Smoking is one reason for the high levels of heart disease

Cardiovascular disease (CVD) is often seen as a disease that affects affluent older people in the west.

But experts from the Center for Global Health and Economic Development warn CVD also affects people elsewhere.

They say it kills almost three times as many people of working age in India, South Africa and Brazil as in the US.

A report by the Center, to be presented to Columbia University's Earth Institute on Monday, will warn CVD causes massive disruption to families and the work force in developing countries.

Lifestyles

The report's authors studied Brazil, South Africa, India and China as well as the former Soviet republic of Tatarstan.

While fighting communicable diseases such as Aids and malaria in these countries is crucial, we must not forget to address these other potentially devastating and preventable conditions Jeffrey Sachs, Earth Institute

They combined population estimates for the five countries with current death rates and workforce data to calculate the future effects of CVD on society and on the workforce.

Based on these figures, they estimated that at least 21 million years of future productive life are lost because of CVD each year, rising to 34 million by 2020.

Five million people die of CVD each year in India, 28% of whom are under 65.

The rate of death among younger people is even higher than the rate seen in the US in the 1950s before prevention and treatment campaigns began.

In South Africa, even though HIV/Aids is the leading cause of death, CVD ranks third biggest cause of disease in women and the sixth for men.

Experts say developing countries often have neither the treatment or prevention initiatives which could reduce deaths.

Stephen Leeder, one of the report's author's, said: "Not only is treatment often unavailable, but lifestyle programmes that have made a big impact in the US over the last 40 years, such as diet and exercise awareness and anti-smoking campaigns or tobacco taxes, have not yet occurred in most developing countries."

'Wake-up call'

Jeffrey Sachs, director of the Earth Institute, added: "These diseases exact a crippling toll on more vulnerable countries, hitting not only individuals and their families, but the economies of nations.

"While fighting communicable diseases such as AIDS and Malaria in these countries is crucial, we must not forget to address these other potentially devastating and preventable conditions.

"In 2020, the less developed nations will have 500 million people aged over 65 years. By 2040 there will be a billion people of this age in these countries. They are the ones most susceptible to these conditions."

Janet Vo�te, chief executive of the World Heart Federation, said: "We expect this report to be a significant wake up call."

She added: "Until now, governments, health authorities and the medical community have neglected CVD and the burden it imposes on developing economies.

"Virtually no international aid goes into CVD prevention and control.

"Unless intervention programmes are put into effect now we will witness a global health crisis in developing countries as skilled workers die or become disabled, women are widowed and older people require expensive medical support for disability related to CVD."

Belinda Linden, head of medical information at the British Heart Foundation, said: "The total number of people in the developing world with high blood pressure is high and few are receiving adequate treatment.

"Smoking also remains a serious problem worldwide and the incidence of obesity and diabetes is growing.