Prevalence and associated risk factors of coronary artery disease in a rural south Indian population on a governmental health insurance scheme

Abstract

PrevalenceCoronary heart disease a b s t r a c t Objectives: To examine the prevalence of Coronary heart disease (CHD) and associated risk factors based on coronary angiography among a geographically well-defined rural population of south India having an access to a governmental health insurance scheme.Study design: Observational cross-sectional study.Methods: This study in rural Andhra Pradesh covers 413 rural primary health centers each catering for 30,000 people was conducted between December 2007 and November 2011.From an eligible population of 43,025 subjects screened through health camps and clinically assessed for CHD based on (1) History of angina or myocardial infarction (2) ECG changes suggestive of Ischemic heart disease, 3692 subjects were CHD-diagnosed but 3248 got admitted as inpatients for additional clinical ascertainment before 3050 in-patients were studied finally based on angiographic findings. Results: 8.58% were diagnosed as CHD; all the conventional risk factors were significantly associated with CHD risk except BMI. 2005 subjects (65.7%) of those with diagnosed CHD had hypertension, 1013 (33.2%) had diabetes, 1292 (42.4%) were smokers (current and former), 938(30.8%) had Dyslipidemia and 848 (28%) had BMI >25 kg/m 2 (Table 1) 0.1171 (38.4%) had single vessel disease, 1452 (47.6%) had two vessel disease and 427 (14%) had triple vessel disease (Table 3). Left ventricular dysfunction was found in 1187 (38.9%) patients and renal impairment was seen in 519 (17%) patients.Conclusions: This study shows that CHD and associated cardio-metabolic risk factors are growing concerns in rural India even in rural populations. Both community based strategies and clinic based targeted approach to high risk patients are necessary to address such a public-health problem.

A study of risk factors for ischemic heart disease in a village of Davanagere district: a case control study

“…In contrast, other studies showed that majority of the study participants were hypertensives. 4,7,15,18 In this study, majority of the cases and controls do not practice exercise regularly but no significant association was found with development of IHD. This is similar to study conducted by Mendagudali et al, Oommen et al at rural block of Vellore, Krishnan et al at rural block of Kerala and Dhungana et al at Sitapaila Village in Nepal.…”

“…7,11 In contrast, studies done by others showed that majority of study participants had BMI >25 Kg/m 2 and study done by Dhungana et al showed that majority of the study participants had BMI in the range of 25-30. 4,14,18 The limitations of the present study were the sample size was small. Cases who have died are generally not taken and these may be systematically very different from living case as regards the exposure status and leads to survivorship bias.…”

“…3 This is due to rapid epidemiological transition, increased life expectancy, lifestyle changes and genetic predisposition of Indians to atherosclerotic Ischemic heart disease (IHD). 4 Seventy percent of the Indian population lives in rural areas 5. The rural population of Karnataka is 61.32%.…”

Prevalence of coronary heart disease in rural population of Bagalkot, Karnataka, India

“…This is perhaps due to rapid epidemiological transition, increased life expectancy, lifestyle changes and genetic predisposition of Indians to atherosclerotic coronary heart disease (CHD). 3 The risk of CHD in Indians is 3-4 times higher than white Americans, 6 times higher than Chinese and 20 times higher than Japanese. Among adults over 20 year of age, the estimated prevalence of CHD is around3-4 per cent in rural areas and 8-10 per cent in urban areas, representing a two-fold rise in rural areas and a six-fold rise in urban areas between the years 1960 and 2000.…”

Status of serum lipid profile in young population in rural area

“…This is perhaps due to rapid epidemiological transition, increased life expectancy, lifestyle changes, and genetic predisposition of Indians to atherosclerotic coronary heart disease (CHD). [4] International Journal of Medical Science and Public Health 122 2018 | Vol 7 | Issue 2…”