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Cardiovascular

Cardiovascular disease, including heart disease and stroke, is a major global health concern and the leading cause of death and disability worldwide. At Boehringer Ingelheim we address unmet medical need by providing innovative treatments that improve the care of patients suffering from a range of cardiovascular conditions including irregular heart beats (atrial fibrillation), stroke, blood clots in deep veins or lungs (deep vein thrombosis or pulmonary embolism), high blood pressure (hypertension) or heart attack (myocardial infarction).


In the last couple of decades, the disease burden across the world has shifted from communicable diseases to non-communicable disease. Cardiovascular diseases (CVDs) were once thought to be impacting the rich and affluent, but it is now well established that they afflict the poor as well. Today, the average age of a person suffering from heart attacks has come down drastically. And this is mainly a result of today’s changing lifestyles.

In fact, the rate of coronary heart disease in the Indian community –particularly in young men – is almost twice as high as their western counterparts. Cardiovascular disease is the leading cause of mortality and morbidity worldwide. India is projected to lose approximately USD 236 billion between 2005-2015 due to CVDs and diabetes.1 Cardiovascular disease (CVD) is the leading cause of death in India leading to premature death, disability, and financial catastrophe due to high out-of-pocket expenditures for acute cardiovascular care. 2

Antihypertensive treatment against cardiovascular events

Hypertension is a major risk factor for cardiovascular morbidity and mortality. The organs at risk are primarily the heart, the main blood vessels, the brain and the kidneys. The primary goal of any antihypertensive treatment is to prevent cardiovascular events, such as heart attacks or strokes, and finally to reduce cardiovascular mortality. Current evidence suggests that even moderately high blood pressure increases cardiovascular risk and should, therefore, be treated to achieve blood pressure goals.

Acute Myocardial Infarction (AMI) is still the main cause of death in the industrial nations, with around three million people suffering from it every year. During the last decade, the treatment of patients with AMI has been revolutionized.

Time is an important factor for successful treatment. The most important factor for a successful treatment of an acute myocardial infarction is time to early reperfusion. In the real world, from the onset of symptoms until treatment a lot of precious time is wasted. Delays are caused by the patients who hesitate to call for help due to lack of awareness as well as unavailability or inaccessibility to cardiac care ambulance that can be accessed by a central helpline, response and journey times further delayed by traffic jams and delays at in-hospital procedures. The average time from symptom onset to hospital admission in an India is ~ 300 minutes.6 In such a situation where “time is muscle” it is critical to save the dying cardiac muscle by attempting early reperfusion, thrombolytic therapy has established itself as one of the most successful modern treatment options of an acute myocardial infarction. Such treatments are easy to apply, available across hospitals/ intensive care settings and are considered safe in view of the serious nature of the disease.

References:

  1. International Heart protection Summit. www.deloitte.com/in. (September 2011)
  2. PP Mohanan et.al. Eur Heart J. 2013 Jan;34(2):121-9.
  3. Gupta R, Guptha S. Strategies for initial management of hypertension.Indian J Med Res.Nov 2010;132(5):531-542
  4. Gupta R, al-Odat NA, Gupta VP. Hypertension epidemiology in India: meta-analysis of 50 year prevalence rates and blood pressure trends.J Hum Hypertens.Jul 1996;10(7):465-472.
  5. Joshi SR, Saboo B, Vadivale M, et al. Prevalence of Diagnosed and Undiagnosed Diabetes and Hypertension in India-Results from the Screening India’s Twin Epidemic (SITE) Study.Diabetes Technol Ther.Jan 2012;14(1):8-15.
  6. Denis Xavier et.al.Lancet 2008; 371: 1435–42.

 

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