Habil Khorakiwala, founder and chairman, Wockhardt Synopsis Wockhardt’s Habil Khorakiwala has seen the most harrowing days. From a payment default to bond holders to troubled factories, Khorakiwa
Category: Medicine
Ozempic, Wegovy, Mounjaro: Are GLP-1 drugs weight loss wonders or health gamble?
India, home to the world’s largest low- and middle-income (LMIC) population, is now facing a weighty challenge — literally. It accounts for a staggering 15% of the global obesity burden, and by
As Novo Nordisk scales back, Eris and Biocon Biologics hit the sweet spot in India’s insulin market
“It is a small emergency,” says Amit Bakshi, chairman of Ahmedabad-based drugmaker Eris Lifesciences. He points to the recent decision of Novo Nordisk, the world’s top seller of insulin, to g
India has a major health insurance headache
It is important for state-run health insurance to ensure more hospitals join to provide a safety net to the poor.
How a genome map can help India fight cancer better
Genetic structure could hold some answers to the vexed issue of cancer. A reference set of genetic variants, specific to India’s diverse ethnic groups, can improve disease modelling and treatment
What’s making GBS nerve disorder go viral in Pune
Getty Images Guillain-Barre syndrome (GBS) test, a rare disorder where the body’s immune system damages nerve Synopsis Guillain-Barré Syndrome is a rare nerve disorder. It is not a communicable
This Ichnos Glenmark drug promises to BEAT cancer, affordably. Can it challenge Big Pharma?
Cyril Konto, CEO, Ichnos Glenmark Innovation and Glenn Saldhana, CMD, Glenmark Pharma; image credit: Glenmark. Synopsis The drug has given promising results for the treatment of multiple myeloma, a
Can Cipla make inhaled insulin a successful option for diabetes patients?
Umang Vohra, Global CEO, Cipla. Will Cipla’s big bet work?; image credit: Company. Synopsis Millions of diabetes patients have to take a painful insulin injection to keep sugar levels in control.
PE firms in pink of health on improving returns from hospital investments.
Private equity investors have been investing large sums of money in hospitals. Certain types of hospital chains are delivering healthy returns for such investors.
Can herbs, starvation cure cancer? Sidhu flicks row, gets caught by Twitterati
Navjot Singh Sidhu with wife Navjot Kaur Sidhu Synopsis Navjot Singh Sidhu claimed his wife’s advanced-stage cancer was cured through alternative remedies, sparking controversy. His suggestion th
These bugs are killing 5 million every year, yet doctors have few options to fight them
Doctors are grappling with a raft of unsparing hospital-acquired superbugs broadly known as anti-microbial resistance or AMR. Are bacterial infections the next big lethal adversary for mankind?
What the headlong fall of 23andMe signals for India’s genetic-testing market
Collage by Manali Ghosh Synopsis 23andMe, a pioneer in genetic testing, struggles to maintain its early success. As quickly as it soared, its market value plummeted, leaving the company’s future
How fake drugs, Jan Aushadhi push are eating away the profits of top pharma companies
Is the pharma market, which is currently at INR2.17 lakh crore (USD25.8 billion), getting too crowded? While some industry experts believe a few clear signs of fatigue have emerged, many say it is
The dark reality of melatonin behind India’s USD289 million wild chase for good sleep
Synopsis Most Indians are sleep-deprived and are turning to melatonin for a better night’s rest. The global melatonin market reached USD2.15 billion in 2022, and India’s sleep aid market is pro
Sun Pharma, Torrent, Alkem under lens for inferior medicines. It points to a leaky supply chain.
In the crosshairs of the latest controversy on whether a drug is spurious or “not of standard quality” is the Indian patient. The pharma industry suffered a body blow recently after government
Affordability is critical when it comes to patient care: GE HealthCare’s Sarawate
Chaitanya Sarawate, president and CEO of GE HealthCare South Asia and managing director of Wipro GE Healthcare; image credit: company Synopsis GE HealthCare is riding high on the India opportunity.
How raising awareness about infertility is making IVF a USD4.6 billion opportunity
Infertility, once shrouded in cultural taboos and superstition, has emerged as a critical health issue worldwide. In India, the narrative is no different. Let’s reflect on Bimla’s story. She st
Mpox virus is back. Are India’s vaccine makers Serum Institute, Bharat Biotech ready?
Doctor holding blood sample for mpox virus test Synopsis The mpox virus that started from Central Africa has now reached Europe and closer to home, Pakistan. While it’s too early to gauge the thr
India must protect doctors. They are scarce, and it takes years to train one.
Kolkata woman PGT doctor rape-murder: Junior doctors hold protest in state-run hospitals Synopsis The tragic case in Kolkata’s RG Kar Medical College once again exposed the deep flaws in India’
Sun Pharma’s new drug to take on Pfizer, Eli Lilly is having a bad hair day.
Synopsis Last year, Sun Pharma infused over INR4,688 crore to buy US-based Concert Pharma. That deal gave it rights to a drug that helps hair growth in patients suffering from alopecia areata. Leqs
Why leading doctors, scientists pin hope on green jackfruit to fight fatty liver and cancer
Visualisation by Sadhana Saxena via Ai Synopsis A recent animal study has proven green jackfruit flour’s potency in treating fatty liver and liver cancer. An expert group of doctors, scientists,
This Ranjan Pai investment opens the door to a USD30 billion opportunity
Ranjan Pai is among India’s most influential investors. So, when he makes a move into senior care, it is time to sit up and take notice of the sector, not to mention the broader grey economy.
What an Indian pharma giant’s new drug find can gain the world’s obesity fight
Dilip Shanghvi , founder, chairman and managing director, Sun Pharmaceutical Industries Limited. Synopsis Selling weight-loss drugs is an opportunity no pharma company wants to miss. Now a leading
This is the lady responsible for helping improve USD50 billion Indian pharma’s quality
Sarah McMullen, USFDA India director Synopsis In the past, many within the Indian pharma industry looked at US FDA audits as motivated and a larger conspiracy against it. But this senior official,
Why Mankind, Dr Reddy’s and PE firms are so interested in low-profile BSV
Image credit: Compiled by Manali Ghosh via AI Synopsis Advent controlled-BSV has charted an exceptional turnaround over the last five years, seeing a 3x jump in its valuation. Its specialised produ
Cracking DaVinci: How this Indian doctor’s Mantra is revolutionising robotic surgeries
Sudhir Srivastava (centre) with his expanding team at SS Innovations; image credit: SS Innovations Synopsis In an exclusive interaction with ET Prime, cardiac surgeon Sudhir Prem Srivastava, the ma
Say cheese! A drug to regrow teeth is in clinical trials
Japanese researchers are soon embarking on human clinical trials for a medicine that will help regrow teeth.
How a 2012 bet supercharged Sun Pharma
Shares of Sun Pharmaceuticals, India’s largest drug manufacturer, gained more than 50% over the last one year. In its latest results, the company also posted a 34% on year jump in Q4 profit.
J-Labs: For scientific breakthroughs, India needs its own J-Labs…or lose the race
Credit: illustration by Sadhana Saxena via Ai Synopsis Something as cool as a J-Labs can be a welcome step. From fear of failing, scientists can look at the opportunities of scaling. On its part, t
Prostate cancer: what the blue ribbon needs to unlearn from the pink ribbon
As per a recent report in The Lancet, the incidence of prostate cancer is expected to double in India over the next few years. A crucial weapon in averting a severe health catastrophe will be early
Guns, tinctures, and a brave excise official’s lonely fight with Narcos North India
Rakesh Singh took on the tincture syndicate in Agra during his tenure as excise inspector between 2019-23; image credit: N Sundaresha Subramanian Synopsis A well-oiled syndicate of producers, whole
Decades late, these set of basic rules for Indian pharma can save lives
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How this Advent PE-backed Indian firm is prepping to take on Chinese big pharma
Illustration by Sadhana Saxena via AI. Synopsis Advent, which merged Suven Pharma with Cohance Lifesciences in February, looks to take advantage of the China+1 wave and other geopolitical tailwinds
How this Indian state is showing the way to treat cancer patients
Synopsis With an alarming rise in cancer diagnosis rate in India, especially among the younger cohort, timely screening and therapeutic intervention are the need of the hour. One small state has de
Many new mothers face this problem that plucks the joy out of giving birth.
An overlooked mental health challenge faced by new mothers. A powerful new drug could be critical in fighting back. It should have been an obvious match. Yet things may not turn out that way becaus
No free gifts to doctors, but UCPMP is not effective
Getty Images Synopsis The new government notice tries to prevent the pharmaceutical companies from inducing doctors to prescribe their medicines through vacations, gifts, and free educational mater
Remembering Novartis’ Ranjit Shahani: The pharma titan who walked a tightrope for India
Ranjit Shahani, former chief of Novartis Synopsis Ranjit Shahani will be remembered for his astute leadership and trademark calmness amid chaos. As chief of Novartis in India for nearly two decades
Kotdwar to Hyderabad: How a fake-drugs racket in Uttarakhand with roots in south India was busted.
Officials from enforcement agencies with the accused charged with making and supplying spurious drugs; image credit: Telangana Drug Control Administration Synopsis In a rare breakthrough, the Telan
AI can bring transformational medicines; India has incredible talent pool: Bristol Myers CEO
Chris Boerner, Global CEO, Bristol Myers Squibb; image credit: BMS Synopsis “We are building to be one of the fastest-growing companies by the end of the decade,” says Chris Boerner, CEO, Brist
Chronic Lyme and other pathogens: Tackling long-haul diseases.
As long-haul infections continue to surge, and climate change pushes ticks into new habitats, finding out the causes of these conditions and coming up with cures will become ever more essential.
Read MoreOnce dumped by investors, Orchid Pharma blooms in glory with first novel antibiotic drug
Getty Images Synopsis Orchid Pharma had outlicensed its experimental antibiotic drug to Allecra Therapeutics of Germany. After years of research that drug has won crucial approvals from the US FDA
A new lease of life: How India’s first CAR-T cell therapy is helping patients battle cancer.
The ImmunoACT team that worked on India’s first approved CAR-T therapy NexCAR 19; image courtesy: ImmunoACT Synopsis NexCAR 19, India’s first cell therapy to treat a specific form of blood
An army of 12,000 medical reps: How Rajeev Juneja flexed Mankind to the pharma top order
Rajeev Juneja, vice-chairman and managing director, Mankind Pharma; image credit: Company Synopsis While Ramesh Juneja has led Mankind Pharma for three decades, his brother Rajeev kept in tow and t
Ka-Ching: How global drug makers are riding on luck in their pursuit of blockbuster drugs, vaccines
Illustration by Sadhana Saxena via AI Synopsis The recent successes of leading pharmaceutical products show that drug companies have been plain lucky to hit the jackpot. While long-term strategies
We do a few things, but those few things must be the best in the world: Novo Nordisk’s top exec
Maziar Mike Doustdar, executive VP, Novo Nordisk; image credit: Company Synopsis Novo Nordisk, the most valuable pharmaceutical company in the world, turned 100 last year. While it is largely known
Fixing India’s broken healthcare infra at the bottom, Ujala Cygnus is a rare example
India’s smaller cities and hinterland remain a neglected lot even as five-star specialty hospitals flourish in the metros. To have its healthcare parameters on track, India needs an urgent flow o
Medanta Earning Growth: After a strong debut, can Medanta sustain gains? Earnings growth, retaining specialists will be key.
Last week, Global Health Ltd, the company which operates hospitals under the brand Medanta, made a strong debut on the Indian stock exchanges. Its shares gained 19% on the listing day. At Thursday�
MSD: As MSD puts iconic Januvia and Janumet up for sale, India’s diabetes-drugs market goes into churn
A sharp surge in the number of diabetes patients, 77 million and counting, has turned India into a hotspot for deals to buy or sell prestigious medicine brands to treat the chronic disease. In the
China Covid: Why China’s zero-Covid-19 policy went awry, whereas India fared better against a tenacious virus
Epidemic control workers wear PPE as they wait to remove medical waste from apartments where people who have tested positive are doing home quarantine on December 6, 2022 in Beijing, China. Synopsi
Piramal Pharma Stock: Piramal Pharma expects healthy growth in its key businesses. But does it cure the debt ailment?
Nandini Piramal, chairperson, Piramal Pharma; image courtesy of Piramal Pharma. Synopsis Piramal Pharma’s management is optimistic that with revenue growth and margin expansion, it will be able t
diabetes: Can one beat diabetes without a daily mouthful of pills? There is hope but the path is rigorous.
An Indian nurse (L) collects a blood sample from a policeman using a glucometer at a free diabetic health check-up camp on World Health Day in Hyderabad on April 7, 2016. Synopsis India nurses the
India pharma industry: From whistleblower, Dinesh Thakur’s long road to reforming India’s pharma industry
His name splits the Indian drug industry down the middle. Dinesh Thakur is either admired for his tireless zeal to bring about reform in India’s drug-regulatory system, or tempers flare up at the
Debt-hobbled Glenmark is looking to boost earnings. Execution will be key to winning back investors.
Glenn Saldanha, managing director and CEO, Glenmark pharmaceuticals; image credit: Agencies Synopsis Coping with a tough US generics business and high R&D spends, Glenmark’s earnings growth h
High risk of adverse reaction to two diabetes drugs: Doctors advise caution; will patients be safe?
Canadian physician William Osler is said to have once remarked that medicine is a science of uncertainty and an art of probability. The quote by Osler, known as the father of modern medicine, has o
Sun Pharma: Why Sun Pharma is shelling out USD576 million on a hair-loss drug to fire its specialty-drugs game
Sun Pharmaceutical Industries is scaling new heights. After a setback in the US generic-drugs business, India’s largest drugmaker has gradually moved up the value chain and built a sizeable speci
Rajendra Badwe: How Rajendra Badwe is making cancer treatment affordable by repurposing easily available drugs
Dr. Rajendra Achyut Badwe, Director, Tata Memorial Center. Synopsis Badwe, director of Mumbai’s Tata Memorial Centre, has reset the rules to revolutionise treatment standards. His views on diseas
e-pharmacies: Government glare on e-pharmacies of Amazon, Reliance, Tata et al. after nudge from chemists
The convenience of ordering medicines online has attracted millions, especially the elderly. While it may have made life easier for patients, questions have cropped up, leading up to a clash betwee
Carrying organs to blood samples, drones can change healthcare. But not before limitations are fixed.
Technicians fly a drone to deliver medical supplies during testing at Gauribidanur, near Banglore. Synopsis The use of drones in healthcare is in its test phase. There are already instances of medi
Silent epidemic: the health catastrophe India is not talking about, and why that should change
“I feel exhausted all the time.” Cheryl (name changed on the condition of anonymity), a 30-year-old artist from New Delhi, was suffering from heavy menstrual bleeding, hot flashes, and chronic
From ‘facilitator’ to ‘regulator’: How Rajeev Raghuvanshi is fixing the gaps in pharma industry
Rajeev Singh Raghuvanshi, the Drug Controller General of India; image credit: Vikas Dandekar Synopsis The pharmaceutical industry, and the central drug regulatory agency, faced a severe reputation
Why New Delhi needs to mount an India-driven global health-diplomacy push, and what it needs to do
Workers unload cartons of a Covid-19 coronavirus vaccine being delivered from India to Myanmar Synopsis The pandemic has catapulted India to the high table of global health diplomacy. Using its pos
With data, we want to boost genomics, personalised medicines, manufacturing: WEF health chief
Shyam Bishen, chief of health and healthcare division, World Economic Forum; image credit: Twitter Synopsis The scars from the pandemic will take time to heal. Shyam Bishen, chief of health and hea
Low-quality drugs are posing a risk to India’s global image. Can Rajeev Raghuvanshi fix the faults?
Synopsis At a conference last year, India’s new drug controller general Rajeev Raghuvanshi, who was then the scientific director at the Indian Pharmacopeia Commission, cited examples of drugs fou
obesity: Tale of two anti-obesity drugs for diabetics: Does the euphoria signal an end to the chronic disease?
For most diabetics, an age-old challenge has been the inability to lose weight despite workouts. For millions of others, tweaking their diet to get slimmer hasn’t produced much of a result. Now,
Redcliffe Labs is taking on incumbents like Dr Lal PathLabs. But is it biting more than it can chew?
Dheeraj Jain, founder and MD, Redcliffe Labs; image credit: Redcliffe Labs Synopsis Having set itself a target to reach INR5,000 crore in revenue by 2029, Redcliffe Labs is expanding rapidly and sp
Data-integrity woes have come back to haunt Indian pharma. How can it deal with the USFDA’s glare?
Regulatory lapses have been hurting the industry since long. In several instances earlier, such issues had eroded the financials of top-tier companies. Of late, many companies have again come under
Mankind Pharma IPO: Mankind Pharma IPO: Reasonably priced, investors may join the company on its ‘Bharat-to-India’ quest
Rajeev Juneja, Vice Chairman & Managing Director at Mankind Pharma Ltd. image courtesy: company. Synopsis Adopting a contrarian strategy, Mankind Pharma chose to tap into small-town markets —
Dilip Jose: Manipal Health has set its sights on the top spot. Can it get there amid the intense competition?
Dilip Jose, Managing Director and CEO at Manipal Hospitals Synopsis Of late, Manipal Health has been focusing on getting bigger and improving operational efficiencies. With an aggressive and execut
Lifesaver to litigant: how a Covid-19 drug drove a wedge between Max Healthcare and Novacare
Synopsis Ronapreve came as a boon at the peak of the Delta wave in 2021. But as the injection turned ineffective against the Omicron variants, stocks piled up. While Novacare, the distributor, says
WHO: WHO just removed Covid-19’s emergency tag. That doesn’t mark the end of the virus or the pandemic.
Concept by Vikas Dandekar and Muhabit ul haq. Synopsis The World Health Organization has lifted the emergency status of the pandemic. With most of the world dropping guard against the virus, it was
sexual healh: How digital healthcare startups are helping Indians break the taboo of sexual disorders
Getty Images Synopsis Discussing sexual disorders is no longer a taboo. Young Indians are leading the way to bring out the most secretive healthcare issues around sexual and reproductive health. St
Sun Pharma’s earnings pace is likely to slow down as it takes two steps back for a leap forward
A bird flies past the logo of Sun Pharma installed on the facade of its corporate office in Mumbai, India. Synopsis Dilip Shanghvi’s Sun Pharma made a bold move entering the specialty-drugs busin
Antimicrobial resistance: Would you drink a vial of virus? That could be your best bet against antimicrobial resistance
Synopsis Phages — microscopic viruses that infect bacteria — were discovered over a 100 years ago, and a small band of scientists quickly realised their potential. However, within a few decades
diabetes: A ticking blood-sugar bomb: As diabetes snares more Indians, it is turning into an economic risk
Synopsis A recent study found that 101 million Indians are living with diabetes. From 70 million just four years ago, that’s a jump of over 40%. What’s worse, another 136 million are on the bri
PharmEasy has skipped the growth pill for profitability. This may lead to side effects
Healthtech company PharmEasy seems to finally be able to hold its head above water. The unicorn, which has been struggling with slowing growth, debt burden, and steep valuation cuts by investors, h
How a scientist at Enzene is rethinking manufacturing to make anti-cancer drugs affordable in India
Himanshu Gadgil, CEO, Enzene Biosciences; Enzene Biosciences in Pune; image credit: Enzene Synopsis Anti-cancer drugs are beyond the reach of average Indian patients. Early-stage patients spend up
India Diabetes: Curbing the surge of diabetes in India needs collaborative effort: Novo Nordisk CEO
Lars Fruergaard Jorgensen, global CEO, Novo Nordisk; image credit: Company Synopsis Lars Fruergaard Jørgensen, the CEO of Novo Nordisk, the world’s largest producer of insulins, shares his thoug
eGenesis plans to transplant gene-edited pig hearts into human babies by next year
By Jessica Hamzelou The baby baboon is wearing a mesh gown and appears to be sitting upright. “This little lady … looks pretty philosophical, I would say,” says Eli Katz, who is showing me th
cipla: Leap of faith: how Cipla veteran Nikhil Chopra got JB Pharma out of the woods, on to a growth path
Nikhil Chopra, CEO, JB Chemicals and Pharmaceuticals Ltd. Image credit: Special Arrangement Synopsis When PE firm KKR took control of JB Pharma in 2020, it was struggling for growth. Competitors ha
Cipla in talks for a private-equity deal? Here’s what could be on the mind of founder Yusuf Hamied.
Friends, I represent the Third World. I represent the needs and aspirations of the Third World. I represent the capabilities of the Third World. And above all, I represent an opportunity…. We all
cipla: Why Hamied family’s exit would mark the end of an era for Cipla and millions of patients
YK Hamied, non-executive chairman, Cipla Synopsis Cipla may be privately owned, but effectively it has been a ‘national asset’ — with each brick representing Indian ingenuity, enterprise, and
apollo: Apollo Hospitals: all bulked up for its next phase of expansion,yet conservative on acquisitions
Apollo Hospital in Mumbai, India. Synopsis Strong financial and operational performance marked the last five years, a consolidation phase for the company. While the robust balance sheet will provid
Indian doctors: From Kanjivarams to Thai trips: inside the toxic give-and-take between pharma companies and doctors
Doctors have earned a place of reverence and high esteem in Indian society. They have been known to selflessly care for patients, a trait that was in ample display during the pandemic. Some of them
Cipla takeover: Torrent Pharma is gearing up to take over Cipla. Here’s why it’s a tightrope walk.
Synopsis If Torrent Pharma were to acquire Cipla, which is 2.5 times its size in sales, it would be a bold move. While the acquisition would catapult Torrent to the top of the heap in the domestic
syngene: Syngene gets booster dose of sky-high valuation, but investors cautiously upbeat on stock
Contract research and manufacturing company Syngene International has had a fabulous run this year. Its stock price has risen over 40% since January amid robust growth and a positive outlook for th
Heart ailments in young Indians are on a tear. But fixing lifestyle remains an arduous task.
“When I started practice in India about 30 years ago, I would see a person under 30 years or between 30 and 35 years with some heart trouble only once or twice in a year. Now I see them every wee
Disease X: Battling deadly Disease X: here’s a checklist to prep India for logistics, operations, and finance
Health workers wearing personal protective equipment (PPE) take part in a mock drill to check preparations of Covid-19 facilities at JLNM hospital in downtown Srinagar on April 10, 2023. Synopsis A
healthcare: Not ‘arms and legs’, healthcare companies are using AI to make ‘brains’: health-tech expert Yan Chow
Yan Chow, global healthcare leader, Automation Anywhere Synopsis The healthcare industry is on the verge of a transformation due to the increasing demands and the challenges it faces. Historically,
us shark tank: Selling cut-price generics, Mark Cuban is shaking up US pharma. Can Indian drug makers benefit?
Getty Images Mark Cuban. Synopsis Most of the large Indian pharma companies earn a big chunk of their revenue by supplying drugs to the US market. Shark Tank attraction Cuban’s online pharmacy la
Ayurvedic: Ayurvedic herbs are unsafe; Homeopathy is a classical quackery: Liverdoc Cyriac Abby Philips
Cyriac Abby Philips, popular on X as Liverdoc, has waged an unyielding battle against alternative medicines like Ayurveda, Homeopathy, Unani and Siddha. This is a daunting task given the deep cultu
iit: How IIT Madras’s cutting-edge research on the human brain can help treat Alzheimer’s and Parkinson’s
Prof. Mohanasankar Sivaprakasam with his team of senior scientists; image credit: IIT Madras Synopsis Using indigenous proprietary technology, scientists at the institute are slicing the brain down
Cyriac Abby Philips: Intermittent fasting has benefits in diabetes, but is overrated like fad diets: Liverdoc Philips
Liver specialist Cyriac Abby Philips says there are no approved medicines for treating NASH or non-alcoholic steatohepatitis. Synopsis November 14 was World Diabetes Day. With over 100 million pati
usfda: Closer USFDA lens will keep Indian pharma edgy, but companies now better placed to handle the glare
Three months ago, Robert M Califf, commissioner of the US Food and Drug Administration (USFDA) visited India to strengthen efforts on development, supply, and quality of drugs. For the US, where mo
weight loss: Planning a ‘skinny jab’? The truth behind miracle weight-loss drugs
Cui Xiaotian, Zhao Jinzhao, Zhou Xinda, Hua Ang, Chengxi, Tan Chen, and Han Wei Liu Ping, a 25-year-old living in Beijing, is queuing up outside the obesity clinic of the Peking University People�
narayana hrudayalaya: Narayana Hrudayalaya’s shares are on a growth beat. What’s driving the hospital chain’s optimism?
Synopsis Improving financials of hospital chains, future growth prospects of the sector itself have attracted investors to hospital stocks. But while Apollo Hospitals and Max Healthcare led the gai
copd: Silent killer: India gasps for breath as COPD spreads to rural areas, affects non-smokers.
Getty Images Synopsis The irreversible lung disease is affecting a large part of India’s population, especially the elderly. It is the biggest cause of mortality after heart ailments, while the r