Trends in prevalence of coronary risk factors in an urban Indian population: Jaipur Heart Watch-4

Rajeev Gupta, Vijay Kaul, Namita Bhagat, Mukta Agrawal, V P Gupta, Anoop Misra, Naval K Vikram
Indian Heart Journal 2007, 59 (4): 346-53

BACKGROUND: To determine prevalence of multiple coronary risk factors in a North Indian Punjabi community and to compare these with previous population based studies in the same city in North India we performed an epidemiological study.

METHODS: A community-based epidemiological study that focused on lifestyle determinants of obesity and its correlates in migrants from Punjab was performed at a single location in Jaipur. A house-to-house enumeration was performed to enroll all adults>or=20 years age in the locality who were then invited for participation in the study. Of the 1400 eligible subjects, 1127 participated (response rate 80.5%, men 556, women 571). Risk factor measurements included smoking or tobacco use, body-mass index (BMI), waist:hip ratio (WHR) and body fat, and in 644 (56.6%) subjects (men 340, women 304) blood examination for fasting blood glucose and lipids. Coronary risk factors were determined using pre-specified criteria.

RESULTS: There was a significant prevalence of risk factors in both men and women respectively with smoking or tobacco use in 209 (37.6%) and 12 (2.2%), obesity (BMI>or=25 kg/m2) in 303 (54.5%) and 350 (61.3%), truncal obesity (high WHR) in 339 (61.0%) and 310 (54.30%), hypertension in 322 (57.9%) and 279 (48.9%), high total cholesterol>or=200 mg/dl in 111 (32.6%) and 120 (39.5%), low HDL cholesterol<40 mg/dl in 103 (30.3%) and 83 (27.3%), high triglycerides>or=150 mg/dl in 146 (42.9%) and 132 (43.4%), metabolic syndrome in 166 (48.8%) and 137 (45.1%), and diabetes in 88 (25.9%) and 64 (21.1%) subjects. In both men and women there was a significant age-associated escalation in obesity, central obesity, hypertension, high cholesterol and diabetes prevalence (Mantel-Haenszel chi2 for trend p<0.05). Logistic regression analyses revealed that obesity and truncal obesity were major determinants of multiple risk factors such as hypertension, hypercholesterolemia, metabolic syndrome and diabetes (age-adjusted odds ratios p<0.01). Comparison with previous population-based risk factor studies from the same city in years 1995 and 2002 revealed that risk factors were significantly greater in the present group. Age-stratified differences revealed that obesity at younger age was more frequent in the present cohort.

CONCLUSIONS: There is a significant prevalence of multiple cardiovascular risk factors in this population group. Obesity is a major determinant of multiple risk factors and appears at a younger age compared to other studies in the same location.

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