Cardiovascular Disease Intervention

Shabana Tharkar, AVP, Epidemiology – ICTPH

The two-day Research Conference held at the ICTPH office in Thanjavur recently, primarily involved a series of comprehensive brainstorming sessions on potential healthcare interventions and their delivery channels. The long-term objective of the conference was to eventually alleviate the disease burden in our adopted villages, by identifying and engaging the relevant interventions to do so.

Research shows that across the globe, morbidity and mortality is highest due to cardiovascular diseases (CVDs) – a finding backed by the results of the ICTPH baseline survey which also reports similar statistics in the village population. Additionally, the evidence from current epidemiologic transition suggests a pandemic of diabetes and heart diseases. The process of industrialisation and resulting economic growth is responsible for improved infrastructure in villages and increased affordability and availability for the population, leading to the eventual manifestation of lifestyle-related diseases and disorders. Karambayam and Alakkudi are in this path of transition, and ICTPH has realised the urgent need for action and the necessity to start health intervention programmes at this stage. The etiology of cardiovascular diseases is well established and evidence based, pointing to the fact that translational research is the need of the hour. To simplify, the established disease process should be reversed with multi-faceted intervention strategies because most of the cardiovascular diseases and their risk factors are largely preventable.

Given this background and owing to the enormous burden due to high prevalence of individual risk factors of cardiovascular disease, like diabetes, hypertension, dyslipidemia and so on, there is much need to design a structured protocol for screening and early detection of CVD. The goal is to capture the undiagnosed cases early and initiate necessary treatment, and to identify those at risk for health promotion and primary prevention. A well outlined treatment algorithm with an integrated approach towards the management of CVD and its risk factors must be designed next. Planning and designing these protocols, carefully keeping in mind low resource settings are being considered for improved outcomes. But implementing protocols for rural settings can often be a challenge due to physical barriers, economic barriers and false faiths and traditions. Low levels of awareness related to health issues, as well as compliance to advice and management is another issue of concern that needs to be kept in mind while designing an intervention.

The two hour long discussion concluded with a consensus on prioritising cardiac health, particularly in terms of the need for effective diagnostic and management protocols, along with regular follow-ups of patients. We also hope that this will in turn contribute a wealth of data and subsequent research publications. To summarise our process: first, an epidemiology of cardiovascular disease and its risk factors will be obtained; second, the efficacy of the protocols will be studied; and finally, long term follow-ups will generate data that will give us information on the patterns of co-morbid conditions as related to CVD. We hope that the design, planning and implementation of our intervention go well so as to achieve our primary goal of empowering these communities, by leading them towards healthy, disease-free villages.

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