Circulation. 1998;97:596-601
(Circulation. 1998;97:596-601.)
© 1998 American Heart Association, Inc.
Emerging Epidemic of Cardiovascular Disease in Developing Countries
K. Srinath Reddy, MD, DM;
; Salim Yusuf, DPhil
From the Department of Cardiology, All India Institute of Medical
Sciences (K.S.R.), New Delhi, India, and the Department of Medicine, McMaster
University (S.Y.), Hamilton, Canada L8L 2X2.
Correspondence to Dr K.S. Reddy, Professor of Cardiology, Cardiothoracic Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
Key Words: cardiovascular diseases • mortality • risk factors
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Introduction
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As the twentieth century draws
to a close, it is clear that cardiovascular disease
(CVD) has become a ubiquitous cause of morbidity and a leading
contributor to mortality in most countries.1 2
The rise and recent decline of the CVD epidemic in the developed
countries have been well documented.3 4 The
identification of major risk factors through population-based studies
and effective control strategies combining community education and
targeted management of high risk individuals have contributed to the
fall in CVD mortality rates (inclusive of coronary and stroke
deaths) that has been observed in almost all industrialized countries.
It has been estimated that during the period 1965 to 1990, CVD related
mortality fell by 
50% in Australia, Canada, France, and the United
States and by 60% in Japan.1 Other parts of
Western Europe reported more modest declines (20% to 25%). The
decline in stroke mortality has been more marked compared with the
decline in coronary mortality. In the United States, the
decline in stroke mortality commenced nearly two decades earlier than
the decline in coronary mortality and maintained a sharper rate
of decline. During the period 1979 to 1989, the age-adjusted mortality
from stroke declined, in that country, by about one third, whereas the
corresponding decline in coronary mortality was
22%.4 5 In Japan, where stroke mortality
outweighs coronary mortality, the impressive overall decline in
CVD mortality is principally contributed by the former. The discordant
trend of rising CVD mortality rates in Eastern Europe, however, is in
sharp contrast to the decline in Western
. . . [Full Text of this Article]
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