Heart Disease In India Research Articles

Predicting the Risk of Diabetes and Heart Disease with Machine Learning Classifiers: The Mediation Analysis

ABSTRACT Purpose This research employs machine learning and mediation analysis, along with path analysis, to investigate the correlations between factors such as body mass index (BMI) and the occurrence of diabetes and heart disease among the Indian population. The objective is to enhance models that are specifically designed to accommodate lifestyles, genetic differences, and healthcare obstacles. Methods Our research combines a range of data that includes aspects such as lifestyle, physical health, and mental well-being. We use mediation and path analysis techniques to identify the factors involved in the process, while also utilizing machine learning classifiers to enhance risk assessment. In addition to considering known risks, we also investigate biomarkers. Incorporate time factors through analyses. Results Mediation and path models analyze that diabetes and heart disease are partially mediated with their coefficients a = 7.85, b = 0.01, and c-c’ = 0.10. In the path analysis model, the standardized values of exposure and outcome variables are 4.14 and 6.85, respectively, showing a significant relationship with the mediator and other covariates. In classification, the Random Forest classifier shows 99% accuracy and precession, while the Decision Tree, Extra Tree, K-Nearest, and Adaboost classifiers have an accuracy of 98%, 97%, 96%, and 95%, which shows that the machine learning classifiers are more significant for the study. Conclusion This study contributes to the development of risk management for diabetes and heart disease in India by utilizing machine learning and mediation analysis. It examines relationships, such as BMI, to provide insights for targeted measures, thereby contributing to global discussions on health.

The outcome of surgery for congenital heart disease in India: A systematic review and metanalysis

ABSTRACT Background: The mortality risks of children undergoing various cardiac surgeries for congenital heart disease (CHD) in India are not well defined. We conducted a systematic review and meta-analysis to estimate the inhospital mortality of various common CHD surgeries reported in India and compared it to representative data from established Western databases. Methods and Results: We searched four bibliographic databases for studies published in India over the last 25 years. In total, 135 studies met the inclusion criteria and included 30,587 patients aged from 1 day to 65 years. The pooled mortality rate of 43 Indian studies reporting multiple CHD surgical outcomes is 5.63% (95% confidence interval [CI]: 4.26–7.16; I 2 = 93.9%), whereas the Western data showed a pooled mortality rate of 2.65% (P value for comparison <0.0001). The pooled mortality risk for ventricular septal defect closure and tetralogy of Fallot repair in Indian studies was 2.87% (95% CI: 0.76–5.91; I 2 = 62.4%) and 4.61% (95% CI: 2.0–8.02; I 2 = 87.4%), respectively. The estimated mortality risk was higher than the Western databases for all subcategories studied except for surgeries in the grown-ups with CHD population and coarctation repair. Conclusions: The estimated mortality risks are higher among Indian patients undergoing cardiac surgery for CHD as compared to Western data. We need prospective multicentric data to document whether the observed excess mortality exists after adjusting for various high-risk features and comorbidities in Indian patients. We need systemic measures to improve the outcomes of CHD surgeries in India.

The Impact of Nurse-led Interventions on Improving Self-management and Quality of Life for Patients with Heart Failure

According to the American Heart Association, over 5 million Americans suffer from heart failure, and an additional 500,000 are diagnosed with the condition every year. It's crucial that you comprehend the nature of the illness and your possibilities for treatment because of this. We provide you the inside scoop so you can give this expanding patient population the finest treatment possible. According to National Institutions of Health, It is anticipated that the number of fatalities in India from CVD will increase from 2.26 million in 1990 to 4.77 million in 2020. According to estimates throughout the past few decades, the prevalence of coronary heart disease in India has varied between 1.6% and 7.4% in rural areas and between 1% and 13.2% in urban areas. Heart failure remains the most common cause of hospitalization for adults over 65, making it a serious public health concern in the US. Regretfully, there isn't much hope for this illness: within four years, 50% of heart failure sufferers will pass away from the condition. Heart failure claims the lives of over 287,000 individuals annually, and 40% of patients who are hospitalized for the illness either pass away or return within a year. Not to add that in 2006, the anticipated yearly cost of treating heart failure was $29.6 billion. In this paper, we will discuss through the pathophysiology, causes, and symptoms of heart failure in this post. I'll also cover key diagnostic resources, available treatments, and patient education techniques to assist your patient take care of his condition

Prevalence and determinants of self-reported heart disease among Indian men aged 15–54 years: Evidence from NFHS-5

IntroductionThere is a scarcity of pan-India epidemiological studies examining the factors associated with self-reported heart disease. Therefore, this study examined the prevalence and factors associated with self-reported heart disease in India using data from a large-scale nationally representative survey conducted in 2019-21. Data and methodsThis study used data from the latest National Family Health Survey (NFHS-5) conducted during 2019-21. A cross-sectional sample of 1,01,529 men aged 15–54 years was analysed. Bivariate statistics and binary logistic regression were employed to assess the prevalence and determinants of heart disease. ResultThe prevalence of self-reported heart disease among Indian men aged 15–54 was 1050 per 1,00,000 men. Men aged 40–49 (OR: 3.70, 95% CI: 2.59–5.28), 49–54 years (OR: 5.67, 95% CI: 3.92–8.19), Muslim men (OR:1.62, 95% CI: 1.32–2.00), men from rural areas (OR: 1.52, 95% CI: 1.23–1.83), and southern region (OR: 1.91, 95% CI: 1.40–2.59) had higher odds of heart disease. Men who consumed tobacco had higher odds of developing heart disease (OR: 1.12, 95% CI: 0.95–1.33), as did those with comorbidities such as cancer (OR: 50.93, 95% CI: 35.26–73.57) and diabetes (OR: 5.06, 95% CI: 4.08–6.28). ConclusionSeveral sociodemographic, geographic, biological and behavioural factors were associated with self-reported heart disease among Indian men aged 15–54 years, highlighting the need for targeted public health interventions to address these risk factors. Further research is needed to develop effective strategies to reduce the burden of heart disease in India.

Evaluating efficiency and equity of prevention and control strategies for rheumatic fever and rheumatic heart disease in India: an extended cost-effectiveness analysis

There is a dearth of evidence on the cost-effectiveness of a combination of population-based primary, secondary, and tertiary prevention and control strategies for rheumatic fever and rheumatic heart disease. The present analysis evaluated the cost-effectiveness and distributional effect of primary, secondary, and tertiary interventions and their combinations for the prevention and control of rheumatic fever and rheumatic heart disease in India. A Markov model was constructed to estimate the lifetime costs and consequences among a hypothetical cohort of 5-year-old healthy children. Both health system costs and out-of-pocket expenditure (OOPE) were included. OOPE and health-related quality-of-life were assessed by interviewing 702 patients enrolled in a population-based rheumatic fever and rheumatic heart disease registry in India. Health consequences were measured in terms of life-years and quality-adjusted life-years (QALY) gained. Furthermore, an extended cost-effectiveness analysis was undertaken to assess the costs and outcomes across different wealth quartiles. All future costs and consequences were discounted at an annual rate of 3%. A combination of secondary and tertiary prevention strategies, which had an incremental cost of ₹23 051 (US$30) per QALY gained, was the most cost-effective strategy for the prevention and control of rheumatic fever and rheumatic heart disease in India. The number of rheumatic heart disease cases prevented among the population belonging to the poorest quartile (four cases per 1000) was four times higher than the richest quartile (one per 1000). Similarly, the reduction in OOPE after the intervention was higher among the poorest income group (29·8%) than among the richest income group (27·0%). The combined secondary and tertiary prevention and control strategy is the most cost-effective option for the management of rheumatic fever and rheumatic heart disease in India, and the benefits of public spending are likely to be accrued much more by those in the lowest income groups. The quantification of non-health gains provides strong evidence for informing policy decisions by efficient resource allocation on rheumatic fever and rheumatic heart disease prevention and control in India. Department of Health Research, Ministry of Health and Family Welfare, New Delhi.

Analysis of Risk Factors for Cardiovascular Disease among Adults Living in Rural Areas of India: A Survey

Cardiovascular diseases (CVD) are a collective term for issues with the heart, blood vessels, and other organs. High blood pressure, diabetes, smoking, excessive fat, obesity, or inactivity are the primary risk factors. The research shows that 30–40% of all fatalities are caused by cardiovascular illnesses, while there is limited information on the frequency of heart disease in India. Cross-sectional research looked at how stress affected the cardiovascular system. The SPSS program and Likert Scale were used in the current study to gather 100 participants. The author acquired information about demographics, diet, alcohol use, smoking, as well as drinking habits using a standardized questionnaire. The finding shows Stress and cardiovascular disease were strongly positively statistically correlated (r = 000, p < 0.005), and alcohol use and CVD were also highly statistically correlated (r = 00.1, p < 0.005). According to the result, stress and alcohol consumption is positively correlated with cardiovascular disease. The main goal of this paper is to analyze the risk factor of CVD among adults in rural areas in India. In the future, this paper will make the reader aware of health factors that can reduce the risk of heart disease.

Efficacy of a family-based cardiovascular risk reduction intervention in individuals with a family history of premature coronary heart disease in India (PROLIFIC): an open-label, single-centre, cluster randomised controlled trial

Coronary heart disease, a leading cause of death globally, is amenable to lifestyle interventions. The family environment can affect the ability or willingness of individuals to make lifestyle changes. We aimed to investigate the efficacy of a targeted family-based intervention for reduction of total cardiovascular risk in individuals with a family history of premature coronary heart disease. We did an open-label, cluster randomised controlled trial (PROLIFIC) in the families (first-degree relatives and spouses, older than age 18 years) of individuals with coronary heart disease who had been diagnosed before age 55 years. Patients with coronary heart disease diagnosed within the past year were selected from a tertiary care speciality hospital that provides care for patients from Kerala, India. Family members of selected patients who were bedridden or terminally ill, and individuals with a history of established cardiovascular heart disease and stroke were excluded, as were families with fewer than two eligible family members. Simple randomisation with computer-generated random numbers was used to randomly assign families to intervention and usual care groups (1:1). Participants in the intervention group received a comprehensive package of interventions facilitated by non-physician health workers, consisting of: screening for cardiovascular risk factors; structured lifestyle interventions; linkage to a primary health-care facility for individuals with established chronic disease risk factors or conditions; and active follow-up for adherence. The usual care group received one-time counselling and annual screening for risk factors. We obtained data on lifestyle, clinical, and biochemical characteristics at baseline and annually during the 2-year follow-up. The primary outcome was achievement or maintenance of any three of the following: blood pressure lower than 140/90 mm Hg, fasting plasma glucose lower than 110 mg/dL, low-density lipoprotein cholesterol lower than 100 mg/dL, and abstinence from tobacco. The primary outcome was analysed in all participants available for follow-up at the relevant timepoint. This trial is registered with Clinicaltrials.gov, NCT02771873. From Jan 1, 2015, to April 30, 2017, 980 patients with coronary heart disease were assessed for eligibility and 230 were excluded primarily due to lack of evidence of coronary artery disease (n=199), or a diagnosis of coronary heart disease more than 1 year previously (n=29). Of the 750 remaining families, 368 (with 825 participants) were assigned to the intervention group and 382 (with 846 participants) were assigned to the usual care group. At the 2-year follow-up, data from 803 (97%) of 825 participants in the intervention group and 819 (97%) of 846 participants in the usual care group were available. Of the 1671 participants, 1111 (66·5%) were women, and 560 (33·5%) were men. The mean age of the study population was 40·8 years (SD 14·2). At the 2-year follow-up, the primary outcome was achieved by 514 (64%) of 803 participants in the intervention group and 379 (46%) of 819 in the usual care group. After adjustment for clustering and baseline risk factors, the odds of achieving the primary outcome at the 2-year timepoint was two times higher in the intervention group than in the usual care group (odds ratio 2·2, 95% CI 1·7-2·7; p<0·0001). The reduction of total cardiovascular risk observed after the intervention could have a substantial public health impact by preventing future cardiovascular events. The Wellcome Trust and Department of Biotechnology, Government of India, and India Alliance.

Burden of Group A Streptococcal Pharyngitis, Rheumatic Fever, and Rheumatic Heart Disease in India: A Systematic Review and Meta-Analysis

To estimate the burden of group A streptococcal pharyngitis (GAS) pharyngitis, rheumatic fever (RF), and rheumatic heart disease (RHD) in India using existing data sources, as well as to recognize the most serious gaps in GAS disease burden data. Fourelectronic databases-PubMed, Scopus, Embase, and Web of Science were searchedusing a comprehensive search strategy. Data were identified primarily from observational studies including school surveys, community-based and hospital-based studies. The standard methodological procedures as per Cochrane guidelines were used. Eligible studies were pooled for estimating prevalence, incidence, and case fatality rate using R software version 3.3.3. The protocol was registered with PROSPERO; registration number CRD42018075742. The pooled prevalence of GAS pharyngitis among asymptomatic children and pharyngitis cases aged 5 to 15 y was estimated as 2.79 percent [95% Confidence interval (CI): 1.58-4.89] and 13 percent (95% CI: 3.18-41.97), respectively. The prevalence rate of rheumatic fever was found to be 0.04% (95% CI: 0.01-0.17). The pooled prevalence rate of RHD among children aged 5-15 y using clinical auscultation and echocardiography was estimated as 0.36 percent (95% CI: 0.02-7.52) and 0.28 percent (95% CI: 0.08-1.03), respectively. The study emphasizes the importance of developing a population-based surveillance framework to track patterns, management strategies, and outcomes in order to develop informed recommendations for launching contextual measures to regulate RF and RHD.

Impact of COVID-19 pandemic on pediatric cardiac services in India.

Background :COVID-19 pandemic has disrupted pediatric cardiac services across the globe. Limited data are available on the impact of COVID.19 on pediatric cardiac care in India.Aims :The aims are to study the impact of COVID-19 pandemic on the care of children with heart disease in India in terms of number of outpatient visits, hospitalizations, catheter-based interventions, and cardiac surgeries.Settings and Design :This is a retrospective, multicentric, observational study.Methods :We collected monthly data on the number and characteristics of outpatient visits, hospitalizations, catheter-based interventions, and cardiac surgeries and major hospital statistics, over a period of 5 months (April to August 2020), which coincided with the first wave of COVID-19 pandemic in India and compared it with data from the corresponding months in 2019.Results :The outpatient visits across the 24 participating pediatric cardiac centers decreased by 74.5% in 2020 (n = 13,878) as compared to the corresponding period in 2019 (n = 54,213). The reduction in the number of hospitalizations, cardiac surgeries, and catheterization procedures was 66.8%, 73.0%, and 74.3%, respectively. The reduction in hospitalization was relatively less pronounced among neonates as compared to infants/children (47.6% vs. 70.1% reduction) and for emergency surgeries as compared to elective indications (27.8% vs. 79.2%). The overall in-hospital mortality was higher in 2020 (8.1%) as compared to 2019 (4.8%), with a higher postoperative mortality (9.1% vs. 4.3%).Conclusions :The current COVID-19 pandemic significantly impacted the delivery of pediatric cardiac care across India with two-third reduction in hospitalizations and cardiac surgeries. In an already resource-constrained environment, the impact of such a massive reduction in the number of surgeries could be significant over the coming years. These findings may prove useful in formulating strategy to manage subsequent waves of ongoing COVID-19 pandemic.

Outcome of Rheumatic Heart Disease and Percutaneous Balloon Mitral Valvotomy

Abstract Background: Rheumatic heart disease (RHD) is still a leading cause of valvular heart disease in India. Balloon mitral valvotomy (BMV) is simple and safe procedure to improve the quality of life in patients with severe mitral stenosis. Aim: (1) To evaluate outcome of RHD patients in tertiary care hospital in developing country like India in twenty first century. (2) To evaluate safety and efficacy of BMV. Materials and Methods: We performed retrospective analysis of 500 patients with RHD undergoing echocardiography in a tertiary care hospital in Maharashtra, India. 15% (74 patients) of them underwent balloon mitral valvuloplasty between June 2012 and November 2019 and 37.6% (188 patients) were treated with valve replacements. Results: Successful BMV was performed in 72 patients. The rate of complication was 2.7%. No mortality was noted. One hundred and eighty-eight patients underwent Valve replacements. Conclusions: Balloon mitral valvuloplasty is a technically difficult procedure and demands considerable expertise in transseptal catheterization. Percutaneous balloon mitral valvotomy is a safe and effective treatment for symptomatic severe Mitral stenosis in experienced centers.

Algorithm for primary care physicians in the management of valvular heart disease in India

In India, the burden of valvular heart disease (VHD) is high due to rheumatic heart disease (RHD). Factors like poverty, overcrowded dwellings, under-nutrition, cultural constraints, and suboptimal medical care contribute to the high prevalence of RHD. The diagnosis of VHD is a problem in routine practice and many cases are either missed in early stages. Also, late identification/ referral of complications in post valvular surgery patients of VHD by physicians working in the periphery to a large extent but not limited to periphery only. Hence, the need of the hour is to enhance the knowledge of Primary care physicians and create an easy-to-use algorithm for physicians to facilitate early identification and diagnosis of VHD and complications in post cardiac surgery patients for timely referral to reduce mortality and morbidity associated with VHD. The algorithm will act as a tool to recognize early signs and symptoms of VHD for early diagnosis of VHD & its management. The algorithm will also facilitate early referral to specialist and identification of post-operative complications in patients who have undergone surgery for VHD. Valvular heart disease patients after prosthetic valve implantation are at a risk of thrombo-embolic and therefore require lifelong follow up and anticoagulant therapy in order to alleviate morbidity and mortality which also needs to be cascaded down to the primary care physicians based on evidence-based recommendations on anti-coagulation management. This easy-to-use guide/algorithm will help physicians better their clinical practice in India, ultimately benefiting the patient outcomes.

FRIED FOOD AND POSSIBLE HEALTH HAZARDS

FRIED FOOD AND POSSIBLE HEALTH HAZARDS

Surgical options in rheumatic heart disease: an Indian surgeon's perspective.

Rheumatic heart disease is the primary cause of valvular heart disease in India and other Southeast Asian countries. The disease is quite different from that seen in France, USA, and Australia. Poverty, malnutrition, and delayed referral affect the outcomes. Rheumatic heart disease can affect all four heart valves, mitral being the most common, aortic second, tricuspid next, and finally the pulmonary valve. The combinations of mitral and aortic, mitral and tricuspid, and all three valves are the next in frequency. Acute rheumatic fever usually manifests as quadrivalvular involvement. However, chronic rheumatic quadrivalvular heart disease has also been reported. The technical aspects taught and practiced in one institution over the past four decades are described here. Closed mitral valvotomy, mitral valve repair, or replacement with mechanical, bioprosthetic, and autograft valves are the choices. Aortic valve disease is usually treated with valve repair or replacement with mechanical, homograft or pulmonary autograft valves.

A study to assess valvular heart disease in a tertiary care hospital: a single centre finding

Background: Diseases of the heart valves constitute a major cause of cardiovascular morbidity and mortality worldwide with an enormous burden on healthcare resources. The present study was undertaken to study incidence and demography of valvular heart disease, to assess echocardiography and colour doppler findings of patients with valvular heart disease and to find out complications in patients with valvular heart disease.Methods: A hospital based longitudinal case study was undertaken at medicine department of Dr. V.M. Government Medical College, Solapur, Maharashtra, India for a period of two years. One hundred and twenty-four (124) patients attending OPD participated in the study.Results: In the present study, out of 124 patients, mitral valve was most commonly involved, 105(84.67%) and the least common involved was tricuspid 1(0.81%). The most common aetiology was rheumatic origin 75(94.94%). In the present study the most common complication was pulmonary hypertension 69(55.65%), followed by congestive cardiac failure (33.87%), acute pulmonary edema (12.09%), infective endocarditis (4.84%), cerebrovascular accident (4.03%), left atrial thrombus (3.23%) and death (3.23%).Conclusions: Multiple valves were affected in more than a third of all cases, although recent research in India continue to demonstrate a declining trend in the prevalence of RHD, rheumatic involvement is still the dominant form of valvular heart disease in India.

Review of Burden of Risk Factors of Coronary Heart Disease in India

Review of Burden of Risk Factors of Coronary Heart Disease in India

Congenital Heart Disease in India: A Status Report

Considering a birth prevalence of congenital heart disease as 9/1000, the estimated number of children born with congenital heart disease in India is more than 200,000 per year. Of these, about one-fifth are likely to have serious defect, requiring an intervention in the first year of life. Currently advanced cardiac care is available to only a minority of such children. A number of cardiac centers have been developed over the last 10 years. However, most are in the private sector, and are not geographically well-distributed. Challenges to pediatric cardiac care include financial constraints, health-seeking behavior of community, and lack of awareness. Government of India is taking a number of steps for improving health of children through its various program and schemes that are likely to benefit children with congenital heart disease, especially those who are vulnerable and marginalized.

Gender Differences in Self-Reported Heart Disease and Multiple Risk Factors in India: Evidence from the 71st Round of the National Sample Survey Office, 2014.

This study examined gender differences in the prevalence of heart disease in India in terms of type of care sought and biological risk factors. The analysis included 142,620 people aged 30 and above from the National Sample Survey Office's 71st round of 2014. While men and women have the same prevalence of seven per 1,000 persons, using a form of prevalence odds ratio the analysis indicated that women were likely to seek care at lower levels of service provision, even though they carried a higher level of multiple morbidities. This difference is not because of the survival effect of women living longer with heart diseases when compared to men. It is possible that women with heart disease complicated by multiple co-morbidities have limited treatment options. Nevertheless, these constraints are not entirely biological and therefore whether these are a consequence of gender discrimination in care options needs further examination.

Linkages between Hypertension and Coronary Heart Disease in India: Evidence from India Human Development Survey-2 (2011-2012).

Background:Cardiovascular diseases (CVDs) are the leading causes of death globally (nearly 17.5 million deaths/year). Hypertension and coronary heart disease (CHD) are two of the most important CVDs. There is a dearth of studies at a large scale in India to ascertain the factors as well as social differentials in the prevalence of heart disease associated with hypertension. This paper attempts to bridge the gap in the relevant area.Methodology:Secondary analysis of the data obtained from India Human Development Survey (IHDS), conducted in two rounds in 2004–2005 and 2011–2012, was done (n = 147,201). Bivariate and logistic regression analyses have been used.Results:In India, the prevalence for CHD is 1.1% for 2011–2012. Findings showed that persons with hypertension are 11 times (odds ratio [OR] = 11.58, P < 0.01) more likely to be affected by CHD among adults (15 and above years) as compared to nonhypertensive adults. When the odds are adjusted for socioeconomic and demographic variables, hypertensives are found to be 5 times more likely (OR = 5.096, P < 0.01) to be having CHD as compared to nonhypertensives.Conclusions:The unadjusted odds of suffering from CHD when hypertension is a predictor are much higher than when the odds are adjusted for socioeconomic and demographic variables. Along with hypertension, age, education, and place of residence have also been found to be important determinants of CHD.

Study of Serum HDL, Serum Non-HDL Levels in Type 2 Diabetes with Ischemic Heart Disease in India

Study of Serum HDL, Serum Non-HDL Levels in Type 2 Diabetes with Ischemic Heart Disease in India

Screening for congenital heart disease in India: Rationale, practical challenges, and pragmatic strategies.

Screening for congenital heart disease in India: Rationale, practical challenges, and pragmatic strategies.