Household air pollution leading cause of cardiovascular disease in high-income countries

Household air pollution an important risk factor for cardiac deaths in low-income countries,

Household air pollution is becoming an important cause of not only overall mortality but also cardiovascular mortality in low-income countries. This is hardly seen as a cause in the high-income countries where the traditional risk factors like cholesterol, blood pressure, diabetes and obesity are major causes of death due to cardiovascular diseases.

However, in low-income countries like India, 12.5 per cent of cardiovascular diseases (CVD) is due to household air pollution. “This is actually a window of opportunity to prevent mortality due to CVD because if the household air pollution can be controlled, we can see significant decrease in mortality in India,” Dr V Mohan, Director Madras Diabetes Research Foundation told The Indian Express Tuesday. He is one of the authors of the study published in ‘The Lancet’.

Two reports from the Prospective Urban and Rural Epidemiologic (PURE) study published online in The Lancet and presented at the European Society of Cardiology 2019, provides information on the common disease incidence, hospitalisation and death and modifiable cardiovascular risk factors in middle-aged adults across 21 high income, middle income and low-income countries.

CVD remains the leading cause of mortality among middle-aged adults globally, accounting for 40 per cent of all deaths, but this is no longer the case in high-income countries, where cancer is now responsible for twice as many deaths as CVD, according to the PURE study.

It was estimated that 55 million deaths occurred in the world in 2017, of which 17.7 million were due to CVD. According to The Lancet, a higher incidence of CVD and related deaths were found in low-income countries as against the high-income countries.

Countries analysed in these two reports from the PURE Study include: Argentina, Bangladesh, Brazil, Canada, Chile, China, Colombia, India, Iran, Malaysia, Pakistan, Palestine, Philippines, Poland, Saudi Arabia, South Africa, Sweden, Tanzania, Turkey, United Arab Emirates, Zimbabwe.

Dr Salim Yusuf, Professor of Medicine, McMaster University, and principal investigator of the study remarked: “While long-term CVD prevention and management strategies have proved successful in reducing the burden in high-income countries, a change in tack is required to alleviate the disproportionately high impact of CVD in low-income countries and middle-income countries. Governments in these countries need to start by investing a greater portion of their Gross Domestic Product in preventing and managing non- communicable diseases including CVD, rather than focussing largely on infectious diseases.”

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