Epidemiology of Ischemic Heart Disease and Diabetes in South Asia: An Overview of the Twin Epidemic.

BACKGROUND & OBJECTIVE Ischemic heart disease (IHD) is one of the most important causes of deaths and disability in the world and diabetes is an important risk factor. To describe mortality and morbidity burden from this twin epidemic in South Asian countries we performed this review. METHODS Country level data on epidemiology of IHD and diabetes were obtained from GBD study. Sub-national data were available only for India. We also retrieved epidemiological studies from published reviews on IHD and diabetes in India. These were supplemented with MEDLINE search. RESULTS GBD study and regional epidemiological studies have reported that there are significant regional variations in IHD mortality and disease burden within South Asian countries. IHD burden has increased significantly from 2000 to 2017. Prospective Urban Rural Epidemiology study has reported that diabetes is an important IHD risk factor in South Asian region. GBD Study and International Diabetes Federation have reported increasing diabetes related mortality and disease burden in South Asian countries, especially India. There are regional variations in diabetes-related mortality, disease burden and prevalence in South Asia. At the macrolevel, rapid food and nutrition transition along with increasing physical inactivity are responsible for this twin epidemic. CONCLUSIONS Increasing trend in IHD and diabetes related mortality and disease burden with regional variations are observed in South Asian countries.