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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
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
2044-6055
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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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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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).

Record type: Article

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.

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Manuscript BMJOpen DiabetesR1_SKV 12092020 - Accepted Manuscript
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Accepted/In Press date: 15 September 2020
e-pub ahead of print date: 22 October 2020
Keywords: cardiovascular system, diabetes mellitus, risk factors, type 2

Identifiers

Local EPrints ID: 443990
URI: http://eprints.soton.ac.uk/id/eprint/443990
ISSN: 2044-6055
PURE UUID: d71a1b02-866f-4a8c-b1be-bb8f0d4d8581
ORCID for Clive Osmond: ORCID iD orcid.org/0000-0002-9054-4655
ORCID for Caroline Fall: ORCID iD orcid.org/0000-0003-4402-5552

Catalogue record

Date deposited: 18 Sep 2020 16:36
Last modified: 18 Feb 2021 16:45

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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
Author: Clive Osmond ORCID iD
Author: Caroline Fall ORCID iD

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