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Premature Heart Disease

Premature Heart Disease 

  • Asian Indians develop heart attacks 6-10 years earlier than other populations.1-3 There has been a significant increase in the prevalence of coronary artery disease (CAD) in young men (20-40 years) and women (20-50 years) in India.1-3
  • In India, an alarming 40% of  first heart attacks occur in people <45 years of age and two-thirds in people younger than 55 years (Figure 018).4 In sharp contrast only 3% of all heart attacks (10,000 women and 30,000 men) occur among Americans <40 years of age.5
  • In India an alarming 50% of CAD deaths occur in people <50 years of age.6, 7 In the US, 13% of cardiovascular disease (CVD) deaths occur in people <65 years of age. Of all the CVD deaths in whites, 1% occurs in people 35-44 years of age, 4% in 45-54, and 8% occurs in those 55-64. The proportions 4%, 10%, and 14% for the three respective age groups in African Americans.8
  • For comparison, only 1% of all CAD deaths among US whites occur in people younger than 45 years of age and 87% of CAD deaths occur in those >65 years of age.9 Besides, one-third of CAD deaths in men and one-half of CAD deaths in women occurs in people who are 85 years of age or older. 5
  • A new analysis of the INTERHEART Study suggests that the earlier age of heart attack in Asian Indians and other South Asians is attributed to earlier onset of risk factors. This in turn is due to poor awareness and failure to adopt healthy lifestyle choices by doctors and public alike (see Physician Heal Thyself).10-12
  • The WHO (World Health Organization) has estimated that India lost $9 billion (USD) in national income from premature deaths due to heart disease, stroke, and diabetes in the year 2005.13  These losses are expected to cumulatively lead to $237 billion over the next 10 years (see Economic Burden).13
  • These alarming statistics highlight the need for aggressive strategies for the prevention and control of CAD in India at an early age and a lower threshold.14


1. Reddy KS, Satija A. The Framingham Heart Study: impact on the prevention and control of cardiovascular diseases in India. Prog Cardiovasc Dis. Jul-Aug 2010;53(1):21-27.

2. Hughes LO, Raval U, Raftery E. First myocardial infarctions in Asian and White men. BMJ. 1989;298:1345-1350.

3. Enas EA, Mehta J. Malignant coronary artery disease in young Asian Indians: thoughts on pathogenesis, prevention, and therapy. Coronary Artery Disease in Asian Indians (CADI) Study. Clinical cardiology. Mar 1995;18(3):131-135.

4. Enas EA. How to Beat the Heart Disease Epidemic among South Asians: A Prevention and Management Guide for Asian Indians and their Doctors. Downers Grove: Advanced Heart Lipid Clinic  USA; 2011.

5. American Heart Association. Heart and Stroke Statistical Update2011.

6. Shah B, Mathur P. Surveillance of cardiovascular disease risk factors in India: the need & scope. Indian J Med Res. Nov 2010;132(5):634-642.

7. Indrayan A. Forecasting vascular disease cases and associated mortality in India. 2010; Sept 25,  2010.

8. Jolly S, Vittinghoff E, Chattopadhyay A, Bibbins-Domingo K. Higher cardiovascular disease prevalence and mortality among younger blacks compared to whites. Am J Med. Sep 2010;123(9):811-818.

9.  American Heart Association. Heart and Stroke Statistical Update2010.

10. Joshi P, Islam S, Pais P, et al. Risk factors for early myocardial infarction in South Asians compared with individuals in other countries. Jama. Jan 17 2007;297(3):286-294.

11.  Gupta R, Gupta VP. Meta-analysis of coronary heart disease prevalence in India. Indian heart journal. 1996;48(3):241-245.

12. Gupta R, Misra A, Vikram NK, et al. Younger age of escalation of cardiovascular risk factors in Asian Indian subjects. BMC cardiovascular disorders. 2009;9:28.

13. World Health Organization. Preventing Chronic Disease: A Vital Investment  World Heath Organization, Geneva 2005. 2005.

14. Enas  EA, Singh V, Gupta R, Patel R, et al. Recommendations of the Second Indo-US Health Summit for the prevention and control of cardiovascular disease among Asian Indians. Indian heart journal. 2009;61:265-74.

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