Cardiovascular Health in India - a Report Card from Three Urban and Rural Surveys of 22,144 Adults.

Roopa Shivashankar ORCID logo; Kalpana Singh ORCID logo; Dimple Kondal ORCID logo; Ruby Gupta ORCID logo; Pablo Perel ORCID logo; Deksha Kapoor ORCID logo; Devraj Jindal ORCID logo; Sailesh Mohan ORCID logo; Rajendra Pradeepa ORCID logo; Prashant Jarhyan ORCID logo; +6 more... Nikhil Srinivasapura Venkateshmurthy ORCID logo; Nikhil Tandon ORCID logo; Viswanathan Mohan ORCID logo; KM Venkat Narayan ORCID logo; Dorairaj Prabhakaran ORCID logo; Mohammed K Ali ORCID logo; (2022) Cardiovascular Health in India - a Report Card from Three Urban and Rural Surveys of 22,144 Adults. Global Heart, 17 (1). 52-. ISSN 2211-8160 DOI: 10.5334/gh.1137
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BACKGROUND: Markers of ideal cardiovascular health (CVH) predict cardiovascular events. We estimated the prevalence of ideal CVH markers in two levels of cities and villages in India. METHODS: We did pooled analysis of individual-level data from three cross sectional surveys of adults ≥ 30 years over 2010-14 (CARRS: Centre for cArdiometabolic Risk Reduction in South Asia; UDAY and Solan Surveillance Study) representing metropolitan cities; smaller cities and rural areas in diverse locations of India. We defined ideal CVH using modified American Heart Association recommendations: not smoking, ≥ 5 servings of fruits and vegetables (F&V), high physical activity (PA), body mass index (BMI) <25 Kg/m2, blood pressure (BP) <120/80 mm Hg, fasting plasma glucose (FPG) <100 mg/dl, and total cholesterol (TC) <200 mg/dL. We estimated (1) age-and sex-standardized prevalence of ideal CVH and (2) prevalence of good (≥6 markers), moderate (4-5), and poor CVH (≤3) adjusted for age, sex, education, and stratified by setting and asset tertiles. RESULTS: Of the total 22,144 participants, the prevalence of ideal CVH markers were: not smoking (76.7% [95% CI 76.1, 77.2]), consumed ≥5 F&V (4.2% [3.9, 4.5]), high PA (67.5% [66.8, 68.2]), optimum BMI (59.6% [58.9, 60.3]), ideal BP (34.5% [33.9, 35.2]), FPG (65.8% [65.1, 66.5]) and TC (65.4% [64.7, 66.1]). The mean number of ideal CVH metrics was 3.7(95% CI: 3.7, 3.8). Adjusted prevalence of good, moderate, and poor CVH, varied across settings: metropolitan (3.9%, 41.0%, and 55.1%), smaller cities (7.8%, 49.2%, and 43%), and rural (10.4%, 60.9%, and 28.7%) and across asset tertiles: Low (11.0%, 55.9%, 33.1%), Middle (6.3%, 52.2%, 41.5%), and High (5.0%, 46.4%, 48.7%), respectively. CONCLUSION: Achievement of ideal CVH varied, with higher prevalence in rural and lower asset tertiles. Multi-sectoral and targeted policy and program actions are needed to improve CVH in diverse contexts in India.


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