Tackling the growing epidemic of cardiovascular disease in South Asia.

Cardiovascular disease will likely become a major public health and clinical problem in South Asia (India, Pakistan, Bangladesh, Nepal). Estimates from the Global Burden of Disease Study suggest that by the year 2020 India will have more individuals with atherothrombotic cardiovascular disease than any other region (1). Over the last 50 years, life expectancy in India has increased from 41 years between 1951 and 1961 to 61.4 years in the period 1991 to 1996. It is projected to reach 72 years by 2030. This change in life expectancy is due to a substantial decline in both infectious disease mortality and childhood deaths from perinatal causes. Furthermore, with increasing rates of urbanization in India, major changes in lifestyle patterns have occurred for a large proportion of individuals. This has led to a trend toward decreasing physical activity, increasing weight and, consequently, increasing rates of diabetes, hypertension and dyslipidemia in urban populations. The shift from a predominance of infectious diseases to a predominance of chronic diseases, such as cardiovascular disease or cancer, is called the “epidemiological transition.”