Prevalence, incidence and predictors of cardiovascular risk factors – longitudinal data from rural and urban South India and comparison with global data
Prevalence, incidence and predictors of cardiovascular risk factors – longitudinal data from rural and urban South India and comparison with global data
Introduction India has high mortality rates from cardiovascular disease (CVD). Understanding the trends and identifying modifiable determinants of CVD risk factors will guide preventive strategies and policy making.
Research design and methods CVD risk factors (obesity, central obesity, and type 2 diabetes (T2D), hypertension, hypercholesterolemia and hypertriglyceridemia) prevalence and incidence were estimated in 962 (male 519) non-migrant adults from Vellore, South India, studied in: (1) 1998–2002 (mean age 28.2 years) and (2) 2013–2014 (mean age 41.7 years). Prevalence was compared with the Non-Communicable Disease Risk Collaboration (global) data. Incidence was compared with another Indian cohort from New Delhi Birth Cohort (NDBC). Regression analysis was used to test baseline predictors of incident CVD risk factors.
Results The prevalence at 28 and 42 years was 17% (95% CI 14% to 19%) and 51% (95% CI 48% to 55%) for overweight/obesity, 19% (95% CI 17% to 22%) and 59% (95% CI 56% to 62%) for central obesity, 3% (95% CI 2% to 4%) and 16% (95% CI 14% to 19%) for T2D, 2% (95% CI 1% to 3%) and 19% (95% CI 17% to 22%) for hypertension and 15% (95% CI 13% to 18%) and 30% (95% CI 27% to 33%) for hypertriglyceridemia. The prevalence of T2D at baseline and follow-up and hypertension at follow-up was comparable with or exceeded that in high-income countries despite lower obesity rates. The incidence of most risk factors was lower in Vellore than in the NDBC. Waist circumference strongly predicted incident T2D, hypertension and hypertriglyceridemia.
Conclusions A high prevalence of CVD risk factors was evident at a young age among Indians compared with high and upper middle income countries, with rural rates catching up with urban estimates. Adiposity predicted higher incident CVD risk, but the prevalence of hypertension and T2D was higher given a relatively low obesity prevalence. Preventive efforts should target both rural and urban India and should start young.
cardiovascular system, diabetes mellitus, risk factors, type 2
Vasan, Senthil K.
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Antonisamy, Belavendra
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Gowri, Mahasampath S.
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Selliah, Hepsy Y.
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Geethanjali, Finney S.
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Jebasingh, Felix S.
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Paul, Thomas V.
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Nihal, Thomas
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Karpe, Fredrik
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Johnson, Matthew James
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Osmond, Clive
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Fall, Caroline
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22 October 2020
Vasan, Senthil K.
57b46c7b-074d-4d99-a284-40b592aec067
Antonisamy, Belavendra
ec356bbb-f468-48a3-a375-ec2f3b20852a
Gowri, Mahasampath S.
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Selliah, Hepsy Y.
8103e317-aace-497b-b235-e112116cd1d7
Geethanjali, Finney S.
a3e2b129-87f5-40de-bcaf-af4f2e76a500
Jebasingh, Felix S.
c2af8855-bae0-455e-8517-191254a7ff4e
Paul, Thomas V.
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Nihal, Thomas
98bc3bea-cba2-4685-81dd-54c0c63995b3
Karpe, Fredrik
05abcb32-83b7-44eb-ab12-7c360f4f9c12
Johnson, Matthew James
d272ca76-f017-4457-96f5-daf6a7af6adf
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Fall, Caroline
7171a105-34f5-4131-89d7-1aa639893b18
Vasan, Senthil K., Antonisamy, Belavendra, Gowri, Mahasampath S., Selliah, Hepsy Y., Geethanjali, Finney S., Jebasingh, Felix S., Paul, Thomas V., Nihal, Thomas, Karpe, Fredrik, Johnson, Matthew James, Osmond, Clive and Fall, Caroline
(2020)
Prevalence, incidence and predictors of cardiovascular risk factors – longitudinal data from rural and urban South India and comparison with global data.
BMJ Open, 8 (1), [e001782].
(doi:10.1136/bmjdrc-2020-001782).
Abstract
Introduction India has high mortality rates from cardiovascular disease (CVD). Understanding the trends and identifying modifiable determinants of CVD risk factors will guide preventive strategies and policy making.
Research design and methods CVD risk factors (obesity, central obesity, and type 2 diabetes (T2D), hypertension, hypercholesterolemia and hypertriglyceridemia) prevalence and incidence were estimated in 962 (male 519) non-migrant adults from Vellore, South India, studied in: (1) 1998–2002 (mean age 28.2 years) and (2) 2013–2014 (mean age 41.7 years). Prevalence was compared with the Non-Communicable Disease Risk Collaboration (global) data. Incidence was compared with another Indian cohort from New Delhi Birth Cohort (NDBC). Regression analysis was used to test baseline predictors of incident CVD risk factors.
Results The prevalence at 28 and 42 years was 17% (95% CI 14% to 19%) and 51% (95% CI 48% to 55%) for overweight/obesity, 19% (95% CI 17% to 22%) and 59% (95% CI 56% to 62%) for central obesity, 3% (95% CI 2% to 4%) and 16% (95% CI 14% to 19%) for T2D, 2% (95% CI 1% to 3%) and 19% (95% CI 17% to 22%) for hypertension and 15% (95% CI 13% to 18%) and 30% (95% CI 27% to 33%) for hypertriglyceridemia. The prevalence of T2D at baseline and follow-up and hypertension at follow-up was comparable with or exceeded that in high-income countries despite lower obesity rates. The incidence of most risk factors was lower in Vellore than in the NDBC. Waist circumference strongly predicted incident T2D, hypertension and hypertriglyceridemia.
Conclusions A high prevalence of CVD risk factors was evident at a young age among Indians compared with high and upper middle income countries, with rural rates catching up with urban estimates. Adiposity predicted higher incident CVD risk, but the prevalence of hypertension and T2D was higher given a relatively low obesity prevalence. Preventive efforts should target both rural and urban India and should start young.
Text
Manuscript BMJOpen DiabetesR1_SKV 12092020
- Accepted Manuscript
More information
Accepted/In Press date: 15 September 2020
e-pub ahead of print date: 22 October 2020
Published date: 22 October 2020
Additional Information:
Funding Information:
Funding Phase 5 follow-up of the study was supported by funds from the British Heart Foundation, UK (BHF_RG/98001 and BHF_CS/15/4/31493). Phase 6 follow-up was supported jointly by the London School of Hygiene & Tropical Medicine, Indian Institute of Public Health, Hyderabad (WTP Project grant/09–2012) and internal funds from Christian Medical College, Vellore. SKV is funded by British Heart Foundation Clinical Research grant, no. CRM: 0022324. Disclaimer The sponsors did not play a significant role in the analysis, interpretation or presentation of the results.
Publisher Copyright:
© 2020 Mary Ann Liebert Inc.. All rights reserved.
Keywords:
cardiovascular system, diabetes mellitus, risk factors, type 2
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Local EPrints ID: 443990
URI: http://eprints.soton.ac.uk/id/eprint/443990
ISSN: 2044-6055
PURE UUID: d71a1b02-866f-4a8c-b1be-bb8f0d4d8581
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Date deposited: 18 Sep 2020 16:36
Last modified: 17 Mar 2024 05:55
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Contributors
Author:
Senthil K. Vasan
Author:
Belavendra Antonisamy
Author:
Mahasampath S. Gowri
Author:
Hepsy Y. Selliah
Author:
Finney S. Geethanjali
Author:
Felix S. Jebasingh
Author:
Thomas V. Paul
Author:
Thomas Nihal
Author:
Fredrik Karpe
Author:
Matthew James Johnson
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