Studies highlight 14 lifestyle-related risk factors that can increase the chances of cardiovascular disease

Fifty-three per cent Indians are likely to die from cardiovascular disease (CVD) before their 70th birthday, compared with 23% Europeans. Now, a study published in The Lancet, a peer-reviewed journal, shows that a significant number of these deaths in India can be averted if we just make a few lifestyle changes.

From 6 January 2005 to 4 December 2016, researchers Salim Yusuf et al studied the factors that increase an individual’s risk for cardiovascular disease events such as heart attack, heart failure, stroke and cardiovascular death. They found that 14 risk factors account for the greatest number of cardiovascular events across the 21 countries (including India) covered in the study.

 Studies highlight 14 lifestyle-related risk factors that can increase the chances of cardiovascular disease

Representational image. Reuters

The 14 risk factors are: hypertension, high cholesterol, ambient and household air pollution (from chulhas, etc.), tobacco use, poor diet, low levels of education, diabetes, excessive consumption of alcohol, lack of physical activity, sodium intake, obesity (including abdominal obesity, measured by hip-to-waist ratio), symptoms of depression and grip strength.

The research was published in The Lancet, a peer-reviewed journal, on 3 September, in an article titled “Modifiable risk factors, cardiovascular disease, and mortality in 155722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study”.

Pattern and policy

By mapping the 14 risk factors to the incidence of heart attack, heart failure, heart stroke and death by heart disease, the study revealed several patterns. For example, the researchers found that people living with high cholesterol were at higher risk for heart attacks while those who had high BP were more likely to have a heart stroke.

Additionally, they wrote, “Of the behavioural risk factors, tobacco use was most strongly associated with cardiovascular disease, followed by physical activity, and low-quality diet. Of the metabolic risk factors, hypertension had the strongest association with cardiovascular disease, followed by diabetes, elevated non-HDL cholesterol, and increased  waist-to-hip ratio.”

The researchers also found that the risk factors could vary from country-to-country, depending on the state of their economy. For example, in low-income countries (LIC), household air pollution and low levels of education were associated more closely with risk for CVD than in high-income and middle-income countries.

In the paper, the researchers expressed the hope that the disaggregated data would help policymakers design interventions that were best suited to their respective countries and economies.

India featured in the list of LIC countries — alongside Bangladesh, Pakistan, Tanzania, and Zimbabwe — in the study.

CVD, an epidemic in India

A quarter of all deaths in India are because of CVDs. According to The Global Burden of Disease study, the CVD death rate is 272 per 100,000 population in India compared with the global average of 235 CVD deaths per 100,000 population.

According to the study, the top 10 risk factors for cardiac events in India are poor diet, low education, low grip strength, household air pollution, tobacco use, diabetes, hypertension, low physical activity, depression and excess alcohol intake.

Dr Ayush Pandey, a medical practitioner associated with, said: “Lifestyle conditions like obesity, diabetes, hypertension are taking a toll on our heart health. This study should give us hope that we can take back control if we just start with the things we can improve today: eat right, exercise, and absolutely quit smoking.”