A Cross Sectional Study of Coronary Heart Disease in Urban Slum Population of Mumbai

Abstract

Apart from widespread clinical impression of a rapid spurt in the proportion of cases with Coronary heart Disease (CHD) being evaluated by various levels of medical practice there are demographic and social reasons to apprehend a major epidemic of CHD in India and other developing countries. A major chunk of Indian population stays in urban slums and Mumbai has a large share in it. Such large population always go ignored when people assume that coronary heart disease is a disease of affluence, while poverty is no bar for coronary heart disease. The objectives of present study are to find out prevalence of Coronary Heart Disease (CHD) in the age group of 25 to 64 years in urban slum community in Mumbai and to study various factor associated with it, also to study the level of knowledge about CHD and its risk factors among the subjects. The present study was designed to be a cross-sectional study conducted in an urban slum, community with a population of 35,967, served by Urban Health Centre, attached to the department of Preventive and Social Medicine of teaching institute. CHD was diagnosed using Rose Questionnaire and/or documentary evidence of MI. Total 186 cases (126 males and 60 females) of CHD were found in the community and prevalence of CHD was 15.80 per thousand. It was maximum (99.11 per thousand) in the age group of 55-64 years. Majority of cases were Muslims as the community was predominantly having Muslim population. The rate of detection of new cases increases with increasing age in both sexes, especially, more among females. Proportion of newly detected cases in males is 45.2% and in females 61.7%. In the age group of 55 to 64 years 81 males (75.7%) and 31 females (81.6%) were suffering from hypertension. The mean systolic blood pressure of all 186 subjects was 161.8 (SD-18.4 & SE-1.35) while mean diastolic blood pressure was 97.6 (SD-10.3 & SE-0.76). The 6 males (4.8%) and 11 females (18.3%) were suffering from Diabetes among the study group. The mean total cholesterol was 255.30 (SD-41.1 SE-3.0). Only 13 cases (7%) had total cholesterol levels were below 200mg/dl while 73% had levels above 240 mg/dl. The 51 cases (27.4%) were receiving 2800 or more calories through daily diet. But only 3.8% cases were eating fats amounting 30% or more of total calories. Among cases 66.7% were smokers while 39.8% had given history of passive smoking. The study findings show that knowledge about CHD and its risk factor is very poor in general. To obtain a composite picture for the whole country, large community based epidemiological studies will have to be conducted in different parts of the country. It will help the policy makers to chalk out programmes to minimize the extent of the problem of CHD.