BMJ  2004;328:1499 (19 June), doi:10.1136/bmj.328.7454.1499-a

Letter

Burden of non-communicable diseases in South Asia

Evidence for epidemic of coronary heart disease in India is weak

The first 150 words of the full text of this article appear below.

EDITOR—India is widely believed to be on the verge of an epidemic of coronary heart disease, as expressed by Ghaffar et al in their clinical review.1 2 We believe this assumption to be based on weak evidence.

We found one meta-analysis, reporting a ninefold increase in urban India (1-9%) and twofold increase (2-4%) in rural India between the 1960s and 1990s.3 We believe these results to be inaccurate because of the poor quality of underlying data and because comparisons were based on studies defining coronary heart disease differently. Coronary heart disease was measured by using either Minnesota coded electrocardiograms or clinically defined using non-validated translations of the Rose angina questionnaire. The questionnaire tends to give greater positive results and is less valid in women and South Asian populations.4 5

Our review, which is currently undergoing peer review, focused on Minnesota coded electrocardiograms to provide an objective measure. We reviewed 31 . . . [Full text of this article]

Naseer Ahmad, house officer

c/o 89 Clitheroe Road, Manchester M13 0QU naseer102@hotmail.com

Raj Bhopal, professor of public health

Public Health Sciences Section, Division of Community Health Sciences, University of Edinburgh, Edinburgh EH8 9AG


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Relevant Article

Burden of non-communicable diseases in South Asia
Abdul Ghaffar, K Srinath Reddy, and Monica Singhi
BMJ 2004 328: 807-810. [Extract] [Full Text] [PDF]

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