Coronary Artery Disease : An Emerging Epidemic in Nepal

Abstract

Cardiovascular disease is the commonest cause of death globally and is the major contributor to the burdenof premature mortality and morbidity. Coronary artery disease ( CAD) is greatest killer of mankind. Coronaryartery disease in western industrialized countries show a declining trend. However developing countrieshave shown an alarming increase. The identification of major risk factors and effective control of themthrough population based strategies of prevention were mainly responsible for this decline.A few cases ofacute myocardial infarction were seen in Kathmandu ,Nepal in 1950 and in the sixties the incidence startedrising rapidly. In a study between 1960-1968 a total of 150 cases were reported with myocardial infarctionin Kathmandu , Nepal. Although national datas for incidence and prevalence on CAD in Nepal is notavailable, hospital based datas on admission pattern in different hospitals of Kathmandu, capital city ofNepal show 40 fold increase in incidence of acute myocardial infarction (AMI) in last 30 years. Prevalenceof coronary artery disease (CAD) estimated from these figures of AMI cases indicate that 5 % of adultpopulation in Kathmandu suffer from CAD. Hence, Coronary artery disease is emerging as epidemic in Kathmandu, Nepal.Key Words: Coronary artery disease (CAD), acute myocardial infarction (AMI), Epidemic.

Risk factors, clinical features, angiographic characteristics and treatment outcomes of young myocardial infarction patients

“…1,2 Framingham study 3 reports a 10 year incidence rate per 1000 cases of myocardial infarction of 12.9 in men 30e34 years old and 5.2 in women of 35e44 years old. Men and women of 55e64 year old showed an incidence of myocardial infarction that was eight and nine times greater respectively.…”

State of non-communicable diseases in Nepal

“…Similarly prevalence of hypertension was 22.7% in Dharan municipality [ 8 ]. Studies have shown that the prevalence of hypertension in adult population was around 20% in urban population [ 9 ]. According to the data of 'Sunsari Health Survey’ of the year 1993, the prevalence of diabetes and hypertension in Sunsari District, from eastern Nepal, was about 6% and 5.1% respectively in adults [ 10 ].…”

Variation in Prices of Cardiovascular Drugs in Public and Private Pharmacies in Nepal

“…1 –3 Nepal Heart Foundation in 2011 reported that over 40,000 people of Nepal are having heart diseases, and it accounts for 25% of the total deaths in the country. 4 There has been increase in cardiovascular diseases (CVDs) 5 in Nepal, largely attributed to unhealthy lifestyles. 6 Primary health care facilities form the foundation of health system in Nepal.…”