K. Srinath Reddy

Reddy is a clinical cardiologist and epidemiologist who presently serves as the coordinator of the Cardiovascular Health Research Initiative in Developing Countries, a global partnership launched by the World Health Organization (WHO), Global Forum for Health Research and 14 other international agencies. The lecture was sponsored by the Office of the Dean and the Departments of Epidemiology, Nutrition, and Population and International Health.

In 1998, about 85 percent of the global burden of disease fell on the poorest countries, Reddy said. Until that time, most deaths were the result of communicable diseases. When non-communicable diseases, including cardiovascular disease (CVD) and cancer, overtook infection as the major cause of death in the world in 1999, Reddy said, "It changed the debate."

Cardiovascular disease is now the world’s number one killer. "We must fight this battle on every front," Reddy said.

In 1990, CVD claimed 14.5 million lives worldwide, but by 2020, it is projected to kill 25 million people, including 19 million in developing countries.

"Let’s not lose life we’ve saved earlier from infection [to preventable disease]," he said.

In economically stable countries, Reddy pointed out, death from CVD may come after a long and productive life; in developing countries, almost half of CVD deaths are among those in the prime of their working lives. Their deaths are not only personal tragedies, but they also impact the course of economic growth in their countries.

In underdeveloped regions, cardiovascular disease is likely to be related to infection, nutritional deficiency or congenital conditions, he said. As an area urbanizes, the population is more likely to lead a sedentary lifestyle, experience higher levels of stress, and consume unhealthy food, tobacco and alcohol. These factors, in conjunction with biogenetic ones, increase the rate of hypertension, diabetes, respiratory diseases and CVD, especially stroke and ischemic heart disease. Globalization is speeding up this process, he said.

However, many of these deaths and disabilities can be prevented, through a combination of policy measures and public education that promotes healthy behaviors and improves access to preventive services as well as cost-effective clinical care.

"As public health professionals, we need to get the measure, the message, the medium and the method right for promoting prevention," said Reddy. It’s not necessary to make huge, sweeping changes, he added, because "even small shifts can have widespread effects."

For example, "If we can reduce diastolic blood pressure by two percent, we can reduce the number of CVD deaths projected for 2020 by one million in Asia alone," he said. "With further treatment of clinical hypertension, this figure can rise to two million lives saved in that year. Even between now and 2020, many millions of lives can be saved by effectively applying the knowledge we have."

--Paula Hartman Cohen