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

https://doi.org/10.1016/j.jcdr.2013.03.002Get rights and content

Abstract

Background

Cardiovascular diseases (CVD) are a leading cause of mortality among adults in India, and their risk factors (tobacco, hypertension, diabetes, overweight, and obesity) are common. Most risk-factor surveys have focused on young and middle aged adults. We measured the prevalence of risk factors for CVD among elderly (age 60 years or more) in rural India.

Methods and results

In a door-to-door cross-sectional survey we did a non-laboratory based assessment of risk factors (smoking or tobacco use in any form, diabetes mellitus, either known or newly detected hypertension, abnormal waist-hip-ratio, or a high body mass index) among elderly living in 23 villages in rural central India. Laboratory based assessment of risk factors was done in those who had two or more of the five measured conventional risk factors. We compared the distribution of risk factors between men and women. Among 2424 elderly included in the study (51% women, mean age 67), the prevalence of smokeless tobacco use was 50.8% (95% CI 48.1–52.8; smoking 10.5% (95% CI 9.3–11.8); and hypertension46.3% (95% CI 44.3–48.4). Only 10.2% participants were previously known to have had hypertension, and remaining 36.1% were detected to be hypertensive during the survey. A total of 8.2%(95% CI 7.0–9.5) participants were overweight and 4.1% (95% CI 3.3–4.9) had central obesity. The prevalence of dyslipidemia in those who underwent blood based tests was 40.6% (95% CI 36.5–44.9); and hyperglycemia 4.9% (95% CI 3.2–7.1).

Conclusions

Strategies to reduce the risk of cardiovascular disorders among elderly should be focused on reducing tobacco use and early detection and optimal control of hypertension.

Introduction

Cardiovascular diseases (CVD; coronary artery, cerebro-vascular, and peripheral vascular diseases) are a leading cause of mortality among middle aged and older adults in India,1 with current prevalence estimates of 10–12% in urban and 4–5% in rural adults.2 It is now well known that conventional risk factors (smoking, hypertension, diabetes mellitus, obesity, dyslipidemia, unhealthy diet, and reduced physical activity) together account for more than 95% of population-attributable risk for CVD, and novel risk factors have only a small contribution to make.3 These risk factors, attributed to a set of life-style changes are prevalent both in urban and rural India.4

Most previous risk-factor studies have focused on young and middle aged adults, and results from these are usually extrapolated to elderly.5 Three decades ago, we had performed CVD risk factor prevalence studies in middle and young adults in the same villages of rural central India, and prevalence of either hypertension or manifest coronary artery disease was low.6, 7 It is possible that with the passage of time, and a change in the life-style of rural people, more villagers could have acquired risk factors for CVD. Further, little is known about the prevalence of risk factors in rural elderly. Hence, we designed this study to know the distribution of CVD risk factors among elderly in rural India.

Section snippets

Ethics statement

In this study, we performed a community-based door-to-door cross-sectional survey. We first held a meeting of stakeholders in the village and verbally explained the study process. After obtaining community consent, we performed a survey to identify and enumerate all members in all the households. In each household, we obtained a written informed consent from the eligible participants first at the time of risk factor interview (step 1) and subsequently before performing laboratory based

Results

Of the total 2761 eligible elderly individuals, 2424 (87.7%) agreed to participate in step 1 of the study (1250 women (51.6%) and 1174 men (48.4%); mean age 67 (SD 6.5) years). The prevalence of manifest CVD was 3.3% (95% CI 2.7–4.1), Stroke 2% (95% CI 1.6–2.6), and Acute coronary syndrome 1.3% (95% CI 1.0–1.8). Information for manifest CVD events was verified from the patient records in all 36 patients with acute coronary syndrome, and 38 out of 55 (69%) patients with stroke. Step 1

Discussion

Our study shows that a proportion of elderly individuals in rural India have risk factors for CVD. Six out of ten elderly were exposed to tobacco; four out of ten had hypertension; and one out of ten was overweight. Only one out of five elderly with hypertension knew about high blood pressure, and only a third of those who knew had optimum blood pressure control. Two out of five high risk elderly had dyslipidemia. Women had a higher prevalence of hypertension compared to men. In this population

Funding source

Internal research funds in the Department of Medicine were used for this study.

Conflicts of interest

None. The authors declare that they had no financial or personal relations to other parties whose interests could have affected the content of this article in any way, either positively or negatively.

Acknowledgments

We thank Mr. Santosh Chavhan BSW, Mr. Kiran Munjewar BA, Mr. Vinod Kulkarni MSW, Mr. Prashant Raut BA, and Mr. Nitin Jinde MSW, for coordinating data collection and data entry for this study.

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