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Author Notes:

Address for correspondence: Mohammed K. Ali, 1518 Clifton Rd NE, Atlanta GA, 30322 Tel: 404 727 9776; Fax: 404 727 3350; mkali@emory.edu

Contributorship Statement: The CARRS Study Group includes the following: Planned, Designed, and Oversaw study Steering Committee: Dorairaj Prabhakaran, K. M. Venkat Narayan, K Srinath Reddy, Nikhil Tandon, V. Mohan, Muhammed M. Kadir, Mohammed K. Ali, Vamadevan S Ajay Conduct and Operations: Dorairaj Prabhakaran, Nikhil Tandon, K. M. Venkat Narayan, Mohammed K Ali, S. Roopa, Imran Naeem, R. Pradeepa, M. Deepa Coordinating Centre (Delhi): Dorairaj Prabhakaran, Nikhil Tandon, S. Roopa, Vamadevan S Ajay, Deksha Kapoor Data management and statistical team: Dimple Kondal, Shivam Pandey, Praggya, Naveen Laboratory: Lakshmy Ramakrishnan, Ruby Gupta, Savita Reporting: Authors Mohammed K Ali, Nikhil Tandon, K. M. Venkat Narayan, and Dorairaj Prabhakaran conceived of the analysis and study question, and wrote the manuscript. Authors Binukumar and S. Roopa conducted analyses. All other authors contributed to editing and revising of manuscript. Authors Mohammed K Ali, Nikhil Tandon, K. M. Venkat Narayan, and Dorairaj Prabhakaran are the guarantors of the data.

The authors would like to thank and recognize Drs. Bob Gerzoff and Kai M. Bullard (U.S. Centers for Disease Control and Prevention) for their help with statistical analyses, data management, and multiple imputation.

The authors have no conflicts of interest to disclose.


Research Funding:

The CARRS Study and authors MKA, MMK, VM, NT, KMVN, and DP were funded in whole or in part by the National Heart, Lung, and Blood Institute of the National Institutes of Health, Department of Health and Human Services (Contract No. HHSN268200900026C) and UnitedHealth Group (Minneapolis, MN, USA).

Authors BB and RS were supported by grant number 1 D43 HD065249 from the Fogarty International Centre and the Eunice Kennedy Shriver National Institute of Child Health & Human Development at the National Institutes of Health.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Cardiovascular System & Cardiology
  • Cardiovascular risk factors
  • South Asians
  • socioeconomic status
  • global cardiovascular health

Socioeconomic status and cardiovascular risk in urban South Asia: The CARRS Study

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Journal Title:

European Journal of Preventive Cardiology


Volume 23, Number 4


, Pages 408-419

Type of Work:

Article | Post-print: After Peer Review


Background : Although South Asians experience cardiovascular disease (CVD) and risk factors at an early age, the distribution of CVD risks across the socioeconomic spectrum remains unclear. Methods We analysed the 2011 Centre for Cardiometabolic Risk Reduction in South Asia survey data including 16,288 non-pregnant adults (≥20 years) that are representative of Chennai and Delhi, India, and Karachi, Pakistan. Socioeconomic status (SES) was defined by highest education (primary schooling, high/secondary schooling, college graduate or greater); wealth tertiles (low, middle, high ho usehold assets) and occupation (not working outside home, semi/unskilled, skilled, white-collar work). We estimated age and sex-standardized prevalence of behavioural (daily fruit/vegetables; tobacco use), weight (body mass index; waist-to-height ratio) and metabolic risk factors (diabetes, hypertension, hypercholesterolaemia; hypo-HDL; and hypertriglyceridaemia) by each SES category. Results Across cities, 61.2% and 16.1% completed secondary and college educations, respectively; 52.8% reported not working, 22.9% were unskilled; 21.3% were skilled and 3.1% were white-collar workers. For behavioural risk factors, low fruit/vegetable intake, smoked and smokeless tobacco use were more prevalent in lowest education, wealthy and occupation (for men only) groups compared to higher SES counterparts, while weight-related risks (body mass index 25.0-29.9 and ≥30 kg/m 2 ; waist-to-height ratio ≥0.5) were more common in higher educated and wealthy groups, and technical/professional men. For metabolic risks, a higher prevalence of diabetes, hypertension and dyslipidaemias was observed in more educated and affluent groups, with unclear patterns across occupation groups. Conclusions SES-CVD patterns are heterogeneous, suggesting customized interventions for different SES groups may be warranted. Different behavioural, weight, and metabolic risk factor prevalence patterns across SES indicators may signal on-going epidemiological transition in South Asia.

Copyright information:

© European Society of Cardiology 2015.

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