World Heart Day

29 September ,the World Heart Day

World Heart Day emphasizes the urgent need for global awareness and action against cardiovascular diseases (CVDs), which account for 3.9 million deaths annually in the WHO South-East Asia Region. This burden is largely driven by modifiable risk factors, including unhealthy diets, tobacco use, and physical inactivity. Initiatives like SEAHEARTS aim to improve prevention and management strategies, targeting better hypertension and diabetes control to reduce CVD-related mortality and enhance overall heart health across the region.

Epidemiology

Cardiovascular diseases (CVD) have emerged as a significant public health challenge in Pakistan, contributing substantially to morbidity and mortality rates across the country. Situated at the crossroads of Central Asia, the Middle East, and South Asia, Pakistan is the fifth most populous country in the world, with a growing burden of non-communicable diseases (NCDs) like CVDs.

Statistics

In recent years, the incidence of CVD has escalated alarmingly. According to the 2019 Global Burden of Disease study, Pakistan reported an age-standardized incidence rate of 918.18 per 100,000 people, which is notably higher than the global average of 684.33 per 100,000. The age-standardized death rate from CVD in Pakistan stands at 357.88 per 100,000, compared to 239.85 per 100,000 globally. Furthermore, a National Socioeconomic Registry Survey indicated that 18.9% of surveyed participants self-reported having CVD.

Risk Factors Contributing to CVD in Pakistan

Several risk factors contribute to the high prevalence of CVD in Pakistan:

1. Demographics:

• A predominantly young population is entering middle age, where the risk for CVD increases significantly.
• High rates of consanguinity, with approximately 58% of marriages occurring between first or second cousins, contribute to genetic predispositions to heart disease.

1. Modifiable Risk Factors:

• Hypertension: Approximately 37% of adults in Pakistan suffer from high blood pressure, a significant contributor to CVD.
• Diabetes: The age-adjusted prevalence of diabetes is around 30.8%, which increases the risk of cardiovascular complications.
• Obesity: Poor dietary habits and a lack of physical activity have resulted in rising obesity rates, further exacerbating the CVD epidemic.
• Smoking: About 25% of adult men smoke, significantly increasing their risk of heart disease.

1. Socioeconomic Factors:

• Limited government investment in health and inadequate healthcare infrastructure hinder effective management and prevention of CVD.
• Health spending in Pakistan is low, at approximately $43 per person, with government health expenditure constituting only 1.2% of the gross domestic product (GDP).

1. Infectious Diseases: Despite the rise of NCDs like CVDs, infectious diseases remain prevalent in Pakistan, complicating healthcare responses and resource allocation.

Unique Challenges in CVD Management

Pakistan faces unique challenges in managing CVD. The country has a high burden of rheumatic heart disease and early-onset coronary artery disease. Furthermore, there is currently no comprehensive national strategy to monitor, prevent, and manage CVD in both rural and urban populations, which constitute 37% of the total population.

Need for Improved Data and Monitoring

Despite the urgent need for effective intervention, comprehensive data on CVD prevalence and outcomes are sparse. Recent initiatives, such as the Cardiac Registry of Pakistan, aim to monitor the quality of interventional procedures and the management of acute coronary syndromes. However, ongoing efforts are required to enhance vital registration systems, improve cause-of-death documentation, and conduct regular community health surveys to track CVD trends.

Conclusion

Lets create an awareness on the world heart day because the rising incidence of cardiovascular diseases in Pakistan necessitates urgent action. With a high prevalence of risk factors and limited healthcare resources, public health strategies must focus on prevention, early detection, and management of CVD. Strengthening health systems and promoting awareness are essential steps toward addressing this growing public health crisis and improving cardiovascular health outcomes across the country.