Socioeconomic status and the prevalence of coronary heart disease risk factors

Abstract

South Asian countries have a high prevalence of coronary heart disease (CHD) in line with their economic development. India, in particular, has a high burden of CHD. Hence, the aim of the present study was to assess the prevalence of CHD risk factors in a semiurban population of Andhra Pradesh, India, in different socioeconomic status (SES) groups. Information was collected on socioeconomic status, physical activity, cigarette smoking, body mass, blood pressure (BP) and serum lipid profiles among a healthy sample of 440 men and 210 women with an age range of 20-70 years. Mean levels of serum cholesterol (SC), high density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC) and skinfold ratio were found to be higher among women, whereas triglycerides (TG), systolic BP and diastolic BP were higher in men. No statistically significant differences in body mass index (BMI) or pulse rate were observed between the sexes. In men, a significant positive rank correlation (rho = P < 0.05) was observed between SES and SC, TG, systolic and diastolic BP, pulse rate and BMI, but in women, the same trend was found only with SC, TG, skinfold ratio and age. The prevalence (age standardized to the world population of Segi, 95% CI) of obesity was 14.37% (11.06-17.68), hypertension 13.13% (9.11-17.15), hypercholesterolemia 18.56% (13.88-23.24), hypertriglyceridemia 45.98% (36.47-55.49) and low HDLC 31.01% (24.25-37.77). In both sexes, the prevalence of hypercholesterolemia, hypertriglyceridemia and sedentary life style increased among higher SES groups (P < 0.05). Also, an increase in the level of social class was positively associated with mean levels of serum cholesterol and triglycerides in both men and women. The results demonstrate that higher SES groups have greater prevalence of CHD risk factors than lower SES groups. Preventive measures are required to reduce the risk factors among higher SES groups.

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

“…However, published crossj sectional studies on risk factors, such as hypertension, [8][9][10][11] diabetes, 11-14 impaired fasting glucose, 14 dyslipidaemia, 15 overj j weight, [16][17][18][19] obesity, 18,20 and smoking, [21][22][23] are highly heterogeneous and limited by variations in measurement techniques, interviewer bias, and differing definij j tions for risk factors and time periods of survey. We designed and established a sentinel surveillance system for CVD risk factors in Indian industrial populaj j tions with the following objectives:…”

Socioeconomic Patterning of Cardiovascular Disease and its Risk Factors among Indians: A Systematic Review of Literature

“…The 23 studies 8,9,[12][13][14][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] selected in this review to evaluate hypertension have used the same diagnostic criteria, which include the WHO criteria 25 as well as self-reported hypertensive cases with or without treatment. 22,27,29 The trend of hypertension among Indians is different from that of developed countries, where the problem of hypertension clearly lies with lower socioeconomic population.4 In India, there is no clear pattern for hypertension.…”

“…Sixteen studies 9,14,22,23,26,[27][28][29][30]32,37,39,[54][55][56][57] were reviewed to determine the effect of sedentary lifestyle on CVD. In these studies, varied criteria were used for measuring sedentary lifestyle, including Johnson Space Centre (JSC) physical activity scale, 51 MET scores calculated using WHO's Global Physical Activity Questionnaire 43,53 Paffenberger's criteria 23 and the scale developed by Bharthi et al 26,27 Out of the 18 studied associations w.r.t.…”

“…[8][9][10][11][12] On the other hand, some studies have also reported a negative association and have concluded that the CVD mortality rate is higher in lower SES groups. 6,[13][14][15][16] However, Subramanian et al have reported a higher prevalence of CVD risk factors in high SES groups, but a higher death rate among lower SES groups. 17 They also suggested that many studies have wrongly concluded that the pattern of CVD in India is now similar to that in developed countries.…”

Risk Factors of Myocardial Infarction in the Northern Region of Bangladesh

“…At present MI is the leading underlying cause of death in developed countries. It imposes disability, loss of productivity and a high economic burden as the treatment costs of the disease increase with the disease progression [3][4][5]. In 2005, approximately 7.6 million deaths were reported worldwide due to coronary heart diseases [6].…”