But it’s a view that needs a serious reappraisal. Heart disease is accelerating so fast in developing countries that it may soon be seen as a disease ‘of the East’.

Heart disease is already the major cause of death in many developing countries, and it is expected to gain a similar status in others fairly soon. Around nine million people died from cardiovascular disease in developing countries in 1990, but this is anticipated to rise to 19 million by 2020.

In China, there has been a doubling of the numbers of heart-related deaths during the past 20 years, especially among the 35-54 years age group, while the prevalence of heart disease in India has increased by a factor of eight in the past 40 years.

Stroke is the major type of cardiovascular disease in China, Southeast Asia and sub-Saharan Africa, while coronary heart disease predominates in Latin America, the Middle East and urban India.

So why is it happening? Many factors play a part, but it’s principally due to the fact that more and more of these people are taking to a Westernised diet. The other significant factor is that more in the developing countries are starting to smoke (presumably Western-style cigarettes).

(Source: New England Journal of Medicine, 2004; 350: 2438-40).