Present public health strategies, which intend to reduce future C.V. burdens, must focus on current levels of risk behaviors, biological risk factors (which relate principally to those behaviors) as well as the proximate social determinants of those risk behaviors and risk factors. Inappropriate nutrition, reduced physical activity and tobacco consumption are among the behaviors most associated with an increased risk of C.V. while overweight, central obesity, high blood pressure, displacement and diabetes are among the risk factors which principally contribute to the manifestation of that risk.
A rise in total fat intake and a decline in carbohydrate consumption (especially the complex variety), excess energy intake coupled with encountering deficiencies, reduced physical activity with energy -activity mismatch leading to obesity and excess salt intake characterize the nutrition transition that is becoming increasingly well documented in many developing countries. The falling price of vegetable fat in the international market and the rising price of dietary fiber (fruit and vegetables) in the domestic markets are economic factors propelling this . 0% fat as an energy source in their daily diet rose steeply across all income classes between 1989 and 1993. The forces of arbitration and globalization – which shift production from the small farmer to the large corporation, distribution from the shopkeeper to the supermarket, consumption from fresh to processed foods and supply from local to export markets – are the dynamos of this change in dietary patterns.
World-wide, food is becoming part of a ‘common culture’ that reflects the dominant forces in globalization. While nutrition is an essential need, tobacco is an entirely avoidable external agent that contributes greatly to the risk of C.V.. The proportion of all deaths attributable to tobacco is estimated to rise in India from 1. 4% in 1990 to 13. 3% 2020, and from 9. 2 to 16. 0% in China during the same period. The overall global escalation would be from 6. 0 to 12. % in this 30-year period. Of the 10 million lives that would be lost globally in 2025 due to tobacco, 7 million would be from the developing countries. The declining tobacco consumption patterns and the tactical, albeit limited, retreat of the tobacco industry in the developed countries are accompanied by aggressive marketing and rising consumption patterns in the developing countries. C.V. would be the largest contributor to these tobacco-related deaths.
Recent reports from many developing countries chronicle rising rates of sectarianism, overweight, high blood pressure, displacement, diabetes and tobacco consumption in their populations,19. These presage a sharp rise in future C.V. events, unless effective public health interventions to prevent, recognize and reduce risk actors are urgently introduced and implemented. Prevalence of hypertension varies according to the definition used in different studies.
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Recent surveys in China, as well as in India, confirm higher urban prevalence of hypertension compared with rural populations. The overall prevalence in China, with threshold values of 140/90 mug, was 12. 5% in adults aged 35-64 years. Recent Indian studies estimate a prevalence of adult hypertension to be 27. 3% in an urban setting and 12. 2% in a rural setting. Based on these estimates, the number of adults with hypertension in India and China together