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. 2022 Aug 2;17(1):52.
doi: 10.5334/gh.1137. eCollection 2022.

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

Roopa Shivashankar  1   2 , Kalpana Singh  2   3 , Dimple Kondal  2   4 , Ruby Gupta  2   4 , Pablo Perel  5 , Deksha Kapoor  6   7 , Devraj Jindal  2 , Sailesh Mohan  2   4   8 , Rajendra Pradeepa  9 , Prashant Jarhyan  4 , Nikhil Srinivasapura Venkateshmurthy  4 , Nikhil Tandon  6 , Viswanathan Mohan  9 , K M Venkat Narayan  10 , Dorairaj Prabhakaran  2   4   11 , Mohammed K Ali  12
Affiliations

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

Roopa Shivashankar et al. Glob Heart. .

Erratum in

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.

Keywords: Cardiovascular health; India; Population Survey; socioeconomic status; urban living.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Flow chart of participant selections from CARRS, UDAY, and SSS.
Figure 1
Flow chart of participant selections from CARRS, UDAY, and SSS. Notes: Abbreviations CARRS- Centre of Cardiometabolic Risk Reduction in South Asia; SSS- Solan Surveillance Study; h/o CVD- history of CVD. * Missing outcome- If data is missing on one or more of tobacco use, diet, physical activity, blood pressure, body mass index, fasting plasma glucose or total cholesterol.
Adjusted prevalence of good, moderate and poor cardiovascular health by socio-demographic factors (N = 22,144).
Figure 2
Adjusted prevalence of good, moderate and poor cardiovascular health by socio-demographic factors (N = 22,144). Notes: The bars show precentages and line represents 95% confidence intervals. * Adjusted for age, sex, education, asset index and place of residence.
Adjusted prevalence of good, moderate and poor cardiovascular health by asset index in Metropolitan cities, smaller cities, and rural areas.
Figure 3
Adjusted prevalence of good, moderate and poor cardiovascular health by asset index in Metropolitan cities, smaller cities, and rural areas. Note: The bars show percentages. *Adjusted for age, sex, and education.
See this image and copyright information in PMC

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