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Study: Heart Disease Major Overlooked Problem in Developing Nations - 2004-04-26

A new global health study shows that heart disease is an overlooked problem of epidemic proportions in developing countries. Low and middle-income nations suffer the overwhelming majority of deaths from from heart ailments, including stroke.

Heart disease was once an affliction of affluent industrial nations where fatty diets, lack of exercise, and smoking prevailed. But a report from Columbia University's Earth Institute in New York reveals that the rest of the world has inherited it for the same reasons.

It shows that developing countries account for 80 percent of the world's 17 million heart disease and stroke deaths each year. Those 17 million deaths are nearly six times as many as AIDS kills annually.

The study?s chief author, Stephen Leeder says, ?Regrettably, these conditions do not attract the kind of attention that infectious diseases do.?

Mr. Leeder is a University of Sydney public health expert temporarily working at Columbia University in New York. He says the rise in heart disease is linked to increasing urbanization and affluence around the world.

?Big cities are very economically efficient, but they do create a climate where people tend to eat perhaps more than they need, where food is cheap, and where cigarette smoking becomes more frequent, and where because everything is close, they do not exercise as much, or use a car instead of feet or a bicycle,? Mr. Leeder said.

Mr. Leeder's team bases its findings of widespread heart disease on a detailed study of five nations - Brazil, China, India, South Africa, and the Russian autonomous republic Tartarstan.

In South Africa, for example, heart disease kills 75 percent more men aged 34 to 65 each year than in the United States. In India, the death rate is 44 percent higher; in Brazil, 27 percent higher; and in Russia, 460 percent higher. Only China has a lower heart disease rate than the United States.

Mr. Leeder points out that the victims in developing nations are of prime working age, exacting a crippling toll on labor productivity. In contrast, wealthy industrial countries have relegated heart disease mostly to the elderly through prevention and treatment.

Among the most worrisome trends is its increasing impact on women around the world, especially those under age 40.

?In many, many places, we found up to four times as many deaths in women that age were due to these two conditions of heart disease and stroke than they were to HIV and obstetric [birth] calamities,? Mr. Leeder said. ?So I think we really need to add heart disease and stroke to the women's health agenda and not just focus on obstetric causes and HIV,? he added.

The Columbia University report says the problem will worsen as the global population ages.

It recommends that nations put heart disease high on their political agenda, viewing it as an economic issue as well as a health burden. Among the steps it urges are tobacco control, designing cities to encourage healthier lifestyles, and making relatively cheap health interventions available at neighborhood clinics.

These would include tests for high blood cholesterol and high blood pressure, two leading risk factors for heart disease, and dispensing drugs to treat them.