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      Surveillance of cardiovascular disease risk factors in India: The need & scope

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          Abstract

          There is a rise of non-communicable diseases (NCDs) burden, which is causing increasing morbidity and premature mortality in developing countries. In 1990, cardiovascular diseases (CVD) accounted for 63 per cent of all deaths and India contributed to 17 per cent to the worldwide mortality. Several surveys conducted across the country over the past two decades have shown a rising prevalence of major risk factors for CVD in urban and rural populations. These surveys are limited by their generalisability to other parts of the country, and more was required to roll out of an action plan. There was lack of an organized national system for monitoring these risk factors over time so as to inform policy and programme for appropriate interventions. The Indian Council of Medical Research (ICMR) leveraged its research on NCD risk factor surveillance to the development of the national plan under the Integrated Disease Surveillance Project (IDSP) which will obtain State-based prevalence of selected risk factors. This review provides the scenario of CVD in India and the need for a surveillance system. By examining similar experiences globally, it outlines the scope of CVD surveillance in India.

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          Most cited references29

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          World Health Organization.

          Ala Alwan (2007)
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            The world health report 2002 - reducing risks, promoting healthy life.

            J Guilbert (2003)
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              Explaining the decline in coronary heart disease mortality in England and Wales between 1981 and 2000.

              Coronary heart disease mortality rates have been decreasing in the United Kingdom since the 1970s. Our study aimed to examine how much of the decrease in England and Wales between 1981 and 2000 could be attributed to medical and surgical treatments and how much to changes in cardiovascular risk factors. The IMPACT mortality model was used to combine and analyze data on uptake and effectiveness of cardiological treatments and risk factor trends in England and Wales. The main data sources were published trials and meta-analyses, official statistics, clinical audits, and national surveys. Between 1981 and 2000, coronary heart disease mortality rates in England and Wales decreased by 62% in men and 45% in women 25 to 84 years old. This resulted in 68 230 fewer deaths in 2000. Some 42% of this decrease was attributed to treatments in individuals (including 11% to secondary prevention, 13% to heart failure treatments, 8% to initial treatments of acute myocardial infarction, and 3% to hypertension treatments) and 58% to population risk factor reductions (principally smoking, 48%; blood pressure, 9.5%; and cholesterol, 9.5%). Adverse trends were seen for physical activity, obesity and diabetes. More than half the coronary heart disease mortality decrease in Britain between 1981 and 2000 was attributable to reductions in major risk factors, principally smoking. This emphasizes the importance of a comprehensive strategy that promotes primary prevention, particularly for tobacco and diet, and that maximizes population coverage of effective treatments, especially for secondary prevention and heart failure. These findings may be cautiously generalizable to the United States and other developed countries.
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                Author and article information

                Journal
                Indian J Med Res
                IJMR
                The Indian Journal of Medical Research
                Medknow Publications (India )
                0971-5916
                0971-5916
                November 2010
                : 132
                : 5
                : 634-642
                Affiliations
                Division of Non-communicable Diseases, Indian Council of Medical Research, New Delhi, India
                Author notes
                Reprint requests: Dr Prashant Mathur, Scientist ‘D’, Division of Non-communicable Diseases, Indian Council of Medical Research, Ansari Nagar, New Delhi 110 029, India e-mail: mathurp@ 123456icmr.org.in
                Article
                IJMR-132-634
                10.4103/0971-5916.73420
                3028945
                21150017
                4d7f9845-0ddb-48c7-8c78-867a7da575e8
                © The Indian Journal of Medical Research

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 April 2009
                Categories
                Review Article

                Medicine
                risk factor,cardiovascular diseases,surveillance
                Medicine
                risk factor, cardiovascular diseases, surveillance

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