Ischemic Heart Disease Burden in Indian Women

The burden of ischemic heart disease is rising more rapidly in women than in men in India.

Ischemic heart disease (IHD) has been associated with increased mortality and disability-adjusted life years (DALYs) over the past few decades in India. Sex-specific trends in IHD-related mortality and morbidity in India have not been well-established in the literature. This study aimed to evaluate the sex-specific burden of IHD on mortality and DALYs in India.

The study conducted secondary data analyses using the following publicly available datasets: Global Burden of Disease (GBD) study, Non-Communicable Disease Risk Factor Collaboration (NCDRiSC), and National Family Health Surveys (NFHS) (India). These are the key findings that were reported in the study:

  • The absolute burden of IHD among Indian women was high (deaths = 623,042; DALYs = 13,798,687). But the IHD mortality was lower in women than in men, both in terms of absolute deaths and DALYs and rates/100,000.
  • The percentage increase in IHD mortality was significantly higher in women (+47.4%)  than in men (+32.8%) (p<0.05). IHD DALYs also increased more in women (+30.9%) than in men (+22.1%).
  • Risk factors like BMI, diabetes, and chronic periodontal infection (marker of chronic inflammatory state) increased more rapidly in women than in men. Systolic blood pressure increase was greater in men than in women.
  • From the three NFHS surveys conducted in a 20-year period (1998-99, 2005-06, 2015-16), tobacco use among women increased from 3.0% to 10.8%, and then decreased to 6.8%. The prevalence of overweight and obesity among women demonstrated a rising trend across the 20-year period, from 10.6% to 14.8% and then to 20.6%.

Therefore, the IHD burden is increasing more rapidly among Indian women than in Indian men, resulting in the sex-related covergence in IHD-related mortality and morbidity. This may be attributed to the greater rise in IHD risk factors like obesity, diabetes, tobacco use, and periodontal infections among women.