- Although two thirds of India’s 1.2 billion population lives in rural areas, the greater interconnectedness increasingly allows rural populations to adopt urban lifestyles without migration to urban areas.1, 2
- Although the coronary artery disease (CAD) rates are lower in rural than urban India, the overall CAD burden is higher in rural India. This is because far more Indians live in rural areas, where access to health care is limited.3, 4 CAD rates are also increasing in rural areas as lifestyles become more westernized.5-8
- Despite a higher rate of tobacco use, the heart disease and diabetes rates are approximately half in rural than in urban India.9-12 Nonetheless, the prevalence of cardiovascular disease (CVD) in rural areas is increasing rapidly and is emerging as a major cause of death.
- Although CVD prevalence is likely to remain lower in rural areas relative to urban areas, it is projected to increase considerably over the next few years, reaching a high of 14% among the rural elderly (60-69 year olds).13 In a study of 45 villages in the state of Andhra Pradesh, CVD accounted for 32% of deaths in the area.14
- A cross-sectional survey done in rural Haryana in 1998 revealed a CAD prevalence rate of 6% in rural Indians aged 35-64 years.15 This CAD rate is 2-fold higher than contemporary U.S. rates and 3-fold higher than the 2% reported in 1974 from the same village.16, 17
- Contemporary data show a high age-standardized prevalence of modifiable risk factors in rural India which indicates that the epidemic of CAD would soon expand to rural India: tobacco use (40% men, 4% women); low fruit and vegetable intake (69% -75% ); dyslipidemia (cholesterol problems) 33% – 35%; high blood pressure 20%- 22% ; diabetes 5% – 6%, metabolic syndrome 24%-33% and obesity 19%- 28%. However, 18%-21% were underweight and thus undernutrition and overnutrition coexist in rural India.18, 19
- Higher prevalence of many risk factors (obesity, dyslipidemia, and diabetes and high blood pressure) is common in those in the high socioeconomic group in rural India.18 For example, 35% of women in the highest socioeconomic group were obese compared with 13% in the lowest.18
- Rural populations have limited access to health care and can least afford to pay for the high treatment costs associated with medications, let alone coronary angioplasty and bypass surgery
- Given that two thirds of Indians still live in rural areas, the high prevalence of CVD risk factors there has important public health implications.12, 20, 21
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