Once non- communicable diseases were the biggest killers in India but they have been replaced by lifestyle ailments over the past two decadesDISEASES of the affluent — heart disease, diabetes and hypertension — normally seen as bane of the developed West have emerged as top killers even in India. The change in disease pattern — from infectious diseases to non- communicable disease –— has happened rather rapidly and coincides with the period of economic growth from 1990 to 2010. This, however, does not mean that infectious diseases like tuberculosis and vector- borne diseases like malaria have disappeared, altogether. The change means that the highest number of deaths and disease burden in the country now is the due to lifestyle diseases. In fact, heart disease has emerged as the largest killer even in rural areas. The data from the recently announced ‘ Global Burden of Disease’ study has only confirmed what doctors and scientists have been saying for a few years now. Cardiovascular diseases — heart disease and stroke — are responsible for nearly a quarter of all deaths in India, according to data compiled by the health ministry. “ The occurrence of heart disease goes up with the increase in disposable incomes. We have seen this happen in the West and now this is happening in India and across the developing world. The only difference is that it the shift to heart disease happened over a longer period in the rich world, but it is occurring at a faster pace in India because of fast- track development — urbanisation, liberalisation and overall economic growth”, explained Dr K. Srinath Reddy, president , World Heart Federation. Unhealthy diets, lack of physical activity and rise in tobacco consumption are leading causes of the rise in lifestyle diseases. Disposable incomes, Dr Reddy said, increases the exposure to all these risk factors. “ The rise in heart disease is linked to mass production and mass consumption of mediating factors — diets rich in fats, salt, processed foods and so on”, he added. The increased use of labour- saving devices and motorised personal transport has greatly reduced physical activity. “ Technology has crept in there as well, and this has clearly made their life mechanised and thereby sedentary too,” said Dr Ashok Seth, chief cardiologist, Fortis Escorts Heart Institute. Diabetes and hypertension — two key precursors of heart disease have seen dramatic rise. The results of a government- sponsored study, the largest of its kind , have jolted policy makers in the health ministry. Some 1.76 crore people above 30 in were screened for these two ailments in 100 districts across the country. Of them, 7.22 per cent were suspected of having diabetes and 6.59 per cent hypertension. H EALTH secretary Keshav Desiraju said, “ The prevalence of non- communicable diseases such as cardiovascular disease, diabetes, chronic obstructive pulmonary disease, and cancers is definitely increasing”. High blood pressure — the theme of this year’s World Health Day — is a leading risk factor for cardiovascular disease. “ India is facing a difficult set of health challenges,” Dr Reddy said. “ While we still have significant work to do in combating major infectious diseases like diarrhoea and tuberculosis, we must prepare to grapple with the dangerously increasing burden of non- communicable conditions like heart disease, stroke and diabetes”. “ Urban young Indians face a lethal combination of unhealthy lifestyle and environmental factors. More than 15 per cent of our patients are below the age 40. We have women in their 20s reporting with coronary artery diseases”, said Dr Aparna Jaswal, cardiologist at Fortis Hospital. With both men and women caught up with their work lives, health takes a backseat. Young people consume food which contains high levels of sodium and salt, which causes hypertension. Lack of exercise, smoking and alcohol are other major triggers. Occurrence of heart disease goes up with the increase in disposable incomes. The shift happened over a longer period in the rich world, but it is occurring at a faster pace in India Lalit Sharma, 39 From: Bulandshahr, Uttar Pradesh Underwent bypass surgery in Delhi “ I used to complain of regular chest pains which were not relieved even by medication. It once became really bad and I rushed to the doctor,” says Sharma, who runs small business of air coolers. A coronary angiogram showed that three of his heart vessels were diseased. DOCTORSPEAK: “ Sharma was prone to heart problems as he was under stress all the time. To add to that he is a heavy smoker, drinker and a diabetic,” said Dr Pradeep Nambiar, senior consultant, cardiology, Max Hospital Pradeep Srivastav, 45 From: Basti, Uttar Pradesh CASE FILE: It was only when the discomfort of walking and breathlessness became unbearable that Srivastav, an assistant engineer, decided to seek professional medical help. He ended up suffering a heart attack and was admitted to a hospital. DOCTORSPEAK: “ He is prone to heart disease because of a familial history. Lifestyle factors like irregular and unhealthy eating habits and smoking aggravated his risk factors”, said Dr Praveen Chandra, chairman, division of interventional cardiology, Medanta - The Medcity Suresh Singh, 55 From: Ramgarh, Jharkhand CASE FILE: A diabetic, patient of high blood pressure and weighing on the higher side since his 30s, Singh immediately rang the alarm, with the first signs of chest pain. He underwent tests, which confirmed that he had suffered a heart attack. DOCTORSPEAK: “ Though Singh had a healthy diet, diabetes, high blood pressure and being overweight put him at risk for heart disease. While his food habits were healthy, his lifestyle was sedentary as he is a government employee into a desk job,” said Dr Ratnesh Jain, deputy CMO, Central Hospital, Ranchi | 
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