Level Household and Facility Survey-4. Diabetes prevalence defined as fasting blood glucose 160 mg/dL or above, n=456 261.

Two papers in this issue of Heart Asia describe new data on trends and determinants of CVD, risk factors and treatment in diverse settings in rural Punjab and semiurban West Bengal.5 6 In the study by Goyal and colleagues, repeated surveys were conducted …

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