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

• Type of Material: Article
• Authors: Roopa Shivashankar, Emory University; Kalpana Singh, Centre for Chronic Disease Control (CCDC), New Delhi; Dimple Kondal, Emory University; Ruby Gupta, Centre for Chronic Disease Control (CCDC), New Delhi; Pablo Perel, Centre for Chronic Disease Control (CCDC), New Delhi; Deksha Kapoor, All India Inst Med Sci AIIMS; Devraj Jindal, Centre for Chronic Disease Control (CCDC), New Delhi; Sailesh Mohan, Centre for Chronic Disease Control (CCDC), New Delhi; Rajendra Pradeepa, Madras Diabet Res Fdn MDRF; Prashant Jarhyan, Publ Hlth Fdn India PHFI; Nikhil Srinivasapura Venkateshmurthy, Publ Hlth Fdn India PHFI; Nikhil Tandon, All India Inst Med Sci AIIMS; Viswanathan Mohan, Madras Diabet Res Fdn MDRF; Venkat KM Narayan, Emory University; Dorairaj Prabhakaran, Emory University; Mohammed Ali, Emory University
• Language: English
• Date: 2022-01-01
• Publisher: UBIQUITY PRESS LTD
• Publication Version: Final Published Version
• Copyright Statement: © 2022 The Author(s)
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.5334/gh.1137
• Title of Journal or Parent Work: GLOBAL HEART
• Volume: 17
• Issue: 1
• Start Page: 52
• End Page: 52
• Grant/Funding Information: The CoE-CARRS (Center of Excellence – Center for Cardiometabolic Risk Reduction in South Asia) project was funded by the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Department of Health and Human Services, under Contract No. HHSN268200900026C, and the United Health Group, Minneapolis, Mn, USA. Several members of the research team at PHFI, Emory University, and CCDC were/are supported by the Fogarty International Clinical Research Scholars – Fellows programme (FICRS-F) through Grant Number 5R24TW007988 from NIH, Fogarty International Center (FIC) through Vanderbilt University, Emory’s Global Health Institute, and D43 NCDs in India Training Program through Award Number 1D43HD05249 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) and FIC; However, the contents of this paper are solely the responsibility of the writing group and do not necessarily represent the official views of FIC, Vanderbilt University, Emory University, PHFI, NICHD, or the NIH. The Comprehensive Diabetes Prevention and Management Program (UDAY) study was supported by an unrestricted educational grant from Eli Lilly and Company under the Lilly NCD Partnership. Solan Surveillance Study was funded in part by the Indian Council of Medical Research, the Medtronic Foundation, and the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services.
• Keywords: Cardiovascular health; urban living; Science & Technology; GPAQ; India; PHYSICAL-ACTIVITY QUESTIONNAIRE; Cardiovascular System & Cardiology; TRANSITION; PREVALENCE; Life Sciences & Biomedicine; IMPACT; RISK; Population Survey; socioeconomic status; RELIABILITY; Cardiac & Cardiovascular Systems
• Research Categories: Health Sciences, Public Health; Health Sciences, Medicine and Surgery

Abstract

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.