Methods for establishing a surveillance system for cardiovascular diseases in Indian industrial populations

Abstract

Objective To establish a surveillance network for cardiovascular diseases (CVD) risk factors in industrial settings and estimate the risk factor burden using standardized tools. Methods We conducted a baseline cross-sectional survey (as part of a CVD surveillance programme) of industrial populations from 10 companies across India, situated in close proximity to medical colleges that served as study centres. The study subjects were employees (selected by age and sex stratified random sampling) and their family members. Information on behavioural, clinical and biochemical determinants was obtained through standardized methods (questionnaires, clinical measurements and biochemical analysis). Data collation and analyses were done at the national coordinating centre. Findings We report the prevalence of CVD risk factors among individuals aged 20-69 years (n = 19 973 for the questionnaire survey, n = 10 442 for biochemical investigations); mean age was 40 years. The overall prevalence of most risk factors was high, with 50.9% of men and 51.9% of women being overweight, central obesity was observed among 30.9% of men and 32.8% of women, and 40.2% of men and 14.9% of women reported current tobacco use. Self-reported prevalence of diabetes (5.3%) and hypertension (10.9%) was lower than when measured clinically and biochemically (10.1% and 27.7%, respectively). There was marked heterogeneity in the prevalence of risk factors among the study centres. Conclusion There is a high burden of CVD risk factors among industrial populations across India. The surveillance system can be used as a model for replication in India as well as other developing countries. Voir page 467 le résumé en français. En la página 468 figura un resumen en español. IntroductionCardiovascular diseases (CVDs are maj j jor contributors to the global burden of chronic diseases with 29.3% of global deaths and 9.9% of total disease burden, in terms of disabilityjadjusted life years (DALYs) lost, being reported in 2003. 4 Major causes for the inj j crease in disease burden are rising rates of hypertension, dyslipidaemia, diabetes, overweight, obesity, physical inactivity and tobacco use. 5In India, CVD is projected to be the largest cause of death and disabilj j ity by 2020, 5 with 2.6 million Indians predicted to die due to coronary heart disease, which constitutes 54.1% of all CVD deaths. Nearly half of these deaths are likely to occur among young and middlejaged individuals (30-69 years). This is because Indians experience CVD deaths at least a decade earlier than their counterparts in developed countries. This has the potential to adversely affect India's economy with 52% of CVD deaths occurring in those below the age of 70 years compared to 23% in countries in established market economies. 4 Demographic and health transij j tions, genejenvironmental interactions and early life influences of fetal malnuj j trition have been implicated as the causes of increasing CVD burden in India. • to conduct a baseline survey and continual surveillance of CVD risk f...

Prevalence of cardiovascular risk factors among rural population of elderly in Wardha district

“…These estimates are lower than those reported in two studies from rural Andhra Pradesh. 4,11 Another multi-centric study among industrial worker families, 12 (age 20e69 years) also reported that40% of all participants were exposed to tobacco and about 30%had central obesity. The prevalence of known hypertension in this study was similar to that in our study (10%), while that of incident hypertension was lower (30%).…”

Prevalence and Risk Factors of Type 2 Diabetes Mellitus among Adults in a Rural Area of Thrissur, Kerala

“…[14,15,16,17] Among 131 males in this study, 46 were tobacco smokers and of them, 10 persons were diabetic but this association was not found to be significant. This is similar to the findings in several studies [14,16,17,21] It was observed that in our study, 42% of the male participants had a history of alcohol consumption and of them, 16 (21.1%) had diabetes. This association was not found to be significant.…”

Metabolic syndrome

“…The study demonstrated very high levels of CVD risk factors among a relatively young population from 10 industrial settings across India [7].…”

“…The prevalence of MS among South Asians is higher than in other Asians and Europeans [6].In India, CVD is projected to be the largest cause of death and disability by 2020, with 2.6 million Indians predicted to die due to coronary heart disease, which constitutes 54.1% of all CVD deaths [7].…”