Author + information
- Received February 5, 2018
- Revision received April 11, 2018
- Accepted April 25, 2018
- Published online June 25, 2018.
- Dorairaj Prabhakaran, MD, DMa,b,∗ (, )
- Kavita Singh, MSc, PhDa,
- Gregory A. Roth, MD, MPHc,
- Amitava Banerjee, MA, MBBCh, MPH, DPhild,
- Neha J. Pagidipati, MD, MPHe and
- Mark D. Huffman, MD, MPHf
- aPublic Health Foundation of India and Centre for Chronic Disease Control, Gurgaon, India
- bLondon School of Hygiene and Tropical Medicine, London, United Kingdom
- cInstitute for Health Metrics and Evaluation and the Division of Cardiology at the University of Washington School of Medicine, Seattle, Washington
- dFarr Institute of Health Informatics, University College London, London, United Kingdom
- eDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina
- fDepartment of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- ↵∗Address for correspondence:
Dr. Dorairaj Prabhakaran, Centre for Chronic Disease Control, Public Health Foundation of India, London School of Hygiene and Tropical Medicine, Plot No. 47, Sector 44, Institutional Area, Gurgaon 122002, India.
This review describes trends in the burden of cardiovascular diseases (CVDs) and risk factors in India compared with the United States; provides potential explanations for these differences; and describes strategies to improve cardiovascular health behaviors, systems, and policies in India. The prevalence of CVD in India has risen over the past 2 decades due to population growth, aging, and a stable age-adjusted CVD mortality rate. Over the same time period, the United States has experienced an overall decline in age-adjusted CVD mortality, although the trend has begun to plateau. These improvements in CVD mortality in the United States are largely due to favorable population-level risk factor trends, specifically with regard to tobacco use, cholesterol, and blood pressure, although improvements in secondary prevention and acute care have also contributed. To realize similar gains in reducing premature death and disability from CVD, India needs to implement population-level policies while strengthening and integrating its local, regional, and national health systems. Achieving universal health coverage that includes financial risk protection should remain a goal to help all Indians realize their right to health.
The Public Health Foundation of India received unrestricted educational grants from Merck Sharp & Dohme, Eli Lilly, GlaxoSmithKline, Torrent, and Sun Pharmaceuticals for primary care physician training programs. Dr. Prabhakaran has received support from the National Heart, Lung, and Blood Institute, Fogarty International Center, National Cancer Institute, Wellcome Trust, and the Indian Council of Medical Research; and has received honorarium from Torrent for serving on the data safety and monitory board. Dr. Pagidipati has received grant support from Amgen, Sanofi, Regeneron, Novartis, and Alexion. Dr. Huffman has received support from the National Heart, Lung, and Blood Institute (R00HL107749) and the World Heart Federation, the latter to serve as senior program advisor for the World Heart Federation’s Emerging Leaders program, which is supported by unrestricted educational grants from Boehringer Ingelheim and Novartis, with previous support by AstraZeneca and Bupa; and has received grant support from the American Heart Association, Verily, and AstraZeneca. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received February 5, 2018.
- Revision received April 11, 2018.
- Accepted April 25, 2018.
- 2018 American College of Cardiology Foundation
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