India is grappling with a silent cardiovascular epidemic, as evidenced by the alarming 14.23 per cent rise in heart attack cases in 2022. The epidemic is often described as ‘silent’ because many forms of cardiovascular disease (CVD) can develop without noticeable symptoms, potentially leading to sudden and severe events. What makes this crisis a concern is its unique characteristics: early onset, rapid progression, and high fatality rates.

As our cities grow and our lifestyles evolve, we feed this crisis unwittingly. Lifestyle changes have introduced a host of risk factors, including diabetes, hypertension, and obesity, and these, coupled with social determinants such as poor diet, tobacco use, physical inactivity, and air pollution, further intensify the problem. With CVD accounting for over a quarter of all deaths in India, the need for comprehensive action is urgent. As Indians face a higher risk of CVDs at a younger age compared to Western counterparts, it’s evident that we need a paradigm shift in our approach to heart health.

Heart disease is complex and influenced by many factors, including our environment, requiring a holistic approach that falls outside the box of traditional healthcare. India’s age-standardised CVD death rate of 272 per 100,000 people is way above the global average, underscoring the gravity of the situation. This troubling statistic calls for innovative and comprehensive strategies:

Harnessing Integrated Care for Heart Health

Integrated care is emerging as a beacon of hope in India’s heart disease epidemic. This approach combines patient-centric strategies, transdisciplinary collaboration, and continuity of care, all while harnessing the power of technology. The rising adoption of smartphones and fitness trackers has paved the way for Digital Therapeutics (DTx). DTx solutions such as Lyfe offer tailored interventions to transform disease prevention, management, and treatment through an integrated ecosystem of professionals and devices. Incorporating DTx into heart health strategies can boost patient engagement, improve monitoring, and achieve better outcomes.

India’s rich cultural heritage offers valuable resources for cardiovascular health. Practices such as yoga, meditation, and breathing exercises (pranayama) serve as powerful tools for stress reduction and heart health improvement. A report from Harvard Medical School highlights that yoga enhances heart rate variability, a key indicator of cardiovascular health Higher variability suggests a more resilient heart better equipped to handle stress. Integrating these practices into mainstream healthcare, alongside community-based activities such as walking, exercising and more, can yield dual benefits: improving physical health while fostering social connections.

Early detection and efficient management of cardiovascular risk factors are pivotal for improving heart health and preventing premature mortality. By prioritising routine cardiovascular health assessments, deploying low-cost mobile screening units, and training local health workers, we can empower individuals to take control of their heart health. Implementing stress-reduction techniques in schools and workplaces is also crucial for long-term heart health. Patient support initiatives such as NovaShakti, which aim to raise awareness about cardiovascular health among women, are steps in the right direction. We need more such programs to dispel myths, promote understanding of risks, and raise awareness about treatment options and preventive measures.

Enabling Affordability

The rising prevalence of CVDs in India not only exacts a heavy toll on the health and well-being of individuals but also imposes a significant financial strain on the country’s healthcare system, economy and households. A study conducted in a super-speciality hospital revealed that the average cost of treating a single CVD patient can amount to Rs 2,47,822^. A holistic approach that focuses on prevention and early intervention offers hope and economic benefits, reducing the cost of treatments and hospitalisations. Additionally, integrating holistic therapies into health insurance plans is crucial for improving accessibility and outcomes for millions. Public-private partnerships can play an integral role in making comprehensive heart care more attainable across socioeconomic groups. Collaboration between pharmaceutical companies, healthcare professionals, hospital chains, and the public sector is essential for ensuring inclusive and affordable care.

Identifying Innovative Solution

Despite the promise of holistic approaches, challenges persist in India’s battle against cardiovascular diseases. Regional disparities in cardiac care access, insufficient India-specific clinical trial data, and cultural resistance to lifestyle changes remain significant hurdles. These issues necessitate culturally sensitive strategies and targeted research to develop effective and context-specific practices. However, these challenges also open doors to innovation. The advent of AI and machine learning technologies presents opportunities for early detection and risk prediction in cardiovascular health. These advanced tools could enable more timely interventions. A recent study found that the integration of AI and genomics can revolutionise CVD risk assessment, reveal unique genetic biomarkers, and allow the development of more precise predictive models and personalised treatment plans based on individual genetic profiles.

Combating India’s cardiovascular crisis demands a multifaceted approach that leverages both traditional and modern strategies. The integration of technological advancements such as AI and DTx, combined with culturally relevant practices like yoga and meditation, can create a robust framework for heart health. We can pave the way for a healthier future by prioritising early detection, affordable care, preventive measures, and fostering public-private partnerships. On World Heart Day, the road ahead may look challenging, but with innovation, collaboration, and a commitment to holistic care, we can address the cardiovascular epidemic and improve the quality of life for millions of Indians.

This article was first published in the Businessworld Healthcare World on 29^th September 2024, on account of World Heart Day