Escalating ischemic heart disease burden among women in India: Insights from GBD, NCDRisC and NFHS reports

OBJECTIVE: To determine trends in ischemic heart disease (IHD) mortality and burden among women in India we performed a study. METHODS: Data were obtained from three publicly available resources. Cardiovascular disease (CVD) and IHD mortality were obtained from 2017 Global Burden of Diseases (GBD) Study. Metabolic risk factor data (body-mass index, blood pressure and diabetes) were obtained from Non-Communicable Disease Risk Factor Collaboration (NCDRiSC) and lifestyle factors were obtained from National Family Health Surveys (NFHS). Descriptive statistics are reported. RESULTS: GBD study reported that in year 2017 in India CVD caused 2.64 million deaths (women 1.18, men 1.45 million) and IHD 1.54 million (women 0.62, men 0.92 million). Burden of IHD related disability adjusted life years (DALYs) was 36.99 million (women 13.80, men 23.19 million). From 2000 to 2017 annual IHD mortality increased from 0.85 to 1.54 million (+81.1%) with greater increase in women 0.32 to 0.62 million (+93.7%) compared to men (0.53–0.92 million, +73.6%). Increase in age-adjusted IHD mortality rate/100,000 was also more in women (62.9–92.7, +47.4%) than men (97.5–129.5, +32.8%). Trends in cardiometabolic risk factors from 2000 to 2015 showed greater increase in body-mass index, diabetes, tobacco-use and periodontal infections among women than men. CONCLUSION: IHD is increasing more rapidly among women than men in India and there is sex-associated convergence. This is associated with greater increase in overweight, diabetes, tobacco use and periodontal infections in women.