More than one quarter of all deaths in India in 2015 were caused by cardiovascular disease, which is mostly affecting the rural populations and young adults, according to a new study. Led by Prabhat Jha, director of the Centre for Global Health Research of St Michael's Hospital in Toronto, the study said the rate of dying from ischaemic heart disease -- cardiac issues caused by narrowing of the heart's arteries -- in populations aged 30-69 years increased rapidly in the rural areas of the country and surpassed those in the urban areas between 2000 and 2015.
In contrast, the probability of dying from stroke decreased overall, but increased in India's northeastern states, where a third of premature stroke deaths occurred and only one sixth of the population lives.
In these states, deaths due to stroke were about three times higher than the national average, according to the study published in the Lancet Journal.
"The finding that cardiac disease rose nationally in India and that stroke rose in some states was surprising," said Jha, who is also a professor in the Dalla Lana School of Public Health at the University of Toronto.
"This study also unearthed an important fact for prevention of deaths due to cardiovascular disease. Most deaths were among people with previously known cardiac disease, and at least half were not taking any regular medications," he added.
Cardiovascular disease, comprising mostly of ischaemic heart failure and stroke, is the leading cause of death worldwide. Until now, most of the evidence of cardiovascular mortality in India has come from small, local studies or from imprecise modelling exercises.
"This work equips us with more detailed information that we could not have predicted based on earlier studies," said Jha.
This research is part of the Million Death Study, one of the largest studies of premature deaths in the world. In India, most deaths occur at home and without medical attention.
Hundreds of specially-trained census staff in the country knocked on doors to interview household members about deaths. Two physicians independently examined these "verbal autopsies" to establish the most likely cause of death.
"Making progress in fighting the leading cause of death in India is necessary for making progress at the global level," Jha said.
"We demonstrated the unexpected patterns of heart attack and stroke deaths. Both conditions need research and action if the world is going to achieve the United Nations Sustainable Development Goal of reducing cardiovascular mortality by 2030," he said.
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