Cardio Vascular Disease (CVD) is not a rare problem which individual face now

a days and Cardio Vascular Disease and is the leading cause of death worldwide in most

of the industrialized nations for over 50 years, both for men and women (Jenkins, 1988,

WHO, 2009, BHF, 2010). Deaths from Cardio-Vascular Diseases were relatively

uncommon in the early 20th Century. Incidence of cardio related deaths increased rapidly,

reaching peak mortality rates in the 1950s and 1960. In the United States, it is responsible

for over 34% of all deaths each year and claims more lives than cancer, accidents and

several other causes combined (USBC, 2010). In the United Kingdom, each year over 1.4

million heart attacks occur, and more than a third of the victims die.

It is now established that non-communicable diseases especially Cardio Vascular

Diseases (CVD) are major causes of death and disability in low income countries

including India (Gersh et al., 2010). In India the latest Registrar General of India report

confirms that Cardio Vascular Disease (CVD, Coronary Heart Disease (CHD) & Stroke)

is the largest cause of deaths. This is observed in all regions of the country, in men and

women (Registrar General of India, 2009). The details are reported in Table No.1

Prevalence of CVD and its risk factors is rapidly increasing (Gupta, et al., 2008).

In India mortality data from Registrar General of India prior to 1998 were

obtained from predominantly rural populations where vital registration varied from

5-15% (Gupta, et al., 2006). The Million Death Study collected mortality statistics from

all the Indian States using country-wide sample Registration System Units (RGI, 2009).

CVD were the largest causes of deaths in males (20.3%) as well as females (16.9%) and

lead to 1.7 - 2.0 million deaths annually (Dhingra, et al., 2010). Regional studies have

also reported that CVD is the leading cause of deaths in urban (Gajalakshmi, et al., 2002)

as well as rural (Joshi, et al., 2006) populations. WHO has predicted that 2000 to 2020,

CHD in India shall double in both men and women from the current 7.7 and 5.5 million

respectively (Gupta, et al., 2008). Prevalence studies reported that CHD diagnosed using

history and ECG changes have troubled both urban and rural adults from early 1960s and

current prevalence rates are 10-12% in urban and 4-5% in rural adults. Stroke is also

increasing in India (Gupta, et al., 2008), and incidence registries using population based

2

surveillance have reported that annual incidence of stroke varies from 100-150/100,000

population in urban locations with greater incidence in rural regions (Bhattacharya, et al.,

2005; Bannered, et al., 2001; Dalal, et al., 2008; Sridharan, et al., 2009). Among adults

over 20 years of age, the estimated prevalence of CHD is around 3-4% in rural areas and

8-10% in urban areas, representing a two-fold rise in rural areas and six-fold rise in urban

areas between the years 1960 and 2007 (Gupta, et al., 2008). Studies among Indian

migrants in various parts of the world have documented an increased susceptibility to

CHD in comparison to the native population studied (Mckeigue, et al., 1989; Tuomilehto,

et al., 1984).