Epidemiology of Atherosclerotic Coronary Heart Disease in India

• Ischemic heart disease (IHD) is the most important cause of disease burden and premature mortality in India.

• The IHD burden is increasing, in contrast to most high and middle-income countries.

• There is significant geographic variation in its incidence and deaths.

• Risk factors of importance are raised total and non-HDL-C, hypertension, diabetes, tobacco, indoor pollution and unhealthy lifestyles.

• Multifactorial approach is required to prevent and control the IHD epidemic.

• Prevention of IHD:

• Lifestyle modification – tobacco control, pollution, healthy diet, physical activity, yoga

• Risk factor management – LDL cholesterol, TGs, blood pressure (BP), diabetes

• Improving clinical inertia, adherence, control of multiple factors – combination of BP therapy + statins (polypill)

• Long-term adherence – patient support + NPHW + Education + polypill

• Focus on social, economic and political determinants – sustainable development goals, pollution control.