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CCDC and University of Leicester rollout £5 million programme to combat the rising cardiovascular burden among older adults in India

CARDIO-India to conduct a cluster randomised controlled trial across 10 states and 2000 adults to improve their blood pressure and quality of life among older adults at the highest risk of cardiovascular disease

New Delhi, March 17th: The University of Leicester, UK, and New Delhi’s Centre for  Chronic Disease Control today kickstart “Integrated, co-developed intervention for  detection and management of cardiometabolic risk factors in older Indians (CARDIO India)”, a £5 million (approximately 62 crore), five-year research programme funded by the National Institute for Health and Care Research (NIHR). The initiative aims to  improve detection and management of cardiometabolic risk factors among adults  aged 60 and above — a population at high risk of cardiovascular diseases (CVDs),  

where access to regular screening and long-term management remains limited. CVDs are the leading cause of death accounting for over 25% of all mortality in India and the burden is growing. This programme will co-design contextually relevant interventions, implement and evaluate by conducting a cluster randomised controlled trial involving 48 Mobile Health Units across 10 states for close to 2000 participants.  

CARDIO-India builds on the Government of India’s Mobile Medical Units (MMUs)  initiative introduced under the National Health Mission to deliver an integrated model of  care across rural and sub-urban areas. A decade since the Government launched their  initiative, more needs to be done.  

CARDIO-India’s programme begins with a formative and co-design phase involving  patients, caregivers, clinicians and frontline health workers. It will then move into a  cluster randomised controlled trial and the intervention will run for 24 months.  Outcomes will be measured at baseline, 12 months and 24 months to assess its  effectiveness in real-world conditions.  

Designed unlike othertelemedicine services thatrely on patients initiating consultations,  CARDIO-India adopts a community-first approach. It combines doorstep clinical  assessment and remote specialist supportwherein community health workers visit older  adults at home, examine them and consult specialists through an assisted telemedicine  platform supported by a clinical decision support system. MMUs are equipped with  diagnostic tools including an electronic stethoscope, AI-enabled ECG and handheld 

echocardiography. All interactions contribute to a digital health record enablement  under theAyushman Bharat Digital Health Mission of Government of India.  

India’s population aged 60 and above is projected to reach 230 million by 2036 (as per  UNFPA India Ageing Report), and by 2050 older adults are expected to outnumber  children for the first time. CVDs are the leading global cause of death, accounting  for 19.8 million deaths in 2022, which represents approximately 32% of all global 

deaths. More than three quarters of these deaths occur in low-and middle-income countries, including a high burden in India. The incidence of heart disease is further  projected to surge worldwide by nearly 90% between 2025 and 2050, accompanied by a more than 70% increase in deaths  

Against this backdrop, CARDIO-India was conceived by the CCDC to lead on the on ground implementation alongside the University of Leicester for its capability in  cardiometabolic research, clinical trial design and health technology. Funded by NIHR,  CARDIO-India will work with HelpAge India to access its Mobile Health Unit network and  patient population. AIIMS New Delhi and Nightingales Medical Trust will also be  consulted for their specialist expertise in ageing and geriatric care whilst Krea University  contributes research and analytical capacity. Along with co-applicant institutions – Queen Mary University London and University of Nottingham (UK).  

Over the long term, the programme is expected to improve control of cardiovascular risk  factors, enhance quality of life and increase health-adjusted life years among older  adults. In the short term, the programme will generate evidence on the design,  acceptability and feasibility of technology-enabled community care. 

Speaking about the partnership, Kamlesh Khunti, Professor of Primary Care Diabetes  and Vascular Medicine at the University of Leicester, said, “We at the University of  Leicester are excited to collaborate with CCDC on CARDIO-India, which will focus on the  care of older adults with cardiovascular disease and its risk factors across India. As a  country with a predominantly young population today, India must begin preparing its  health systems for the needs of an ageing population. CARDIO-India is our effort to  supportthattransition by strengthening ambulatory care.” 

Professor Dorairaj Prabhakaran, Executive Director of the Centre for Chronic  Disease Control, said, “CCDC is excited to co-lead CARDIO-India. It builds on a long standing collaboration with the University of Leicester and is strengthened by the  participation of partners including AIIMS New Delhi, Krea University, HelpAge India and

Nightingales Medical Trust. Just like our languages, the healthcare needs are also very  diverse across the country. With a population that is ageing rapidly, our health systems  must be efficient and resilient in ways to cater for their needs in the coming times.  CARDIO India is a visionary effort which will help India march towards the goal of  Universal Health Coverage (UHC) forits future population.”  

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