New Delhi: A study based on 10,000 heart patients found that ischaemic heart disease or problems caused by narrowed arteries is the most common cause of heart failure in India. It accounts for 72% such cases, followed by dilated cardiomyopathy (18%), which is a type of disease that causes the heart chambers (ventricles) to thin and stretch.
Rheumatic valvular heart disease — a condition in which the heart valves have been permanently damaged by rheumatic fever — is responsible for heart failure in 5. 9% of patients. Valve diseases other than RHD contribute to 2. 1% of the cases among others. Hypertension and diabetes are the most frequent comorbid conditions (48. 9% and 42. 3%, respectively).
The standard treatment, or GDMT, includes a combination of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs)/angiotensin receptor–neprilysin inhibitors (ARNIs), beta-blockers, and aldosterone blockers.
“This study is an alarm bell for us. Unrecognised, under-diagnosed, improperly treated and often poor affordability and availability remains the bottleneck in managing heart failure in India. It requires a focused patientcentric approach and systematic improvements in healthcare systems across the board, particularly primary healthcare,” Dr Mohit Gupta, professor of cardiology at G B Pant hospital, said.
The study observed an inverse relationship between educational class based on years of education and 90-day mortality, with the least educated having the highest mortality. Baseline BMI, ejectionfraction (EF), presence of COPD, haemoglobin, and respiratory support during admission, among others, were associated with 90-day mortality, according to the NHFR registry-based analysis.
According to the Indian College of Cardiology, which maintains the NHFR, heart failure is the commonest cardiac cause for hospitalisation with 1% of the population being affected annually, which adds up to between 8 to 10 million patients. “The 1% average in the general population looks different when only the 65-79 age group is considered, where heart failure-related hospitalisation is 5-10%. In elderly above 80 years of age such hospitalisation is higher at 10-20%,” the ICC says.