Chronic Disease in India

India is undergoing major social and economic changes leading to rapid increases in the prevalence of cardiovascular disease. Many low- and middle-income countries including India are facing an epidemic of chronic diseases, in particular cardiovascular disease and diabetes, with potentially severe consequences for global health, security and the economy. Lifestyle changes resulting from rapid urbanisation and economic development, compounded by predisposition arising from adverse socio-economic conditions in early life, are thought to be responsible. However, the consequences of historical disadvantage overlaid by rapid economic development are unknown. Also unknown are the biological and social mechanisms by which these upstream social determinants, acting over an individual’s lifecourse, lead to downstream physiological changes and disease.

The findings from our research aimed at understanding and addressing the biological reasons for premature development of cardiovascular disease, and its links to environmental, social and behavioural changes associated with economic development and urbanisation, will be important in protecting the health of 600+ million rural Indians and transitional rural communities elsewhere. Childhood malnutrition and infections among these populations are likely to recede, but will not be eliminated anytime soon, making our research relevant to future generations. In addition, the biological and social insights into disease causation will be of universal value in improving public health worldwide.

APCAPS is the only large intergenerational cohort set within a low- and middle-income country, and coupled with a backdrop of a rapid economic transition and a nutritional trial,  is uniquely placed to answer questions and propose solutions for the cardiovascular disease epidemic in low- and middle-income countries.