Fatal and Nonfatal Cardiovascular Disease and the Use of Therapies for Secondary Prevention in a Rural Region of India
Abstract
Background— The rate of cardiovascular disease is widely considered to be increasing throughout India. Precise and reliable data on fatal and nonfatal cardiovascular disease, however, are few, and little is known about the use of preventive therapies. This is particularly true for rural regions. Methods and Results— Data were collected from 53 villages in the Godavari region of Andhra Pradesh. Mortality data were obtained from a verbal autopsy-based mortality surveillance system during a 12-month period in 2003 to 2004. The prevalence of nonfatal cardiovascular disease and the use of preventive therapies were estimated from a stratified random sample of 4535 adults (≥30 years of age) in 2005. Cardiovascular disease was the leading cause of mortality, accounting for at least 32% of all deaths. The average age at cardiovascular death was 65 years, and 51% of all cardiovascular deaths occurred in patients <70 years of age. Among adults, the prevalence of coronary heart disease was estimated to be 4.8% (95% CI, 4.1 to 5.5), and the prevalence of cerebrovascular disease was estimated at 2.0% (95% CI, 1.5 to 2.4). Among individuals with either diagnosis, 14% (95% CI, 10 to 18) reported taking aspirin, 41% (95% CI, 36 to 47) took a blood pressure-lowering medication, and 5% (95% CI, 3 to 7) reported using a cholesterol-lowering medication. Conclusion— This region has a large disease burden attributable to cardiovascular disease with significant underuse of proven, low-cost preventive medications.
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The use of medications for secondary prevention of stroke or myocardial infarction is very low.
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From Engineering a mobile health tool for resource-poor settings to assess and manage cardiovascular disease risk: SMARThealth study (2015) · cites this paper as [5]
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- Authors
- Joshi, R., Chow, C. K., Raju, P. K., Raju, R., Reddy, K. S., MacMahon, S., Lopez, A. D., & Neal, B.
- Affiliations
- The University of Sydney (AU)
- From The George Institute for International Health (R.J., C.K.C., S.M., B.N.), University of Sydney, Sydney, Australia; Department of Cardiology, CARE Hospital, Hyderabad, India (P.K.R.); Department of Urology, CARE Hospital, and Byrraju Foundation, Hyderabad, India (R.R.); Public Health Foundation of India, New Delhi, India (K.S.R.); School of Population Health, University of Queensland, Brisbane, Australia (A.D.L.); and Australian Division of World Action on Salt and Health (B.N.).
- Venue
- Circulation
- Published
- 2009-04-14
- Volume
- 119
- Issue
- 14
- Pages
- 1950-1955
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2037499468
- Cited by
- 67
- References
- 42
- Citations by year
- 2026: 1 · 2024: 2 · 2020: 3 · 2019: 3 · 2018: 6 · 2017: 8 · 2016: 7 · 2015: 6 · 2014: 10 · 2013: 2 · 2012: 5
- FWCI
- 3.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Health Sciences › Health Professions › Health Information Management › Global Health and Epidemiology
- Keywords
- cardiovascular disease, rural India, secondary prevention, cardiovascular mortality, cerebrovascular disease, aspirin use, blood pressure medication, cholesterol-lowering drugs, verbal autopsy
- MeSH terms
- Adult, Aged, Anticholesteremic Agents, Antihypertensive Agents, Autopsy, Cardiovascular Diseases, Humans, India, Middle Aged, Risk Factors, Rural Population, Incidence, Prevalence, Cost of Illness, Secondary Prevention
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