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Are the rich at risk of heart disease?

Heart disease is the leading cause of death in India - and there may be a correlation with wealth.
Heart disease is the leading cause of death in India – and there may be a correlation with wealth.

Do higher wealth and living in an urban environment increase the risk of heart disease? Recent household surveys suggest a correlation.

The findings come as part of a wider study analysing the distribution and risk factors associated with cardiovascular disease in India. The findings were published in the journal PLOS Medicine.

The results indicated that the risks of dying of cardiovascular conditions vary tremendously between locations and demographics. The surveys were comprised of two large household surveys carried out between 2012 and 2014, which sampled 797,540 adults aged thirty to 74.

The results were gathered from across the whole of India before being divided into categories including state, rural or urban residence, age, sex, household wealth and education.

“Do higher wealth and living in an urban environment increase the risk of heart disease? Recent household surveys suggest a correlation.”

Heart disease ranks as India’s biggest killer. In 2016, 28.1 percent of all deaths were due to cardiovascular ailments. This amounts to around 1.7 million lives lost to heart disease every year – far more than any other condition.

The study found that the risk of cardiovascular disease varied considerably on a state-by-state basis. Earlier findings support this. A study published in The Lancet last year found significant disparities between states in terms of their disease burden. Some states suffer more from noncommunicable diseases (NCDs) than infectious conditions and vice versa.

The scale of a state’s NCD burden is often linked to its wealth. On a more personal level, it was found that entirely different risk factors were often associated with risk levels in low-income individuals, compared to those with a higher level of household income.

It was noted that smoking — a well-known risk factor for heart disease as well as lung disease and many cancers — was far higher in prevalence in rural areas and among lower income populations. This was determined to be one of the predominant risks to lower income individuals in developing cardiovascular disease.

Higher-income individuals, as well as those living in urban environments, were found to have higher body mass indexes, higher blood pressure and higher blood glucose levels. All of these are risk factors for heart disease.

Higher levels of income may also be associated with certain lifestyle factors that could elevate the risks of developing heart disease. Those with higher incomes typically do not work manual jobs, reducing levels of physical exercise. Alongside this, elevated body mass indexes typical of higher income individuals suggests a high-calorie diet. Overall bad health due to poor diet and lack of exercise exposes this group to a far higher chance of cardiovascular disease, as well as many other NCDs.

“[This] information will be essential for effective targeting of resources and interventions for prevention, screening, and treatment to those most at risk and most in need,” said the authors. The evidence of differing risk factors may aid in providing targeted prevention schemes to address India’s biggest killer.

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