KARACHI: Over 80% of the world’s deaths from cardiovascular diseases occur in low- and middle-income countries.
According to WHO, people in low- and middle-income countries are more exposed to risk factors such as tobacco, leading to cardiovascular diseasesand other noncommunicable diseases. At the same time they often do not have the benefit of prevention programmes compared to people in high-income countries.
People in low- and middle-income countries who suffer from cardiovascular diseases and other noncommunicable diseases have less access to effective and equitable health care services which respond to their needs (including early detection services).
As a result, many people in low- and middle-income countries die younger from cardiovascular diseases and other noncommunicable diseases, often in their most productive years. The poorest people in low- and middle-income countries are affected most. At the household level, sufficient evidence is emerging to prove that CVDs and other noncommunicable diseases contribute to poverty due to catastrophic health spending and high out of pocket expenditure. At macro-economic level, CVDs place a heavy burden on the economies of low- and middle-income countries. Noncommunicable disease including cardiovascular disease and diabetes are estimated to reduce GDP by up to 6.77% in low- and middle-income countries experiencing rapid economic growth, as many people die prematurely.
Cardiovascular diseases are number one cause of death globally as more people die annually from these diseases than from any other cause. An estimated 17.3 million people died from CVDs in 2008, representing 30% of all global deaths. Of these deaths, an estimated 7.3 million were due to coronary heart disease and 6.2 million were due to stroke. Low- and middle-income countries are disproportionally affected as over 80% of cardiovascular diseases deaths take place in low- and middle-income countries and occur almost equally in men and women.
The number of people who die from cardiovascular diseases, mainly from heart disease and stroke, will increase to reach 23.3. million by 2030. Cardiovascular diseases are projected to remain the single leading cause of death. Most cardiovascular diseases can be prevented by addressing risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity, high blood pressure, diabetes and raised lipids.
9.4 million deaths each year, or 16.5% of all deaths can be attributed to high blood pressure. This includes 51% of deaths due to strokes and 45% of deaths due to coronary heart disease. Heart attacks and strokes are usually acute events and are mainly caused by a blockage that prevents blood from flowing to the heart or brain.
The most important behavioural risk factors of heart disease and stroke are unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. Behavioural risk factors are responsible for about 80% of coronary heart disease and cerebrovascular disease.
The effects of unhealthy diet and physical inactivity may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity. These “intermediate risks factors” can be measured in primary care facilities and indicate an increased risk of developing a heart attack, stroke, heart failure and other complications.
Cessation of tobacco use, reduction of salt in the diet, consuming fruits and vegetables, regular physical activity and avoiding harmful use of alcohol have been shown to reduce the risk of cardiovascular disease. The cardiovascular risk can also be reduced by preventing or treating hypertension, diabetes and raised blood lipids.